Read the full stored bill text
EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb1002*
HOUSE BILL 1002
J3 6lr1789
CF SB 493
By: Delegates Lopez, Foley, Kaufman, and Wims Wims, Alston, Bagnall, Cullison,
Guzzone, Hill, Hutchinson, S. Johnson, Kipke, Martinez, M. Morgan, Reilly,
Rosenberg, Ross, Szeliga, Taveras, White Holland, and Woorman
Introduced and read first time: February 6, 2026
Assigned to: Health
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 7, 2026
CHAPTER ______
AN ACT concerning 1
Nursing Facilities – Involuntary Discharge or Transfer 2
FOR the purpose of prohibiting certain facilities from involuntarily transferring or 3
discharging a resident to certain housing or before receiving certain confirmations; 4
altering the information required to be included in a certain notice or updated new 5
notice; requiring that a certain notice or updated new notice be provided to certain 6
residents at least a certain period of time before an involuntary discharge or transfer; 7
establishing time requirements that apply to the discharge or transfer of a resid ent 8
if a new notice of involuntary discharge or transfer of the resident is provided; 9
requiring that a post discharge plan contain certain information; and generally 10
relating to nursing facilities and involuntary discharges and transfers. 11
BY repealing and reenacting, with amendments, 12
Article – Health – General 13
Section 19–345 and 19–345.1 14
Annotated Code of Maryland 15
(2023 Replacement Volume and 2025 Supplement) 16
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 17
That the Laws of Maryland read as follows: 18
Article – Health – General 19
2 HOUSE BILL 1002
19–345. 1
(a) A resident of a facility may not be transferred or discharged from the facility 2
involuntarily except for the following reasons: 3
(1) The transfer or discharge is necessary for the resident’s welfare and the 4
resident’s needs cannot be met in the facility; 5
(2) The transfer or discharge is appropriate because the resident’s health 6
has improved sufficiently so that the resident no longer needs the services provided by the 7
facility; 8
(3) The health or safety of an individual in a facility is endangered; 9
(4) The resident has failed, after reasonable and appropriate notice, to pay 10
for, or under Medicare or Medicaid or otherwise, to have paid for a stay at the facility; or 11
(5) The facility ceases to operate. 12
(b) A RESIDENT OF A FACILI TY THAT IS TRANSFERR ED OR DISCHARGED 13
FROM THE FACILITY INVOLUNTARILY MAY NOT BE TRANSFERRED OR DISCHARGED: 14
(1) TO A LOCATION OTHER T HAN THE LOCATION IDENTIFIED IN THE 15
NOTICE REQUIRED UNDER § 19–345.1(B)(3) OF THIS SUBTITLE, SUCH AS A HOTEL , 16
SHELTER, OR OTHER TEMPORARY HOUSING; 17
(2) BEFORE THE FACILITY T O WHICH THE RESIDENT IS TO BE 18
TRANSFERRED HAS CONFIRMED THAT: 19
(I) THE RESIDENT MAY BE T RANSFERRED TO THE FA CILITY; 20
AND 21
(II) THE FACILITY IS PREPARED TO ACCEPT THE RESIDENT. 22
(C) (1) A Medicaid certified facility may not: 23
(i) Include in the admission contract of a resident any requirement 24
that, to stay at the facility, the resident will be required to pay for any period of time or 25
amount of money as a private pay resident for any period when the resident is eligible for 26
Medicaid benefits; or 27
(ii) Transfer or discharge a resident involuntarily because the 28
resident is a Medicaid benefits recipient. 29
HOUSE BILL 1002 3
(2) (i) Except as provided in subparagraph (ii) of this paragraph, a 1
Medicaid certified facility is presumed to be transferring or discharging a resident in 2
violation of this subsection, if the resident is or becomes eligible for Medicaid benefits. 3
(ii) A Medicaid certified facility is not presumed to be transferring or 4
discharging a resident in violation of this subsection for transferring or discharging a 5
resident for nonpayment for services while the resident was ineligible for assistance under 6
the medical assistance program. 7
19–345.1. 8
(a) (1) A facility shall provide the resident with written notice of: 9
[(1)] (I) Any proposed discharge or transfer; and 10
[(2)] (II) The opportunity for a hearing in accordance with the provisions 11
of this section before the discharge or transfer. 12
(2) THE NOTICE REQUIRED U NDER PARAGRAPH (1) OF THIS 13
SUBSECTION SHALL INC LUDE, AT A MINIMUM , THE INFORMATION LIST ED UNDER 14
SUBSECTION (B) OF THIS SECTION. 15
(b) The Department shall prepare and provide each facility with a standardized 16
form that provides, in clear and simple language, at least the following information: 17
(1) Notice of the intended discharge or transfer of the resident, including 18
the proposed date of the intended discharge or transfer, which may change as a result of 19
an appeal or the discharge planning process; 20
(2) Each reason for the discharge or transfer; 21
(3) The location to which the resident will be discharged or transferred, 22
which may change as a result of an appeal or the discharge planning process; 23
(4) The name of the social worker or other professionally qualified staff, 24
which may change during the discharge planning process, who: 25
(i) Is designated to provide social services and discharge planning 26
services to the resident in connection with the discharge or transfer; and 27
(ii) Will be responsible for the development of the post discharge 28
plan of care under subsection (g) of this section; 29
(5) A proposed date within 10 days after the date of the notice for a meeting 30
between the resident, the resident’s representative, and facility staff to develop the post 31
discharge plan of care under subsection (g) of this section; 32
4 HOUSE BILL 1002
(6) (I) The right of the resident to request a hearing; 1
(II) THE NAME , MAILING ADDRESS , E–MAIL ADDRESS , AND 2
TELEPHONE NUMBER OF THE ENTITY TO WHICH THE RESIDENT MUST SUBMIT A 3
REQUEST FOR A HEARING; AND 4
(III) INSTRUCTIONS FOR OBTA INING, COMPLETING, AND 5
SUBMITTING A REQUEST FOR A HEARING; 6
(7) The right of the resident to consult with any lawyer the resident 7
chooses; 8
(8) The availability of the ser vices of the Legal Aid Bureau MARYLAND 9
LEGAL AID, the Older American Act Senior Legal Assistance Programs, and other 10
agencies that may provide assistance to individuals who need legal counsel; 11
(9) (I) The availability of the Long–Term Care Ombudsman Program to 12
assist the resident; AND 13
(II) THE MAILING ADDRESS, E–MAIL ADDRESS, AND TELEPHONE 14
NUMBER OF THE LONG–TERM CARE OMBUDSMAN PROGRAM; 15
(10) (I) THE AVAILABILITY OF DISABILITY RIGHTS MARYLAND TO 16
ASSIST RESIDENTS WIT H INTELLECTUAL OR DE VELOPMENTAL D ISABILITIES, 17
MENTAL DISORDERS, AND RELATED DISORDERS; AND 18
(II) THE MAILING ADDRESS, E–MAIL ADDRESS, AND TELEPHONE 19
NUMBER OF DISABILITY RIGHTS MARYLAND; and 20
[(10)] (11) The provisions of this section. 21
(c) Except as otherwise provided in this section, at least 30 days before the facility 22
involuntarily transfers or discharges a resident, the facility shall: 23
(1) Provide to the resident the written notice required under subsection (a) 24
of this section; and 25
(2) Provide the written notice required under subsection (a) of this section 26
to: 27
(i) The resident; 28
(ii) The next of kin, guardian, or any other individual known to have 29
acted as the resident’s representative, if any; 30
HOUSE BILL 1002 5
(iii) The Long–Term Care Ombudsman; and 1
(iv) The Department. 2
(d) (1) (i) In accordance with regulations adopted by the Secretary, the 3
facility shall provide the resident with an opportunity for a hearing on the proposed 4
transfer or discharge. 5
(ii) The regulations adopted by the Secretary may provide for the 6
establishment of an escrow account when: 7
1. The basis for the discharge is nonpayment; and 8
2. The resident continues to reside in the facility while the 9
appeal is pending. 10
(2) Except as otherwise provided in this subsection, hearings on p roposed 11
transfers or discharges shall be conducted in accordance with the provisions of Title 10, 12
Subtitle 2 of the State Government Article and the Medicaid Fair Hearing Procedures. 13
(3) Any hearing on a proposed discharge or transfer of a resident: 14
(i) Is not a contested case as defined in § 10 –202 of the State 15
Government Article; and 16
(ii) May not include the Secretary as a party. 17
(4) A decision by an administrative law judge on a proposed discharge or 18
transfer of a resident: 19
(i) Is not a decision of the Secretary; 20
(ii) Unless appealed, is final and binding on the parties; and 21
(iii) May be appealed in accordance with § 10 –222 of the State 22
Government Article as if it were a contested case but the appeal does not automatically 23
stay the decision of the administrative law judge. 24
(e) The facility shall provide the written notice required in subsection (a) of this 25
section as soon as practicable before discharge or transfer if[: 26
(1) An] AN emergency exists and health or safety of the resident or other 27
residents would be placed in imminent and serious jeopardy if the resident were not 28
transferred or discharged from the facility as soon as possible[; or 29
(2) The resident has not resided in the facility for 30 days]. 30
6 HOUSE BILL 1002
(f) (1) If the in formation in the notice provided under subsection (c) of this 1
section changes before the discharge or transfer, the facility shall provide the changes to 2
the recipients of the notice as soon as practicable after the new information becomes 3
available. 4
(2) IF AN UPDATED NOTICE IS PROVIDED UNDER TH IS SUBSECTION, 5
THE RESIDENT MAY NOT BE DISCHARGED OR TRANSFERRED FOR AT LEAST 30 DAYS 6
AFTER THE UPDATED NOTICE HAS BEEN PROVIDED TO THE RESIDENT. 7
(2) IF A NEW NOTICE IS PR OVIDED UNDER PARAGRA PH (1) OF THIS 8
SUBSECTION, THE FOLLOWING TIME REQUIREMENTS APPLY TO THE DISCHARGE OR 9
TRANSFER OF THE RESIDENT: 10
(I) THE RESIDENT MAY NOT BE DISCHARGED OR 11
TRANSFERRED FOR AT LEAST 30 DAYS AFTER THE NEW NOTICE HAS BEEN PROVIDED 12
TO THE RESIDENT IF THE NEW NOTICE IS PROVIDED BEFORE: 13
1. THE EXPIRATION OF THE TIME PERIOD REQUIRED 14
UNDER SUBSECTION (C) OF THIS SECTION; OR 15
2. THE DATE OF AN ORDER OF DISCHARGE ISSUED BY AN 16
ADMINISTRATIVE LAW JUDGE UNDER SUBSECTION (D) OF THIS SECTION; AND 17
(II) IF THE NEW NOTICE IS PROVIDED AFTER A DATE DESCRIBED 18
UNDER ITEM (I) OF THIS PARAGRAPH: 19
1. IF THE ORIGINAL NOTIC E INDICATED A DISCHA RGE 20
LOCATION THAT WAS A LICENSED SKILLED NURSING FACILITY AND THE NEW NOTICE 21
CHANGES THE DATE OF DISCHARGE OR TRANSFE R ONLY , THE RESIDENT MAY BE 22
DISCHARGED ON THE EARLIEST DATE THAT A BED IS AVAILABLE AT THE FACILITY; 23
2. IF THE NEW NOTICE CHA NGES THE LOCATION OF 24
DISCHARGE OR TRANSFE R FROM A LICENSED SK ILLED NURSING FACILI TY TO A 25
DIFFERENT LICENSED S KILLED NURSING FACIL ITY, THE RESIDENT MAY NOT BE 26
DISCHARGED OR TRANSFERRED FOR AT LEAST 7 DAYS AFTER THE NEW NOTICE HAS 27
BEEN PROVIDED TO THE RESIDENT; AND 28
3. IF THE NEW NOTICE CHA NGES THE LOCATION OF 29
DISCHARGE OR TRANSFE R FROM A LICENSED SK ILLED NURSING FACILI TY TO A 30
LOCATION THAT IS NOT A LICENSED SKILLED NURSING FACILITY BUT IS OTHERWISE 31
DETERMINED TO BE A SAFE DISCHARGE LOCAT ION UNDER AN APPROPR IATE 32
CLINICAL EVALUATION AND AS SET FORTH IN THE POST DISCHARGE PLAN OF CARE, 33
HOUSE BILL 1002 7
THE RESIDENT MAY NOT BE DISCHARGED OR TRANSFERRED FOR AT LEAST 30 DAYS 1
AFTER THE NEW NOTICE HAS BEEN PROVIDED TO THE RESIDENT. 2
(3) AN UPDATED A NEW NOTICE PROVIDED UNDER THIS SUBSECTION 3
SHALL INDICATE: 4
(I) INDICATE ANY DIFFERENCES BETWEEN THE PRIOR NOTICE 5
AND THE UPDATED NEW NOTICE; AND 6
(II) INCLUDE A NOTICE OF T HE RIGHT TO APPEAL T HE NEW 7
NOTICE: 8
1. FOR ANY DISCHARGE OR TRANSFER DESCRIBED 9
UNDER PARAGRAPH (2)(I) OF THIS SUBSECTION; OR 10
2. FOR A DISCHARGE OR TRANSFER DESCRIBED UNDER 11
PARAGRAPH (2)(II)3 OF THIS SUBSECTION , IF THE UNDERLYING BA SIS OF THE 12
ORIGINAL NOTICE HAS CHANGED. 13
(4) FOR A DISCHARGE OR TRANSFER DESCRIBED UNDER PARAGRAPH 14
(2)(II)1 OR 2 OF THIS SUBSECTION, A NEW NOTICE IS NOT REQUIRED TO INCLUDE A 15
NOTICE OF THE RIGHT TO APPEAL THE NEW NOTICE. 16
(g) (1) Before any discharge or transfer and subject to paragraphs (4) and (5) 17
of this subsection, a facility shall develop a post discharge plan of care for the resident to 18
assist the resident with adjusting to the resident’s new living environment and that: 19
(i) Addresses the resident’s post discharge goals of care and 20
treatment preferences; [and] 21
(ii) Identifies each of the resident’s reasonably anticipated medical 22
and basic needs after discharge or transfer and establishes a plan for meeting those needs; 23
(III) IDENTIFIES THE ADDRES S AT WHICH THE RESID ENT WILL 24
RESIDE POST DISCHARGE; AND 25
(IV) IN ACCORDA NCE WITH REGULATIONS ADOPTED BY THE 26
SECRETARY, PROVIDES A SAFE , SECURE, AND SUSTAINABLE ENVI RONMENT FOR 27
THE RESIDENT. 28
(2) The facility shall designate a social worker or other professionally 29
qualified staff member to coordinate the development of the resident’s post discharge plan 30
of care. 31
8 HOUSE BILL 1002
(3) The facility shall, if possible, meet with the resident and, with the 1
resident’s consent, the resident’s representative within 10 days after providing the notice 2
required under subsection (a) of this section to discuss the post discharge plan of care for 3
the resident. 4
(4) (i) The resident’s post discharge plan of care shall be developed with 5
the participation of the resident and, with the resident’s consent, the resident’s 6
representative. 7
(ii) If the po st discharge plan of care was developed without the 8
participation of the resident or the resident’s representative, the facility shall include in 9
the resident’s medical record an explanation of why the resident or the resident’s 10
representative did not participate. 11
(5) The resident’s post discharge plan of care shall be developed in 12
consultation with: 13
(i) The resident’s attending physician; 14
(ii) A registered nurse responsible for the care of the resident; and 15
(iii) Any other appropriate staff or professional involved with 16
meeting the resident’s medical needs. 17
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 18
October 1, 2026. 19
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.