LTC - Involuntary Transfer or Discharge Process

  • This page is to assist long term care providers to comply with state law when an involuntary transfer or discharge (state) / facility-initiated transfer or discharge (federal) of resident occurs. 

State Code and Applicable Administrative Rules

  • Providers must comply with state requirements:

    Michigan Public Health Code:

    • MCL 333.21773 – Involuntary transfer or discharge of a patient
    • MCL 333.21774 – Resident right to appeal
    • MCL 333.21775 – Continuation of Medicaid funding during appeal
    • MCL 333.21776 – Transfer or discharge of patient, plan, counseling services

    LTC Administrative Rule 325.20116

Federal Regulations

  • For federally certified nursing homes participating in the Medicare or Medicaid programs, providers must also comply with 42 CFR 483.15(c).

Facility - Initiated Transfer

  • This form and process will only be used when there is a transfer of a resident from the federally certified nursing home to another facility, such as an acute care hospital, with the expectation that the resident will return to the federally certified nursing home.    

    FIT-100 Facility-Initiated Transfer and Appeal Form

    Basic Steps

    • Prepare FIT-100 form, completing all informational boxes.

    • Completed FIT-100 form must be provided to the resident or resident representative along with an envelope and postage for appeal request.

    • A copy of the notice must be placed in the resident’s medical record.

    • A monthly list of all facility-initiated transfers shall be provided to the Michigan Long Term Care Ombudsman at MLTCOP@meji.org.

    Note:  These basic steps are not a comprehensive outline of all state and federal requirements.

Involuntary Transfer or Discharge and Facility-Initiated Discharge

  • These forms and this process will be used when there is a proposed discharge of a resident from the nursing home to any location with the expectation that the resident will not return to the nursing home. 

    ITD-100 Notice of Involuntary Transfer or Discharge and Facility-Initiated Discharge and Appeal Form

    ITD-101 Proposed Involuntary Transfer or Discharge Plan

    Basic Steps

    • Prepare ITD-100 form.
      • Recommendation:  Have initial discussion with resident or resident representative to assist in identification of transfer or discharge location.
      • Note:  The notice form will be accepted by the department only if all informational boxes have been completed, including a proposed transfer or discharge location, date, and specific information about the reasons for transfer or discharge.
      • If the destination changes and this change was initiated by the facility, an updated notice with the new destination must be issued.  This type of change restarts the 30-day timeline for transfer or discharge.
    • Completed ITD-100 form must be provided to the resident or resident representative at least 30 days prior to an involuntary transfer or discharge along with envelope and postage for appeal request.
    • A copy of ITD-100 form must be submitted to:
    • A copy of ITD-100 form must be included in the resident’s medical record.
    • Resident has the right to request a hearing within 10 days from the date of the notice.
    • Request for a hearing puts on hold the resident involuntary transfer or discharge.
    • Prepare ITD-101 form to outline the proposed transfer or discharge plan and submit the form to LARA via LARA-BCHS-InvoluntaryTransfer@michigan.gov.
      • The resident shall not be transferred or discharged from the facility:
        • Before the 34th day following receipt of the notice or the 10th day following appeal hearing decision, whichever is later, and
        • Without LARA approval of the proposed transfer or discharge plan.
    • LARA will provide written approval of the acceptance of the proposed transfer or discharge plan. The approval of the proposed transfer or discharge plan shall be placed in the resident's medical record.

    Note:  These basic steps are not a comprehensive outline of all state and federal requirements. 

Contact Information

  • Bureau of Community and Health Systems
    Attn: Involuntary Transfer or Discharge Notice
    611 W Ottawa Street
    P.O. Box 30664
    Lansing, MI 48909


    Phone: 517-241-1970

    FAX: 517-241-3354

    E-Mail: LARA-BCHS-InvoluntaryTransfer@michigan.gov