Transfer and Discharge Requirements for Medicaid Clients

DSHS has filed emergency rules that will take effect on January 1, 2026, regarding transfer and discharge notification requirements for home and community-based care settings (HCBS), including assisted living facilities.

DSHS adopted rules to comply with federal regulations that require residential HCBS to have written agreements with Medicaid residents that provide protections related to eviction and appeals comparable to those provided by the Landlord Tenant Act. (42 CFR §441.530(a)(1)(vi)(A), 42 CFR §441.301(c)(4)(vi)(A)). The adopted rules create additional notification standards for residents with Medicaid as a payor.

The stakeholder process for developing the new rules was contentious and lengthy. Although they are not ideal, the final regulations represent a significant improvement over the proposals considered early in the rulemaking stakeholder work. WHCA worked closely with Ballard Spahr Attorneys to push back on a proposal that would have required providers to follow local jurisdictions’ eviction processes.

The final rules will require providers to ensure resident admission/rental agreements comply with the standard and to implement a notification process needed to comply with the new rules.  The new rules also require that residents on Medicaid who are being transferred or discharged be notified about access to free legal counsel.

DSHS is working to finalize the required transfer/discharge notice and WHCA will continue to provide input.

Residential Care Services (RCS) will hold three information sessions to help AFH, ALF and ESF providers and administrators understand and implement the new rules. Sessions are available at varying times and days and will include a presentation and time for participant questions.

• September 17, 2025, 9am-10:30am. Sign up
• September 23, 2025, 1:30pm-3:00pm. Sign up
• October 9, 2025, 11:30am-1pm. Sign up

You must register for the event by clicking the “sign up” link next to the date you want to attend. All sessions are the same, so please sign up for only one session. If you have any questions, please contact [email protected] or call 564-999-3182.

Resources:

DSHS DPL: Details on the rulemaking activity.

FAQs: Frequently Asked Questions

CR-103: Emergency Rules: Read the rules in full.