July 30 2026 | Limited Reasons to Issue a Discharge Notice

WHCA staff have received many questions this past month regarding discharge notices; specifically, in what circumstances a discharge notice can legally be issued. This article outlines the five situations that allow for involuntary discharge notices. Please note, transfers (a temporary move to another care setting for medical and/or nursing care with the intent of the resident’s ultimate return) are not addressed in this article.

RCW 70.129, the resident rights statute, outlines when discharge notices can be issued, and what must be included in those discharge notices. The law is the same for residents living in skilled nursing facilities, assisted livings, enhances services facilities, and adult family homes.

First and foremost, it is important to note that the facility is viewed as the resident’s home. That means care must be taken when considering issuing a discharge notice, and all methods to preserve the resident’s stay must be explored before this extreme event is implemented. A move can be devastating for a resident and their family; your thoughtful and oftentimes creative ways of preserving residency are highly regarded as supporting the individual.

Leadership must be aware of the facility’s disclosure of services document – including what services are typically offered and what services are not – as well as reasonable accommodation efforts that are available, even if those accommodations go beyond the facility’s disclosure of services.

REASONS FOR DISCHARGE

RCW 70.129.110 outlines the five reasons a person can be issued a discharge notice:

The discharge is necessary for the resident’s welfare and the resident’s needs cannot be met in the facility. Some examples of legitimate discharge notices in this category might include a resident who, living in a traditional assisted living, needs memory care due to wandering and elopement behaviors, or a resident who has become a Hoyer lift transfer and the facility does not employ enough staff on the night shift to accommodate this level of service.
The safety of individuals in the facility is endangered. For this example, consider a resident who has become violent towards others and despite documented attempts at redirection, additional staff training on approaches, and/or medication adjustments, changes have not been successful.
The health of individuals in the facility is endangered. This could include a resident who showed symptoms of tuberculosis and tested positive; the facility does not have the physical plant requirements to safely house and care for a resident with active tuberculosis.
The resident has failed to make the required payment for his or her stay. This is one of the most common reasons to issue a discharge notice. Before issuing the notice, however, the facility should demonstrate efforts to obtain payment including meeting with resident and family members, setting up a payment plan, etc. For a resident on Medicaid, DSHS has a Dear Provider letter with resources.
The facility ceases to operate. For facilities that are closing, all residents must be given timely written notice and assistance to locate other feasible living situations.

Reasonable accommodation is a huge factor and expectation in attempts to preserve a resident’s stay. Assisted living regulations call out the definition of reasonable accommodation:

“Reasonable accommodation” or “reasonably accommodate” have the meaning given in federal and state antidiscrimination laws and regulations which include, but are not limited to, the following:

(1) Reasonable accommodation means that the assisted living facility must:

(a) Not impose admission criteria that excludes individuals unless the criteria is necessary for the provision of assisted living facility services;

(b) Make reasonable modification to its policies, practices, or procedures if the modifications are necessary to accommodate the needs of the resident;

(2) Reasonable accommodations are not required if:

(a) The resident or individual applying for admission presents a significant risk to the health or safety of others that cannot be eliminated by the reasonable accommodation;

(b) The reasonable accommodations would fundamentally alter the nature of the services provided by the assisted living facility; or

Minimizing involuntary discharge notices involves upfront collaboration with facility leadership prior to a resident moving in. This includes thoroughly vetting the potential resident’s medical conditions, behaviors and payment resources that may negatively impact a resident’s continued stay. Input from team members should include thoughts on whether the potential resident will be a good fit into the current resident culture; poor placement decisions can negatively impact a resident’s overall health (through transfer trauma) as well as the facility’s reputation in the greater community.

For additional questions about discharge requirements, email Vicki McNealley at the WHCA office.

Posted in Assisted Living, Survey & Regulatory