This letter from CMS provides guidance on the limited circumstances under which nursing homes or other healthcare facilities can initiate transfers or discharges of their residents. The letter outlines that transfers or discharges can only be initiated if the resident's welfare needs cannot be met by the facility, the resident's health has improved, the safety of individuals in the facility is endangered, the health of individuals in the facility is endangered, the resident has failed to pay for their stay, or the facility ceases to operate. The letter also outlines the documentation required in the resident's medical record and the information that must be conveyed to the receiving provider in order for the transfer or discharge to be compliant with the regulations. Nursing homes and other healthcare facilities must ensure that these requirements are met when initiating transfers or discharges in order to remain compliant with the CMS regulations.

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