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⭒ CANHR Advocate Did You Know Articles

Intra-Facility Transfer Rights

“Transfers” usually refer to moving a resident from one room or bed to another within the same nursing home. Nursing homes give one of three reasons for intra-facility transfers. Your basic rights regarding transfers include a written notice stating the reasons for the transfer and your right to appeal the decision. By voluntarily agreeing to move, you can lose some of your rights.

1. Medicare Coverage Runs Out: In California, facilities can choose to certify a separate wing or section of the facility as a Medicare distinct part. Under federal law and regulations (42 U.S.C., Section 1395i-39(c)(1)(A)(x) and 42 C.F.R., Section 483.10(o)), a resident has the right to refuse a transfer out of the Medicare Distinct Part to another part of the facility when Medicare coverage stops. However, if the resident refuses to transfer and Medicare does not continue to pay for the care, the resident must either pay privately for the care or arrange for Medi-Cal payment, if eligible.

2. Conversion to Medi-Cal: Facilities cannot move a resident to another room (except from a private room to a semi-private room) because of a change in payment status from private pay or long-term care insurance to Medi-Cal. (Welfare & Institutions Code, Section 14124.7)

3. Room or Roommate Changes: Changes in rooms or roommates require “reasonable notice in writing and transfer and discharge planning” (Health & Safety Code, Section 1599.78). Federal law also requires notice (42 CFR 483.15(e)(2) and adds other protections by giving residents the right to “choose activities, schedules, and health care consistent with his or her interests, assessments, and plans of care” (Section 483.15(b)(1)).

Transfers are often upsetting and even traumatic for residents. Know and exercise your rights to refuse and appeal intra-facility transfers. To learn more, refer to CANHR’s fact sheet, Transfer and Discharge Rights in Nursing Homes, available on