A State Veterans Home can discharge a resident only for one of six reasons VA's rules allow, usually with 30 days' written notice, and the family has the right to appeal. If a letter just told you Dad has a month to leave, or a VA care team says he "no longer needs this level of care," it's a gut punch. Take a breath. State veterans home discharge rights are real and written down, and a VA Community Living Center has its own appeal route too. The first step is figuring out which rulebook Dad's home follows.

In This Guide

Which Kind of Home Is Dad In?

Before you can push back, you need to know whose rules you're pushing against. That sounds bureaucratic, but it's the single most useful thing to pin down, because the two VA-linked kinds of nursing home answer to different rulebooks and send appeals to different people.

A State Veterans Home is owned, operated and managed by a state government, not by the U.S. Department of Veterans Affairs (VA). VA must formally recognize and certify a home before it joins the program, and VA surveys every State Veterans Home each year to check that it still meets VA standards. To be recognized as a State home and receive VA per diem payments, a State home's nursing care unit must meet VA's standards, including the transfer and discharge rules in 38 CFR 51.80. Our guide to State Veterans Homes covers admission and costs, and links to each state's homes.

A VA Community Living Center (CLC) is VA's own nursing home. There are over 100 CLCs across the country, most on or close to the campus of a VA medical center, and VA says most CLC stays are short stays after a hospital discharge. CLC discharges follow VA's own directives, covered further down, and our guide to VA nursing homes and Community Living Centers explains who qualifies.

Some State Veterans Homes also take Medicare or Medicaid payments. A State Veterans Home certified to participate in Medicare or Medicaid must meet the federal nursing home rules of the Centers for Medicare & Medicaid Services (CMS) as well as VA's. If the VA is paying for Dad's care in a private community nursing home instead, that home is neither a State home nor a CLC; when it's a Medicare or Medicaid nursing facility, CMS's discharge rules in 42 CFR 483.15 are the place to start, and our nursing home discharge rights guide walks through them.

State Veterans Home (VA standards only) State Veterans Home also certified for Medicare or Medicaid VA Community Living Center
Who runs it The state The state VA
Discharge rules VA's 38 CFR 51.80 VA's 38 CFR 51.80 and CMS's 42 CFR 483.15 VHA Directive 1142, plus the 38 U.S.C. 1710A consent protection
Who hears the appeal The State official named in the discharge notice The State official named in the notice; CMS's rule also requires the notice to name the entity that receives appeals Facility Chief of Staff, then the VISN for a final decision
Who can help State long-term care ombudsman State long-term care ombudsman The facility's VA Patient Advocate

Not sure which one Dad is in? Ask the home's administrator or social worker directly, and ask whether the home is certified for Medicare or Medicaid. You can also search for the home by name on Medicare Care Compare.

State Veterans Home Discharge Rights: The Six Allowed Reasons

It can feel like the home holds all the cards. It doesn't. VA's rule starts from the resident's side: the home must let each resident stay and may not transfer or discharge him unless one of six reasons applies.

  1. The move is necessary for Dad's welfare, and his needs can't be met in the nursing home.
  2. His health has improved enough that he no longer needs the nursing home's services.
  3. The safety of people in the facility is endangered.
  4. The health of people in the facility would otherwise be endangered.
  5. He has failed, after reasonable and appropriate notice, to pay for his stay.
  6. The nursing home is closing.

Under 38 CFR 51.80, Dad's primary physician must document the transfer or discharge in his clinical record. That record is where you'll see which of the six reasons the home is relying on and what supports it, so ask for a copy early.

One detail surprises families. Under VA's rule, a "transfer or discharge" means moving a resident to a bed outside the facility, even one in the same building; a move to another bed within the same facility doesn't count. VA's final rule adds that a move outside the nursing home portion of the complex counts as a move outside the facility. So if the home wants to shift Dad from its nursing unit to another part of the campus, the discharge rules still apply.

VA's 38 CFR 51.80 sets these transfer and discharge standards for State Veterans Homes that provide nursing home care. Each state sets its own eligibility and admission criteria for its homes, so read your home's resident handbook too, and take any discharge policy in it you don't understand to the ombudsman.

The 30-Day Notice: What It Must Say and When It Can Come Sooner

Before a State home moves a resident out, it must tell the resident, and a family member or legal representative if the home knows of one, in writing and in a language and manner they understand. Under 38 CFR 51.80, that notice must come at least 30 days before the move.

The 30 days can shrink. VA's rule lets a State home give notice "as soon as practicable" in three situations: when the safety or health of people in the facility would be endangered, when the resident's health has improved enough that he no longer needs nursing home care, or when the resident's needs can't be met in the home. If your notice gave less than 30 days, check whether the home is claiming one of those three reasons.

A State home's written discharge notice must include all five of these items:

  • The reason for the transfer or discharge
  • The effective date
  • The location Dad is being transferred or discharged to
  • A statement that he has the right to appeal to the State official designated by the State
  • The name, address and phone number of the State long-term care ombudsman

If any of those is missing, write it down. A notice that leaves out who hears the appeal, or where Dad is supposed to go, is worth raising with the ombudsman right away.

Hospital Stays, Bed-Holds, and Who Pays

A hospital trip is when many families first hear the word "discharge." VA's rule requires a State home to give a written bed-hold notice when it transfers a resident for a hospital stay or therapeutic leave. If the hospital stay runs past the bed-hold period, the home must have a written policy to readmit the resident to the first available bed in a semi-private room, as long as he still needs the home's services. Keep a copy of that bed-hold notice, and ask the home in writing when Dad can come back.

Money worries are real, and they're one of the six reasons a home can use. A State home can discharge a resident who has failed to pay for his stay only after reasonable and appropriate notice to pay. If a bill has fallen behind, talk with the home's business office early and get any payment plan in writing.

Who pays also can't change the rules Dad gets. Under 38 CFR 51.80, a State home must have identical transfer and discharge policies for all residents, whatever the source of payment. A veteran paying privately and a veteran whose care VA helps fund are owed the same process.

When the State Home Also Takes Medicare or Medicaid

Many State homes answer to two sets of rules. The Government Accountability Office reported in 2025 (GAO-25-108441) that any state veterans home participating in Medicare or Medicaid is also overseen by CMS, and that as of January 2022, 76 percent of state veterans homes were also inspected by CMS. A certified home is held to the federal nursing home requirements in 42 CFR part 483, including the admission, transfer and discharge rights in 42 CFR 483.15, on top of VA's standards.

What that means for you: if Dad's State home is certified, both VA's rule and CMS's rule apply to his discharge. Don't assume one replaces the other. Ask the home which rules it is following and keep every notice it sends.

At a home where CMS's rule applies, the discharge notice must also list the resident's appeal rights, including the name, address, email and phone number of the entity that receives appeal requests. Each state sets the deadline to appeal a nursing home transfer or discharge at a Medicare- or Medicaid-certified home, and federal Medicaid rules cap that deadline at 90 days from the date the discharge notice is mailed. Because your state may set a shorter deadline, act on the notice the week it arrives. If the notice names more than one place to appeal, file with each one and ask the ombudsman to help.

A refused return after a hospital stay is a discharge too at a certified home. When a CMS-certified nursing home decides a resident it sent to the hospital, expecting him to return, can't come back, the home must follow the federal discharge requirements.

A note on paying, since certification often raises it: Medicare Part A covers skilled nursing facility care only on a short-term, post-acute basis, up to 100 days per benefit period, and Medicare doesn't pay for long-term custodial care.

How to Appeal a State Veterans Home Discharge

You have the right to say no to this decision, and the notice itself tells you where to start. Under 38 CFR 51.80, the appeal goes to the State official the State designates, and the notice must name that right. State homes are run by state governments, not VA, so look to the State office named on Dad's notice, not to VA, and file in writing.

The ombudsman is your strongest ally here. VA's resident-rights rule for State homes (38 CFR 51.70) requires the home to give the State long-term care ombudsman immediate access to a resident, and lets ombudsman representatives examine a resident's clinical records with the resident's or legal representative's permission, subject to State law. VA's resident-rights rule for State Veterans Homes, 38 CFR 51.70, also gives each resident the right to voice grievances without discrimination or reprisal, and to prompt efforts by the home to resolve them.

The discharge notice must list the ombudsman's name, address and phone number. If you can't find it, the federal Long-Term Care Ombudsman Program points families to a state-by-state directory. Our guide to the long-term care ombudsman explains what an ombudsman can do for you.

1
Step 1

Read the notice and note which of the six reasons the home gives, the effective date, and the appeal office it names

2
Step 2

Ask the home, in writing, for a copy of the physician's documentation of the discharge in Dad's clinical record

3
Step 3

Call the State long-term care ombudsman listed on the notice and ask for help with the appeal

4
Step 4

File the appeal in writing with the State official named in the notice, and keep a dated copy

5
Step 5

Ask the home, in writing, whether Dad can stay where he is while the appeal is decided, and keep the answer

Can the VA Discharge a Veteran From a Community Living Center?

Yes, but only under VA's criteria, and some veterans have a strong protection. If a CLC team told you Dad "no longer needs this level of care," that phrase maps onto one of VA's written criteria, and you can dispute it.

VHA Directive 1142, VA's standards for Community Living Centers, says discharge to the least restrictive environment is the goal. Under the directive, a CLC resident may be discharged when:

  • He has met his treatment goals, no longer requires a skilled level of care, and is independent enough for discharge to the community.
  • The CLC can no longer accommodate him because his service needs have changed.
  • He shows flagrant disregard for the medical center's rules of resident conduct after being appropriately advised of them; if he still has medical needs, VA must transfer him to an appropriate alternative site of care.

A long-stay resident may also be discharged once he no longer requires CLC or nursing home level of care.

Now the protection. Under 38 U.S.C. 1710A, VA must provide needed nursing home care to a veteran who needs it for a service-connected disability, and to a veteran who needs it and has a service-connected disability rated at 70% or more. VA must ensure such a veteran who continues to need nursing home care isn't transferred out of the facility without his consent, or his representative's consent if he can't give informed consent, and Directive 1142 applies that rule to CLCs. If Dad fits either group, say so in writing to the CLC team, and say that he or you as his representative don't consent to the transfer.

How to Appeal a VA Community Living Center Discharge

Directive 1142 says a CLC resident may dispute a discharge decision, with review and a final decision following VA's clinical appeals process in VHA Directive 1041. Here's how a VA clinical appeal of a CLC discharge works, step by step:

  1. Try to resolve it with the team first. A clinical appeal is for disputes that can't be resolved with the original decision maker or clinical team.
  2. File a written appeal through the Patient Advocate. Dad, or you as his surrogate, files through the VA medical facility's Patient Advocate. If you'd rather explain it out loud, the Patient Advocate will help you put the appeal in writing. VA says you'll first get a Notice of Receipt of Clinical Appeal letter.
  3. The facility decides. The facility's Chief of Staff, under VA's directive, reviews the appeal and Dad's clinical records and makes the decision.
  4. Appeal to the VISN for a final decision. If you disagree, send a second-level written appeal to the Veterans Integrated Service Network (VISN) Patient Advocate Coordinator. The VISN Chief Medical Officer decides, and that decision is the final level of the clinical appeals process.

Directive 1041 sets a target of 45 business days from receipt for a decision, or up to 60 business days at the VISN level when an outside review is needed. The VISN Chief Medical Officer must also make sure the patient's safety and medical condition are considered and that the appeal is expedited as needed. VA's Clinical Appeals page tells veterans to send the written appeal to the facility's Patient Advocate as soon as they can. Under VHA Directive 1041, a VA clinical appeal received 60 or more calendar days after the original decision goes back to the original decision maker for a fresh look first, so filing early saves time.

The Patient Advocate is also the person for complaints that aren't a formal appeal. Under VA policy, each VA medical facility's Patient Advocate documents veterans' complaints and coordinates resolving the ones that can't be settled at the point of service, and family members' contacts count as a place a complaint can start.

What to Do This Week

A discharge notice can make everything feel urgent at once. You don't have to do it all today. Start a folder for every letter and a note of every call, then work down this list.

  1. Work out which rulebook applies. Use the table near the top of this guide: a State home that follows VA's rules only, a State home also certified for Medicare or Medicaid, or a VA Community Living Center.
  2. At a State home, work through the five steps in How to Appeal a State Veterans Home Discharge. If the home is also certified, act the week the notice arrives, because your state may set an appeal deadline shorter than the 90-day federal cap.
  3. At a CLC, write down exactly what the team said and when, ask the team to put the clinical reason in writing, and follow the four steps in How to Appeal a VA Community Living Center Discharge.
  4. Say whether Dad consents. If Dad is at a CLC and has a service-connected need for nursing home care or a 70% or higher rating, put his objection to the transfer in writing.

Frequently Asked Questions

Can Dad stay in the State veterans home while the appeal is decided?

At a State home also certified for Medicare or Medicaid, CMS's nursing home rule (42 CFR 483.15) says the home may not transfer or discharge a resident while his appeal is pending, unless not moving him would endanger the health or safety of the resident or others in the facility, and the home must document that danger. At a home that follows only VA's 38 CFR 51.80, the rule gives Dad the right to appeal to the State official the State designates, so ask that office and the ombudsman, in writing, whether he can stay while the appeal is decided.

Can a veterans home discharge Dad because of his behavior?

Only within the listed reasons. At a State Veterans Home, the six reasons in 38 CFR 51.80 include the safety of individuals in the facility being endangered, or their health otherwise being endangered, and Dad's primary physician must document the discharge in his clinical record. At a VA Community Living Center, VHA Directive 1142 allows discharge when a resident shows flagrant disregard for the medical facility's rules of resident conduct after being appropriately advised of them, and if he still has medical needs, VA must transfer him to an appropriate alternative site of care.

What if the discharge notice sends Dad somewhere we don't think is safe?

A State home's discharge notice must name the location Dad is being moved to, so you can see where the home plans to send him. At a State home also certified for Medicare or Medicaid, CMS's surveyor guidance says discharge planning must identify a destination that meets the resident's health and safety needs as well as his preferences, and CMS's rule requires the home to provide and document enough preparation and orientation for a safe and orderly transfer or discharge. Put your concerns about the destination in writing, and raise them in the appeal and with the ombudsman.

What if Dad's condition changes after we file a CLC appeal?

Under VHA Directive 1041, a VA clinical appeal that asks for new information to be considered is first sent back to the original decision maker for a re-evaluation, and if the dispute isn't resolved, the appeal continues. VA's Clinical Appeals page also says an appeal can be withdrawn at any time, so you can stop it if the team's new plan works for Dad.

Learn More

VA BenefitsState Veterans Homes: Who Gets In, What It Costs, and How to ApplyState veterans homes are state-run, VA-certified care homes. See who gets in, how VA per diem and the 70% rating rule shape the cost, and find your state. VA BenefitsVA Nursing Homes and Community Living Centers: Who Qualifies and What the VA PaysVA community living centers, contracted nursing homes, and state veterans homes: who VA must cover, what the 70% rule means, 21 free days, and the daily copay. Care TypesCan a Nursing Home Kick Out a Resident? Discharge Rights and AppealsCan a nursing home kick you out? Only for one of six federal reasons, with written notice, and an appeal usually stops the move. Here is what to do this week. Care TypesThe Long-Term Care Ombudsman: A Free Advocate for Nursing Home and Assisted Living ResidentsEvery state has a free, confidential long-term care ombudsman for nursing home and assisted living residents. What they do, whose side they're on, how to call. Care TypesNursing Home Won't Take Mom Back After the Hospital: Readmission RightsNursing home refuses to readmit after a hospital stay? Federal rules treat that as a discharge. Find the bed-hold notices and appeal from the hospital.

Got a discharge notice? Find personalized help reading it and planning Dad's appeal at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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