Montana Nursing Home and Assisted Living Resident Rights

Your parent moved into a facility three months ago, and now the administrator is talking about transferring them to another facility because their care needs have increased. Or maybe you've noticed the staff cutting corners on hygiene and meals, and you don't know who to call. Montana law provides specific protections for residents of both nursing homes and assisted living facilities — but those protections only work if you know they exist and how to enforce them.

Involuntary Discharge and Transfer Protections

Under Montana law, a long-term care facility cannot simply decide to move your parent out. A resident is entitled to a 30-day written notice before any involuntary discharge or transfer. That notice must include:

• The specific reason for the discharge or transfer
• The effective date
• The location the facility proposes to transfer the resident to
• Clear instructions on how to appeal the decision

The facility's proposed reason for the discharge or transfer must be stated in the notice. Review that reason, the effective date, proposed location, and appeal instructions promptly with the Long-Term Care Ombudsman or another qualified advocate.

If the discharge is happening during a pending Medicaid application, contact the Long-Term Care Ombudsman immediately. Ask the facility to state its proposed reason in writing and explain the application's status; do not assume that a pending application by itself prevents a discharge over non-payment.

How to Appeal a Transfer or Discharge

If your parent receives an involuntary discharge notice, follow the appeal instructions in the notice and contact the Long-Term Care Ombudsman promptly. For a separate Medicaid denial, benefit reduction, or patient-liability decision, the DPHHS Office of Administrative Hearings handles Fair Hearing requests: the standard Medicaid appeal window is 90 days from mailing, while a patient-liability dispute must reach DPHHS within 30 days. Do not assume either Medicaid deadline is the facility-discharge deadline.

Ask the facility and the ombudsman whether the appeal process permits your parent to remain in the facility while it is reviewed. Do not assume that a "bed hold" applies; follow the notice's instructions and document each request.

Contact the State Long-Term Care Ombudsman at 1-800-332-2272 to get immediate advocacy. The ombudsman can investigate the discharge circumstances, mediate with the facility, and help you file the appeal correctly.

Filing Complaints About Care Quality

If you observe neglect, substandard care, or safety violations, you have several reporting channels:

For assisted living facilities: File a complaint with the DPHHS Licensure Bureau through the Office of Inspector General. They conduct surveys and investigate complaints about licensed facilities across Montana.

For nursing homes: The DPHHS Quality Assurance Division (QAD) Certification Bureau handles complaints about Medicare/Medicaid-certified nursing facilities. They conduct annual compliance surveys and respond to filed complaints. You can also review a facility's survey history through the federal Medicare Care Compare portal and request the facility's most recent Statement of Deficiencies (Form 2567).

For suspected abuse, neglect, or financial exploitation: Call Montana Adult Protective Services at 1-844-277-9300. Montana's Vulnerable Adult Prevention of Abuse Act establishes mandatory reporting requirements — healthcare workers, social workers, and other professionals are legally required to report suspected abuse. Family members can report at any time.

For the Long-Term Care Ombudsman: Call 1-800-332-2272 or contact your regional ombudsman through the Area Agency on Aging. The ombudsman investigates complaints confidentially, advocates for the resident, and can mediate disputes between families and facilities. They also maintain complaint history records that families should review when vetting a new facility.

Key Rights Families Often Don't Know About

Personal needs allowance: When a Medicaid-enrolled resident's income goes to the facility as patient liability, the resident keeps a $50 monthly personal needs allowance for personal expenses — clothing, toiletries, entertainment. The facility cannot claim this amount.

Right to visitors: Your parent has the right to receive visitors at reasonable times. Facilities can set visiting hours, but cannot ban family visits as a disciplinary measure or management convenience.

Right to manage personal finances: Unless a legal guardian or conservator has been appointed by the court, or the resident has voluntarily designated the facility to manage their funds, the resident retains the right to manage their own money.

Right to voice grievances: The facility must have a formal grievance process. Your parent can raise concerns about their care, food, activities, or living conditions without fear of retaliation or discrimination.

The Ombudsman's Role in Resident Protection

Montana's Long-Term Care Ombudsman Program operates under the federal Older Americans Act and Title 50, Chapter 5 of the Montana Code Annotated. The state uses a decentralized model: a state ombudsman in Helena works with local certified ombudsmen embedded within the regional Area Agencies on Aging.

The ombudsman is not a regulator — they're an independent advocate. They can investigate complaints, mediate disputes, and ensure the facility follows its legal obligations. If mediation fails, they can escalate to the regulatory agencies (QAD for nursing homes, OIG for assisted living).

When systemic issues surface — recurrent medication errors, poor hygiene, unexplained injuries, or staffing shortages affecting care — and the facility's administration fails to implement corrective measures, the ombudsman can conduct an independent investigation and advocate for the resident's statutory rights.

The Montana Care Decision Guide covers resident rights protections in detail, including a facility vetting checklist that helps you verify licensing, review complaint histories, and understand the appeal process before your parent moves in — not after a problem arises.

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