Can you legally Discharge a Person from an Assisted Living or Nursing Home?
Nursing home evictions, or involuntary discharges or transfers, violates federal law when it disrupts the lives of people in care facilities.
It will lead to the loss of appropriate care and when a patient and their family are at their most vulnerable when care services are required for activities of daily living.
Federal law applies to all federally-supported nursing homes, meaning all nursing homes that accept Medicare or Medicaid, which is 99% of all nursing homes in the country.
Nursing home evictions are legal only under five specific instances and require a minimum of 30 days advance notice in writing and the opportunity to appeal the removal:
- The person no longer needs the nursing home care services
- The resident did not pay for care services
- The resident is affecting the health or safety of other residents
- The nursing home no longer provides a resident’s needs; or
- The nursing home is no longer in business
When a nursing home gives a 30-day notice of discharge, they must also provide an appropriate discharge care plan, including a suitable place to transfer the resident.
Reasons for Illegal Care Center Discharges
Residents can no longer pay for nursing home care.
The nursing home does not provide notice to apply for Medicaid.
- If an individual is hospitalized for more than three midnights and then transferred to a nursing home for short-term rehabilitation, Medicare will pay for the first 20 days of rehabilitation in full and co-insurance for another 80 days assuming that rehabilitation or skilled nursing care is required.
- After 20 days, residents are responsible for copayments, usually at least $185.00 in 2022. The nursing home suspects the resident will not pay for their stay after Medicare rehabilitation coverage goes beyond 100 days.
- A private-pay resident no longer has the funds. In this situation, the nursing home resident must be given a reasonable time to find the money to pay for care services. If a patient does not have the funds to pay, there will likely be a need to apply for Medicaid.
- A nursing home resident may not be transferred if a Medicaid application is pending.
- The nursing home perceives the resident as disruptive or challenging, which is sometimes the case with individuals with dementia.
- Facilities may claim they cannot meet the resident’s needs as a pretense for eviction. When nursing homes accept residents and have done their pre-evaluation, they agree they have determined they can meet the residents’ needs.
It is legitimate for a care center not to accept or transfer a patient when a resident needs a medical service or device that the nursing home does not offer, such as a ventilator or other specialized services.
- The nursing home misleads and tells the family that their loved one is being discharged from the facility.
- Nursing homes are known for incorrectly telling patients and family members that their loved one is being discharged from the facility only to find out the patient are simply receiving a Notice of Medicare Non-Coverage (NOMNC), which is an official notice required by the Federal Government to tell the patient that Medicare is going to stop paying for rehabilitation on a date in the future.
- The NOMNC must be delivered two calendar days before Medicare-covered services are expected to end.
- Nursing homes routinely call this NOMNC a “discharge notice.”
- When short-term rehabilitation paid by Medicare ends, many nursing homes falsely tell patients and their families that they don’t take Medicaid or that they don’t have any available Medicaid beds.
- The nursing home claims it does not accept Medicaid or doesn’t have any open Medicaid beds.
- Financial motives are the reason for this false information because nursing homes get paid significantly more money by Medicare for short-term rehabilitation patients than long-term care residents.
- Nursing homes prefer to make room for rehabilitation patients than keep people as long-term care residents.
A patient receives nursing home eviction:
- Nursing homes must provide a 30-day notice of termination. Residents who are asked to relocate do not need to leave immediately.
- Residents have the right to appeal a release of the termination. They have the right to remain in the nursing home during the appeal process unless doing so would endanger their health and safety.
- Nursing homes claiming inability to provide for a resident’s needs must provide documentation on why they can no longer provide services.
- Nursing homes must tell their patients the reasons for termination and provide these reasons in writing. Residents have the right to request explanations of their discharges.
- Nursing homes must provide an appropriate discharge plan, including a plan where the patient will be discharged and who will take care of the patient in the new location.
There are valid reasons for individuals and families to have a caregiving plan in place long before caregiving is needed.
Owning a long-term care insurance benefit is valuable because it provides sufficient funds to pay for some or all of a person’s home or care center services. The best time to own a plan is when you have no major health issues and the funds to own a long-term care plan as part of your estate planning.