When Is a Nursing Home Eviction Legal, and What Can I Do?

Nursing home evictions, or involuntary discharges or transfers, disrupt the lives of residents, leading to homelessness, separation from familial support systems, and loss of care. As federal law covers all federally funded nursing home residents, nursing home evictions are legal only in particular instances, such as:

• The nursing home can no longer provide for a resident's needs.
• The resident does not pay for care after "reasonable and appropriate notice," which varies by state.
• The resident no longer needs care.
• The resident jeopardizes the health or safety of other residents.
• The nursing home closes.

Causes of Illegal Nursing Home Evictions

Financial motives are a significant cause of illegal nursing home evictions. When residents can no longer pay for nursing home care, some nursing homes evict residents without providing sufficient notice and time to apply for Medicaid.

Additionally, some nursing homes discharge residents early to avoid financial risks. For instance, some nursing homes remove residents transitioning from higher-paying Medicare to lower-paying Medicaid.

Other nursing homes discharge residents prematurely, suspecting residents will not pay for their stays. Medicare covers the initial 20 days of care. After 20 days, residents are responsible for copayments. A 2019 study in the Journal of the American Medical Association Internal Medicine found that nursing homes more often discharged Medicare recipients on the final day of full coverage than before or after, suggesting that some nursing homes prioritize financial considerations over resident care.

"Hospital dumping," where individuals returning from hospitalizations may find their beds taken, is another illegal practice, according to the American Council on Aging. State laws require that nursing homes hold beds open for hospitalized residents for one to two weeks. Residents receiving Medicaid are also entitled to available Medicaid-certified beds.

Other nursing homes may attempt to remove residents they perceive as disruptive or challenging, such as individuals with dementia. These facilities claim that they cannot meet the resident’s needs as a pretense for evicting them. Yet once nursing homes open their doors to residents, they have already determined they can meet residents' needs. According to the Centers for Medicaid and Medicare Services, discharging residents because nursing homes cannot provide for their needs should not be a common practice.

Dynamics Between Residents and Nursing Homes

Residents facing involuntary discharges or transfers from nursing homes may be hesitant to speak up and may not know their rights under federal law. They may feel pressure to accept discharges, even when they are not ready to go home.

If you or your loved one are facing a nursing home eviction, keep the following in mind:

• Nursing homes must provide 30-day notices of discharges. Residents do not need to depart immediately.
• In addition, residents have the right to appeal a release. They may remain in the nursing home during the appeal process unless doing so would endanger the health and safety of themselves or others.
• Nursing homes claiming to be unable to provide for a resident's needs must document why they can no longer assist the resident. Similarly, nursing homes must tell residents their reasons for discharging residents and provide these reasons in writing. Residents may request explanations of their discharges.
• A long-term care ombudsman is an official who advocates for people in nursing homes. You may contact your ombudsman through the Department of Aging in your state for assistance with nursing home evictions.  
• The national nonprofit Justice in Aging provides a useful resource on resolving common problems with nursing homes.
• For further insight and support, be sure to consult a qualified elder law attorney in your area as well.