Understanding Your Rights Under Federal Law
For many, moving into a nursing home is a difficult transition, and the thought of being forced to leave can be frightening. Fortunately, federal regulations under the Nursing Home Reform Law of 1987 strictly limit the reasons a nursing home can involuntarily transfer or discharge a resident [1]. This law applies to any facility that receives Medicare or Medicaid funding, which covers the vast majority of nursing homes in the United States. Before any discharge can occur, the facility must prove that one of the six permissible reasons applies and follow a detailed procedure to ensure the resident’s safety and rights are protected [1, 2].
The Six Legitimate Reasons for Discharge
An involuntary discharge must be based on one of the following six federal grounds:
- The resident’s needs cannot be met by the facility [1, 2].
- The resident’s health has improved to the point they no longer need nursing home care [1, 2].
- The resident's presence endangers the safety or health of others [1, 2].
- The resident has failed to pay for their stay after reasonable notice [1, 2].
- The facility is closing [1, 2].
The Importance of Proper Notice
Even with a valid reason, a nursing home must provide a written notice of transfer or discharge at least 30 days in advance, containing specific information including the reason, proposed date, and appeal rights [1, 2]. Shorter notice may be allowed in emergencies, but the notification process must still be followed [2].
The Bed-Hold Policy During Hospitalization
Concerns about losing a bed during hospitalization, known as “patient dumping,” are addressed by law, particularly for Medicaid recipients [1, 2]. Facilities must inform residents about their bed-hold policy [1]. Medicaid residents have the right to return to the next available bed if their state doesn't pay to hold their original bed [1, 2].
The Discharge Plan: Ensuring a Safe Move
A legal discharge requires a detailed plan developed by the care team [1, 2]. This plan must consider safe and appropriate placement options, minimize disruption, and include a discharge summary provided to the resident and the receiving facility [1, 2].
Comparison of Legal vs. Wrongful Discharge
| Feature | Legal Discharge | Wrongful Discharge |
|---|---|---|
| Reason | Based on one of six permitted grounds (e.g., non-payment after notice, health risk). | Motivated by retaliation, financial gain, or convenience (e.g., to replace lower-paying Medicaid residents). |
| Procedure | Requires advance written notice, comprehensive discharge planning, and specific documentation. | Lacks proper notice, omits required information, or fails to create a safe transition plan. |
| Appeal Right | Resident is informed of the right to appeal and can remain during the appeal process (unless an immediate threat exists). | Facility discourages or obstructs the appeal process, and may try to force the resident to leave prematurely. |
| Outcome | Transfer or discharge proceeds only after the appeals process is exhausted and a safe move is arranged. | Can result in a resident being left in an unsafe situation, potentially leading to legal action and state penalties. |
How to Fight an Improper Discharge Notice
If you receive a discharge notice that seems unfair, you can fight it [1, 2]. Do not move out [1]. Appeal the decision through the state agency listed on the notice [1, 2]. Contact the Long-Term Care Ombudsman for assistance [1, 2, 4]. Gather documentation and consider seeking legal counsel [1, 2].
The Role of the Long-Term Care Ombudsman
The Long-Term Care Ombudsman Program provides advocates who investigate and resolve nursing home resident complaints [1, 2, 4]. An Ombudsman can explain your rights, mediate disputes, and represent you during an appeal [1, 2, 4]. Their services are free and confidential. For more information, visit the National Consumer Voice for Quality Long-Term Care website to find your local program.
Conclusion
While a nursing home can you be kicked out if a nursing home if specific legal criteria are met, federal law provides robust protections against wrongful eviction [1, 2]. Understanding these rules, knowing your rights, and acting quickly to appeal any improper notice are vital [1, 2]. By engaging with resources like the Long-Term Care Ombudsman, families can empower themselves to challenge unfair decisions and ensure their loved ones remain in a safe and appropriate care setting [1, 2, 4].
