Protecting Nursing Home Residents from Eviction
Residents who can afford to pay for their nursing home care out of pocket are generally more profitable for nursing homes than Medicaid residents. Whether or not a nursing home participates in the Medicaid program is entirely voluntary.
Whether a nursing home participates in the Medicaid program is entirely voluntary. Private-pay residents are generally more profitable for nursing homes than Medicaid residents. But federal law states that if a nursing home decides to withdraw from Medicaid, existing Medicaid residents at the nursing home cannot be evicted.
About 1.4 million nursing home residents in the United States live in more than 15,500 Medicare and Medicaid-certified nursing homes. Medicaid and Medicare are health insurance programs funded by the U.S. government. But each program has different eligibility requirements and coverage.
Medicaid covers nursing home care in Medicaid-certified nursing homes only when the Medicaid beneficiary:
- Has no other means to pay
- Is eligible for the Medicaid program
The cost of care also further complicates matters. Many residents who begin paying out of pocket end up depleting their resources, which forces the resident to rely on Medicaid or loved ones to pay their bills.
The Rights of Medicaid Residents: Nursing Home Reform Act of 1987
Congress addressed the rights of Medicaid residents with two laws. These laws apply to nursing homes that participate in Medicare or Medicaid programs.
The first law is the Nursing Home Reform Act of 1987. This Act identified the services nursing homes must provide their residents and the standards they must meet. It also established a nursing facility resident's Bill of Rights.
These nursing home resident rights include:
- The right to privacy
- The right to be informed about services, health care conditions, and medications
- The right to be treated with dignity and respect
- The right to be free from abuse and neglect
- The right to make independent choices
- The right to proper medical care
- The right to manage their own money or choose someone to do so
- The right to participate in care choices
- The right to reasonable accommodation for disabilities
- The right to communication and visitation with family members
- The right to refuse medication and treatment
- The right to receive timely discharge notice before involuntary discharge or involuntary transfers
The Rights of Medicaid Residents: Nursing Home Resident Protection Amendments of 1999
The second law is the Nursing Home Resident Protection Amendments of 1999. This Act amended the Social Security Act to block the improper transfer or discharge of Medicaid residents when the nursing home withdraws from participating in the Medicaid program.
Under the law, nursing homes can withdraw from the Medicaid program. But such withdrawal is not a sufficient basis for evicting Medicaid residents.
Nursing homes withdrawing from the Medicaid program must inform future residents that they will not accept Medicaid payments. This notice must be given verbally and in writing.
A nursing home withdrawing from the Medicaid program must also get a signed, written acknowledgment of receipt from residents. This written acknowledgment must verify that the resident has received sufficient and timely notice that the nursing home is withdrawing from the Medicaid program. The acknowledgment of receipt must be separate from other documents.
If a resident cannot continue paying out of pocket, the nursing home can require that they move. This is true even if the resident becomes eligible for Medicaid benefits.
An improper nursing home discharge or transfer of a Medicaid resident violates The Nursing Home Reform Act of 1987 or The Nursing Home Resident Protection Amendments of 1999.
Nursing Home Evictions: When Can a Resident Be Transferred or Discharged?
Medicaid residents can be transferred or discharged from their nursing home under the following circumstances:
- The resident's presence in the nursing home threatens the welfare, health, or safety of other residents
- The resident's health improves, and nursing home care is no longer necessary
- The resident does not pay for care after the nursing home provides reasonable and appropriate notice regarding the non-payment
- The nursing home closes
Even when these circumstances exist, nursing homes must follow specific transfer, discharge, or eviction procedures. Requirements for these procedures may vary depending on your state laws.
Rights When Notice of Transfer or Discharge Has Been Given
Nursing home residents have the following rights when a notice of transfer or discharge has been given:
- They can appeal a transfer or discharge that they believe is unlawful
- A nursing home resident can't be forced to leave if the resident is waiting to get Medicaid (and the facility did not provide notice that they do not accept Medicaid)
- Nursing homes must give a 30-day written notice of their plans and reason to transfer or discharge a resident (except in emergencies)
- Nursing homes must safely and orderly transfer or discharge a resident
- Nursing homes must provide proper notice of bed-hold and readmission requirements
- Nursing homes must have a grievance procedure for complaints
Who To Turn To for Eviction Help
If a problem arises, speak with the assisted-living facility staff. Work with the staff's supervisor and administrator if you can't resolve the issue.
A Medicaid-certified nursing home must post the name and contact information for certain state groups, such as the:
- State survey agency
- State licensure office
- State long-term care ombudsman program
- Protection and advocacy network
- Medicaid fraud control unit
Legal issues with nursing homes or assisted living facilities are rarely easy. Consult an elder law attorney specializing in nursing home abuse law for legal advice.
Can I Solve This on My Own or Do I Need an Attorney?
- For situations involving housing issues, it’s best to ask an attorney their opinion
- Cases with nursing homes or assisted living are rarely cut and dry
- Get customized advice and ask your legal questions
- Many attorneys offer a free consultation