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.
Out of the 1.4 million nursing home residents in the United States, two-thirds are Medicaid beneficiaries. Medicaid is a government program funded jointly by the state and federal governments.
It 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 and are forced 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 identified what services nursing homes were required to provide their residents and what standards were applied to them. Importantly, it also established a nursing facility resident's Bill of Rights.
These resident rights include:
- Be informed about services, their health care condition, and medications
- Be treated with dignity and respect
- Be free from abuse and neglect
- Ability to make independent choices
- Get proper medical care
- Manage their own money or choose someone to do so
- Participate in care choices
- Reasonable accommodation for disabilities
- Communication and visitation with family members
- Refuse medication and treatment
- 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 amended the Social Security Act to prohibit the improper transfer or discharge of a Medicaid resident when the nursing home withdraws from participating in the Medicaid program.
Under the law, nursing homes can withdraw from the Medicaid program. Still, such withdrawal is not a sufficient basis for evicting current Medicaid residents.
Nursing homes that have withdrawn from the Medicaid program must inform future residents that they will not accept Medicaid payments. This notice must be spoken and provided in writing.
They must also obtain a signed, written acknowledgment of receipt from the future residents, verifying that they have received this information. 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 transfer or discharge of a Medicaid nursing home resident can violate the above laws.
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:
- When transfer or discharge is necessary for the welfare, health, or safety of others
- The resident's health has improved, and nursing home care is no longer necessary
- The nursing home hasn't been paid for services provided to the resident
- The nursing home closes
Even when these circumstances exist, nursing homes must follow specific procedures for a transfer or discharge to be lawful.
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 plan 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. If the issue can't be resolved, work your way up to the staff's supervisor and administrator.
A Medicaid-certified nursing home must post the name and contact information for certain state groups that can be contacted, such as the:
- State Survey Agency
- State Licensure Office
- State Ombudsman Program
- Protection and Advocacy Network
- Medicaid Fraud Control Unit
It may also be necessary to consult with an older adult law attorney who specializes in nursing home abuse law.
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