Nursing home residents have strong legal rights under federal and state law, and you cannot simply be “evicted” without due process.
Know Your Rights: The 30-Day Rule
Under federal law, a nursing home can only discharge you involuntarily for very specific reasons, such as:
- The facility can no longer meet your medical needs.
- Your health has improved so much you no longer need nursing home care.
- You are endangering the safety of others.
- You are endangering the health of others.
- You have failed to pay (after reasonable notice). Note: A pending Medicaid application generally counts as a “payment,” thereby protecting you from eviction while the state processes your paperwork.
- The facility is closing.
The nursing home must provide a written notice that includes the reason for discharge, the effective date, the location you are being moved to, and instructions on how to appeal. Be aware, however, that the 30-day clock can be bypassed if there is a documented immediate danger to the resident or others. In these cases, the notice can be given “as soon as practicable,” which could be less than 24 hours.
Step 1: File an Immediate Appeal
The moment you receive a discharge notice, the “clock” starts.
- Request a fair hearing. The written notice you received must contain instructions on how to request a hearing with the state agency (usually the Department of Health or Social Services).
- The “stay put” provision. In many states, if you file your appeal within a certain timeframe (often 10–15 days), you have the right to stay in the facility until the hearing officer makes a final decision. However, many states have a “15-day rule” to ensure the hearing is scheduled before the move-out date. It is always safest to appeal within the first 10 days to trigger the strongest protections.
Step 2: Contact Your Long-Term Care Ombudsman
Every state has an ombudsman program—free advocates for nursing home residents.
- They investigate complaints, mediate between you and the facility, and can often help you navigate the appeals process.
- The nursing home is legally required to post the ombudsman’s phone number publicly. You can also search online for your local office.
Step 3: File a Formal Complaint
If you believe the facility is acting in bad faith or the discharge plan is unsafe (e.g., they are trying to send you to a homeless shelter or an ill-equipped relative’s home), you should:
- Contact primary physician. If the discharge is based on a medical need or health improvement, the resident’s own primary physician must document the reason in the medical record. If the facility’s own doctor says you need to leave but your personal doctor disagrees, this will greatly assist your appeal.
- Contact your state survey agency. File a complaint with the state agency that licenses nursing homes. They will investigate whether the facility violated federal or state regulations.
- Check the facility’s discharge plan. A facility cannot discharge you unless they have a safe and appropriate plan for where you are going. If they haven’t coordinated your follow-up care or medications, the discharge may be illegal.
- The bed-hold right. If you are sent to the hospital during this process, the facility must follow the so-called bed-hold policy, which prevents a facility from sending a resident to the ER and then refusing to let them readmit, effectively bypassing the 30-day rule.
Do not sign any voluntary discharge papers if you do not want to leave. Signing these can waive your right to an appeal.
