According To The Wall Street Journal, Nursing Homes Are Forcing Out Frail And Ill Residents In An Effort To Replace Them With Shorter-Term Residents Likely To Bring More Revenue

Federal law allows nursing homes to evict residents for six reasons: they are healthy enough to return home; they require care not offered at the nursing home; they risk the health of other residents or staff; they endanger the safety of other residents or staff; they do not pay their bills; or the nursing home closes. However, some state officials and patient advocates say that nursing homes often go too far, seeking to evict those who are merely inconvenient or too costly, according to the Wall Street Journal. Residents with dementia or demanding families are among the most vulnerable, particularly if they depend on Medicaid to pay their bills. Those on Medicaid bring facilities less – sometimes substantially less – of what nursing homes can get from residents who pay out of pocket, with private health insurance or through Medicare. Roughly two-thirds of those who remain in a nursing home 90 days or longer depend on Medicaid, having exhausted their own savings or other benefits.

Nursing homes are required to give residents 30 days’ notice of eviction, explain their appeal rights and organize a plan to ensure that the move does not harm residents. However, nursing homes “don’t always follow the rules,” according to the Journal. While the homes “rarely roll evicted residents out to the curb,” they often “transfer [residents] to another nursing home or send them to a hospital or psychiatric facility for treatment and observation and then refuse to take them back,” a process which social workers sometimes refer to as “nursing-home dumps.” Although nursing homes frequently list one of the six permitted reasons for eviction, “advocates for the elderly say it can be a stretch.” Even an orderly eviction can carry grave risks for the old and ill. Studies suggest “transfer trauma,” or relocation-stress syndrome, can spur depression and weight loss and increase the risk of falls.

There are no data on U.S. nursing home evictions but formal complaints of eviction practices have doubled over the 10 year period ending in 2006. However, because not all residents who are evicted file formal complaints, the practice may be more prevalent, according to the Journal.


Federal and state laws gives nursing home residents strong protections against eviction — at least on paper. But these protections do not apply to residents of assisted living facilities, which are largely unregulated. And residents who are dependent on Medicaid are particularly vulnerable to eviction, state officials and resident advocates say.

The Wall Street Journal article can be found here – To Be Old, Frail And Evicted: Patients at Risk –

RECENT PERSONAL EXPERIENCE: My most recent personal experience in attempting to transition a private pay assisted living facility resident in New Jersey to Medicaid more than confirms the Journal’s findings. My client, the niece and power of attorney for her frail, elderly aunt, admitted the aunt to a local assisted living facility. The niece chose the facility after being told that the facility would accept residents who transitioned to Medicaid as long as the resident had paid privately for care at the facility for at least two years before the resident became eligible for Medicaid. In addition, the niece was told that, after becoming eligible for Medicaid, the resident might initially be placed on a waiting list for one of the limited number of Medicaid beds in the facility. Thereafter, the niece paid privately for care with the aunt’s assets for almost three years. A significant amount of money was paid to the facility. When the niece exhausted her aunt’s funds, the niece hired my firm to apply for Medicaid on the aunt’s behalf. I filed the Medicaid application and then followed my firm’s usual procedure by giving the facility notice of the pending application. Instead of placing the aunt on the facility’s internal waiting list for a Medicaid-certified bed as the niece had been promised upon admitting her aunt to the facility three years before, the facility immediately issued a 30 day discharge notice. After I objected in writing to the facility’s improper effort to discharge the resident rather than do what it promised to do years before, the facility took additional actions to rid itself of the aunt, a sick, unwanted Medicaid applicant. The facility filed a complaint against the niece/power of attorney with the NJ Office of the Omsbudsman for the Institutionalized Elderly alleging that the niece had financially exploited her aunt. There was absolutely no basis for the facility’s complaint. In fact, the complaint was not filed to protect the aunt. Rather, the complaint was filed improperly for the sole purpose of intimidating the niece/power of attorney in an effort by the facility to force the niece to remove her aunt from the facility so the facility could admit a more profitable resident; i.e., a healthier resident who could pay privately for care. Of course, although the facility’s complaint alleging financial exploitation was wholly without merit, the Office of the Omsbudsman is investigating, involving banks and other financial institutions, and disrupting the lives of the aunt, the niece and other third parties. Unfortunately, the facility’s strategy appears to have worked. The niece is so upset about the facility’s actions that she is trying to locate another facility into which her aunt could be transferred. Based upon legal research and conversations with officials in Trenton, NJ, there do not appear to be any laws protecting either the aunt or the niece from the facility’s totally outrageous and abusive conduct in this situation.

Family members should be very careful when dealing with admission personnel in care facilities to be sure that the promises made at the time of admission are later enforceable. Don’t believe the glossy marketing materials provided by the assisted living facility; review the assisted living facility’s admission agreement closely; ask many questions about the facility’s Medicaid policy and internal waiting list; put the facility’s answers in writing and send the answers to the facility via certified mail. The facility will never put any of their representations in writing so as to avoid potential liability for breach of contract, so the resident or his or her power of attorney should put the answers to questions in writing. Most importantly, advocate for greater legal protections for residents of nursing homes and assisted living facilities because existing law is insufficient to protect residents and their loved ones.