Across the country, nursing homes provide residential care for millions of seniors. Nursing home facilities owe their residents compassionate care and safe living environments, and for the most part, these facilities do their part. Unfortunately, evictions are on the rise, as some facility managers seek to discharge those residents seen as troublesome or beyond the scope of available care. In many cases, nursing home discharges are done illegally, and regulators have launched efforts to stem the tide of such illegal discharges. Nursing home insurance helps to protect facilities from liability claims brought by residents, but it is critical for facility managers to understand what constitutes legality in terms of resident evictions.
Long-Term Care Discharges and Evictions
The Centers for Medicare and Medicaid Services (CMS) is tasked with overseeing U.S. nursing homes, working hand-in-hand with state regulatory agencies. One of CMS’ roles is to develop programs and regulations to protect nursing home residents, often based on complaints lodged by facility residents. In 2015 alone, more than 9000 complaints centered on illegal discharges and evictions were filed. Since then, CMS has launched an initiative to combat resident “dumping” practices. With enhanced monitoring and enforcement of standards, nursing home advocates believe that regulatory agencies can help to protect the vulnerable people targeted for illegal removal from nursing home facilities. It is important to note that nursing home residents have specific rights under state and federal regulations, and it is imperative that nursing homes understand these rights before moving to discharge a resident.
When Can a Nursing Home Legally Discharge a Resident?
Although illegal dumping of nursing home residents is a widespread concern for regulators and healthcare advocates, there are numerous legal reasons why a long-term care facility may discharge certain residents. These legitimate reasons include:
- A discharge may be needed to provide care for the resident’s needs and that cannot be met within the facility.
- A resident’s health status has improved, making service at the facility no longer needed.
- A resident represents a safety or health risk to other residents and staff.
- The facility ceases operations.
A common misconception in the nursing home industry is that if a resident should run out of funds to pay for services and must transition to Medicaid coverage for payment, the facility may discharge that resident. Currently, it is against the law to evict a resident for non-payment, provided that the resident has been given time to make alternate payment arrangements such as filing with Medicaid. An exception to this law is if the facility does not accept Medicaid as payment; in these cases, the facility may legally discharge a resident.
Nursing Home Insurance: Protecting Facilities from Liabilities
Illegal discharges or evictions of nursing home residents can occur for many reasons. In these cases, residents may be able to obtain legal support and advocacy, especially considering that state and federal regulations provide for certain resident rights. Nursing homes have a duty to respect these rights as they provide care, and in most cases must adequately notify a resident if he or she is to be discharged from the facility.
Even if a nursing home resident is discharged for a legally-valid reason, that resident may wish to file a legal claim against the nursing home. Fighting such claims is expensive, and that is where nursing home insurance becomes an important part of the picture. This specialized insurance protects against many general and professional liabilities, providing a blanket of asset protection that allows nursing homes to continue providing compassionate care for their residents.
About Caitlin Morgan
Caitlin Morgan specializes in insuring assisted living facilities and nursing homes and can assist you in providing insurance and risk management services for this niche market. Give us a call to learn more about our programs at 877.226.1027.