Numerous complaints and investigations reveal that nursing homes are illegally evicting and “pushing out” residents who cannot afford to pay. This practice is endangering the lives of nursing home residents. According to the long-term care Ombudsmen, more than 10,600 complaints were filed in 2017 related to discharges and transfers. These complaints make up the majority of all complaints filed with the federal advocacy agency.
Are Nursing Homes Evicting Residents?
The Ombudsmen report more than 10,000 complaints in 2017, which is an increase from 9,192 complaints in 2015. The problem, however, is likely much greater. According to the Vice President of the AARP Foundation, Kelly Bagby,
“Most people don’t even know they have rights,” she said. And many complaints never result in a formal state investigation.
What is perhaps most alarming is the fact that poor discharge and eviction practices seem to be common knowledge. Experts, advocates and even the federal government acknowledge that nursing homes are more likely to evict low-income residents. They are also more likely to evict long-term residents receiving Medicaid. These discharges and evictions are to make room for short-term patients covered by Medicare.
Why? Because Medicare reimburses nursing homes at a rate that is higher than what Medicaid reimburses. Therefore, it is more lucrative for nursing homes to house patients on Medicare. Consider California, for example, where nursing homes are reimbursed $219 per day by Medicaid. In contrast, they may receive more than $1,000 per day from Medicare.
There is a trend in facilities evicting residents around the 20-day mark. This is when residents become partially responsible for the costs of the nursing home. Not only is this a dangerous practice that puts patients at risk, but it is also illegal. Abandonment of a nursing home resident is a tragic form of abuse and neglect.
“It is illegal to discriminate against residents based on payment source, but it happens all the time,” said Tony Chicotel, attorney at the California Advocates for Nursing Home Reform, a nonprofit that supports long-term care residents in the state. “It feels like there’s just a tidal wave of cases.”
When Can Nursing Homes Legally Evict Residents?
A nursing home can legally evict a resident under certain conditions. These include:
- The resident’s health improves
- The resident poses a danger to the facility or other residents
- If the resident’s needs are outside what the facility can provide
- If the resident fails to pay and has not applied for Medicare or Medicaid
- The facility closes its doors
Under federal law, even if these conditions are met, nursing homes must give residents a 30-day notice in writing. They must also work with the resident and his or her family to create a transition plan. Advocates note that residents are often evicted or forced to leave without formal notice or due process rights.
Nursing homes cannot discriminate against low-income residents, and cannot evict them or deny them services due to their financial position or status.
Tragic Stories Highlight Illegal Evictions
As alarming as the data is, the real impact of nursing homes evicting or discharging residents illegally is much worse. Consider these stories highlighted by NBC News:
A resident of Bishop Care Center nursing home in Bishop, California reports a tragic situation that highlights illegal evictions. The 67-year-old woman was discharged from the nursing home after her Medicare rehabilitation coverage ended. She was unable to pay the fees out of pocket – totaling more than $7,000 per month – so she had no choice but to leave.
The woman is unable to walk or care for her daily needs. After being discharged from the nursing home, she was driven to her daughters home where she sat for hours in her wheelchair. She was alone and unable to go to the bathroom or eat. She was also having difficulty breathing.
Her daughter was naturally outraged. The family later found out that they could have appealed the Medicare decision or applied for Medicaid. If she qualified, she would have been able to stay in the nursing home for as long as needed. She was not given that option by the facility, and instead was discharged. After exploring their options, the woman was approved for Medicaid.
The facility argues that they did not evict her, but that her health improved and she left voluntarily. They state that they did give her a notice of appeal for Medicare. It is unclear whether that is the case.
Los Angeles, California
A nursing home resident in Los Angeles was woken from sleep in April 2018 and was told by nursing home staff that he was being evicted. The 51-year-old resident says that Avalon Villa Care Center staff drove him into downtown L.A. and dropped him off on a sidewalk. There, he became a member of L.A.’s burgeoning homeless population.
The man, who is a diabetic, was left on the street in a wheelchair without insulin or diabetic supplies. It is noted in a Department of Public Health report that he could have gone into a coma or could have died. A L.A. city attorney filed a civil complaint in this case, which resulted in a $450,000 settlement paid by Avalon Villa Care Center. The settlement stems from several evictions of homeless residents.
How Serious is the Problem?
Of course, California is not the only state where illegal evictions and discharges happen. Nursing homes across the nation are included in complaints to the Ombudsmen. It does seem, however, that certain parts of the country are affected more by these practices than others. California is one of the states with a burgeoning problem.
In L.A., the problem is significant enough that local shelters are speaking up and taking action. The Union Rescue Mission is one such place. Director, Rev. Andy Bales, says,
“‘resident dumping’ from nursing homes and hospitals is so common that the shelter set up a security camera outside — which Bales calls “the dump cam” — to capture evidence of it.”
Other reports indicate that nursing homes will take evicted or discharged residents to motels and pay for a night or two. This practice leaves them alone without healthcare or supervision. In some cases, residents with dementia have been taken to low-cost motels.
Several lawsuits have been filed in discharge and eviction cases. In addition to the discharges and evictions, some nursing homes are reported to deny residents readmission once they obtain funding.
Is Anything Being Done to Stop Nursing Homes?
The Centers for Medicare & Medicaid Services (CMS) strengthened their requirements for nursing home transfers and discharges in 2016. Strengthened regulations specify that nursing homes cannot evict residents for nonpayment while they are actively applying for Medicaid or are appealing a denial.
In 2017, CMS launched an initiative aimed at preventing illegal discharges. The agency approved funding in states like California for training nursing homes on the new regulations. Advocates say much more needs to happen in order to truly make a difference in how nursing homes handle discharges and transfers. Both state and federal agencies need to do more to train nursing homes and enforce regulations.