Nursing Home Discharges

Feb 03, 2020

According to federal law and Ohio’s Resident Bill of Rights, a nursing home can discharge a resident only for the following reasons:

  • The transfer or discharge is necessary to meet the resident’s welfare and the resident’s welfare cannot be met in the facility;
  • The transfer or discharge is appropriate because the resident’s health has improved sufficiently, making the facility’s services unnecessary;
  • The safety of other individuals in the facility is endangered;
  • The health of other individuals in the facility would otherwise be endangered;
  • The resident has failed, after reasonable and appropriate notice, to pay (or to apply for Medicaid or Medicare coverage) for a stay at the facility; or
  • The facility ceases to operate.

Unfortunately, sometimes nursing homes want to discharge a resident for other reasons, such as if the resident has behavioral issues and/or is difficult, the resident's family is difficult, or the resident is a Medicaid recipient. 

At times, facilities have discharged involuntarily by transferring residents to the hospital and then refusing to readmit them back to the facility.  This is more difficult to do for residents on Medicaid, however, as the facility is required to hold the resident’s bed for up to 30 days in a calendar year.  Medicaid actually pays the facility 50% of the per diem rate while the bed is being held.

Regardless of the reason used to discharge a resident, the facility must still follow a protocol that provides a comprehensive care plan for the resident and ensures that they have a safe place to go.  The protocol includes:

  • Preparing a summary of the resident’s mental and physical health status;
  • Preparing a post-discharge plan of care for the resident which will assist the resident in making alternative arrangements for care and housing; and
  • Notifying the resident (or the legal representative) of the pending discharge (and the reasoning behind it) in writing at least 30 days in advance of the discharge date, unless it is an emergency.

If your ward is being discharged by a facility, you do have the right to appeal the decision.  As Guardian, you would contact the long-term care ombudsman (at Direction Home Akron Canton Area Agency on Aging and Disabilities) at 1-800- 421-7277 or the Ohio Department of Health at 1-800-342-0553.