My mother’s nursing home just informed me that she must leave this week because she no longer qualifies for Medicare coverage. She suffered a stroke several weeks ago and entered the skilled nursing facility because she needs therapy. My mother isn’t ready to go home and needs daily nursing care. Can the nursing home force her to leave just because her Medicare benefits ended?
Worried in Woodland
No. Your mother has a right to stay in the nursing home if she continues to need nursing home care. Strict federal regulations prohibit nursing homes from evicting residents except for very limited reasons, such as non–payment. Whenever a nursing home initiates transfer or discharge, it must provide the resident a detailed written notice explaining the basis for its action and her right to appeal it.
If your mother no longer qualifies for Medicare coverage, she will need to find another way to pay the nursing home. She can use other insurance if available, pay privately, or seek coverage from Medi–Cal. Two of every three nursing home residents qualify for Medi–Cal. A California law prohibits a Medi–Cal certified nursing home from transferring or evicting residents who have made a timely application for Medi–Cal and for whom an eligibility determination has not been made. See Welfare& Institutions Code §14124.7.
For more information, see CANHR’s fact sheet, Transfer and Discharge Rights in Nursing Homes, at www.canhr.org. The federal regulation on transfer and discharge rights is found at Title 42, Code of Federal Regulations, §483.12.