What’s Next? When a Nursing Home Evicts Your Loved One

What those figures don’t capture are the countless quiet discharges that happen every day. An example is when a resident’s Medicare-funded rehabilitation ends and a nursing home insists it’s “time to go home,” even though federal law offers broad protections against such forced removals, says Alison Hirschel, program director and managing attorney of the Michigan Elder Justice Initiative, which supports the legal needs of older adults and adults with disabilities. 

When a discharge notice is received, families need to act fast, says Kelly Bagby, AARP Foundation’s vice president of litigation.

“Long-term care ombudsman, who are available in every state, can guide families through the appeals process, helping spot illegal violations and connect them with resources or attorneys when needed,” she says. “AARP Foundation has litigated select eviction cases that violated state and federal laws, reinforcing the legal protections nursing facility residents have against evictions.​"

Jason Sears of Monticello, Indiana, relied on the state’s ombudsman program when his friend from church, Edith “Edie” Webb, 75, received an illegal eviction notice from her nursing home. Friends since 2014, Sears stepped in as her power of attorney after she started struggling with bills, mental health challenges and being taken advantage of by her nephew, who stole her car and didn’t help her when she was hospitalized for suicidal thoughts. Despite having three children, Webb trusted Sears to safeguard her well-being.

“When Edie faced not one, but two eviction notices, the first one without any reason for discharge, I knew I couldn’t let her be tossed aside,” says Sears. “I appealed the evictions, with help from the ombudsman, got her approval for Medicaid services so we could move her to a facility where she is now safe, cared for and content.”

Why nursing homes may evict a resident

​Nursing homes cannot remove residents arbitrarily. Federal law allows discharge or eviction only under six specific conditions, and facilities must provide proof. The six situations are:​​

1. The resident’s medical needs cannot be met by the nursing home
2. ​The resident’s health improves, and they no longer require long-term care​
3. The resident’s presence or behavior endangers the safety of other residents​
4. The resident’s presence or behavior endangers the health of other residents
5. ​The resident fails to pay for care, although nursing homes must allow up to 15 days before eviction​
6. The facility closes permanently​

After more than two decades on the front lines of long-term care advocacy, senior staff attorney Tony Chicotel of California Advocates for Nursing Home Reform has learned one thing above all: Nursing home evictions are common — and usually done illegally.

Chicotel has taken tens of thousands of calls from residents and caregivers panicked by sudden eviction orders. The patterns he’s observed are unmistakable. The vast majority of eviction attempts, he says, stem from a nursing home’s business model: rapid turnover of highly reimbursed Medicare residents and a quiet push to offload those whose stay will soon be paid for by lower Medicaid rates.

“Everyone in the field knows it’s illegal to discriminate based on payer source,” he says. “But it remains the number one complaint we see, by far.”

Facilities often pressure families to leave within days — or even hours. However, federal law requires nursing homes to provide residents with 30 days’ written notice before an eviction, along with a safe and appropriate plan for where the resident will receive care next. But numerous exceptions weaken the rule, and many facilities either give no explanation in the notice or provide it at the last minute.

Advocates stress that even when a full 30 days isn’t possible, the law still requires notice “as soon as practicable,” which should mean several days to allow families to plan. Instead, families often feel pressured to move a loved one before they’re ready.

Legally, families can push back: If proper notice wasn’t given, residents generally have the right to remain in the facility until the required notice period is honored. Instead, Chicotel says, “facilities give them 24 or 48 hours, which is nowhere near enough notice and almost always unlawful.”​

Getting ahead of evictions

​Gerontologist and clinical psychologist P.K. Beville has spent her career teaching about compassionate dementia care, but nothing prepared her for nearly losing her own father’s housing.

After a careful search, Beville found a facility for her father, who was diagnosed with vascular dementia. After he spent eight months in assisted living, her father’s well-intended behaviors, such as pushing other residents’ wheelchairs, setting up early for church and thanking staff in the kitchen, were frustrating an overstretched staff. Although no formal eviction notice was issued, administrators made it clear that he was becoming “a problem,” and Beville could sense that an eviction was looming.

When the administrator, whom Beville had known professionally for years, called to complain again about his interruptions and liability risks, Beville understood the coded message. Rather than wait for a 30-day discharge letter — or force the staff to move toward a formal eviction — she stepped in. After a frank conversation with her father, he asked whether he could come live with her and her husband. Within weeks, they converted their basement into a private suite. He lived with them for the remainder of his life, until 2021.

Looking back, Beville believes that her insider knowledge allowed her to see what most families miss until it’s too late: the early signs that a facility is preparing to push someone out. She also knew that her father’s charm and independence would not be viewed as assets in a system designed around liability avoidance and institutional order.

“I did the right thing early,” she says, “but they never offered to negotiate, never tried to help him stay. Once a resident is seen as inconvenient, there’s no going back.”​

Know your rights and how to advocate

​As nursing home evictions climb, knowing the rules and residents’ rights has become essential for families trying to protect loved ones. Families should remember that residents are entitled to certain key rights. Chicotel and Hirschel highlight those protections:

• Right to written notice. Facilities must provide a formal written notice, usually 30 days in advance, stating the reason for discharge, the planned discharge location and the resident’s appeal rights.​
• Right to a safe and appropriate discharge plan. A resident cannot be forced out until the facility identifies a safe, appropriate destination and ensures that required services are in place. Sending a resident to a homeless shelter or an ill-prepared family home is not lawful. Families can dispute unsafe or incomplete plans in writing.​
• Right to appeal the eviction. Residents can appeal any proposed discharge, triggering a hearing before a state hearing officer. Many appeals succeed because facilities frequently violate procedural rules and don’t disclose one of the six federally allowed reasons for an eviction.
• Right for protection from last-minute evictions. “24-hour notices” are almost always unlawful. Shortened notice periods are rare and must meet strict federal exceptions.​
• Right to dispute improper notices. Families can challenge defective or misleading notices. For example, when facilities confuse Medicare coverage termination with an actual eviction notice.​
• Right to return after hospitalization. If a nursing home refuses to readmit a resident after a hospital stay, families can request a state hearing to order the facility to take the resident back. Facilities cannot refuse readmission solely because the resident is considered “difficult” or because of an unpaid bill.​
• Right to advocacy support. Long-term care ombudsmen and legal aid organizations can help residents file appeals, document unsafe discharge plans and navigate state-specific procedures. Nursing homes should provide contact information for local ombudsman programs. To find your state legal aid organization for elder justice, contact the National Consumer Voice for Quality Long-Term Care.​