Families are reporting more surprise discharges from nursing homes — and many shouldn’t be happening. Federal law sets strict rules for when and how a facility can evict or transfer a resident. Knowing those rights can stop an unsafe move before it happens.
“Nursing homes cannot evict residents without following strict federal rules — 30 days’ notice, a valid reason, and a safe discharge plan,” AARP guidance notes. Advocates say caregivers who act quickly often succeed in keeping a loved one in place or securing a safe alternative.
What the law requires
Under the Nursing Home Reform Act of 1987 and federal regulations (42 CFR § 483.15), facilities generally must provide at least 30 days’ written notice for non-emergency discharges. The notice must state a specific, lawful reason — such as the resident’s needs can no longer be met, the resident endangers others, non-payment after due process, or facility closure — and include a safe, appropriate discharge plan.
Residents cannot be “dumped” to hospitals or left without services. Vague notices, retaliation after a complaint, or moves made without a documented care plan are red flags. In many states, filing an appeal pauses the discharge until the case is reviewed. Medicaid-covered residents also have added protections in some states, including bed-hold and return-rights after short hospital stays, and facilities cannot discriminate based on a change from Medicare to Medicaid.
How to respond — fast
If a discharge notice arrives, move quickly. Start with the administrator and the resident’s care team to clarify the facility’s claim and press for alternatives. At the same time, mobilize outside help — it’s free and can freeze the process while a review is pending.
- Check the notice: Is there a 30-day lead time? Is the reason specific and consistent with federal rules? Is a safe discharge plan included?
- Call the long-term care ombudsman: Every state has an ombudsman program that investigates complaints and advocates for residents at no cost.
- File an appeal with the state survey or health department: Appeals often suspend the discharge while the state reviews the case.
- Document everything: Keep copies of the notice, payment records, care plans, medical notes, and any communications.
- Ask for a care plan review: An independent or updated assessment can show the facility can, in fact, meet the resident’s needs.
- Get legal help: Legal aid groups and elder law programs, including those supported by AARP in many communities, assist families with appeals and, if needed, litigation.
Families have won reinstatement when facilities failed to follow notice rules or could not justify the move. In a widely cited California case, the AARP Foundation challenged a home’s decision to refuse a resident’s return after a brief hospital visit; the legal pressure helped cement protections against similar practices.
Why evictions are rising
Advocates link the trend to staffing shortages, higher operating costs, and payment disparities that reward short-stay rehab over long-term care. Medicare typically pays far more than Medicaid, creating pressure to favor higher-reimbursed residents. According to federal data cited by consumer groups, regulators log more than 15,000 complaints each year related to discharges and transfers, and investigators find a significant share don’t meet federal standards.
Transparency concerns also persist. A 2025 analysis from AARP’s New Jersey chapter flagged nearly $2 billion in payments from facilities to owners’ affiliated companies over a recent three-year period, including hundreds of millions in apparent overpayments — raising questions about whether public funds are reaching the bedside.
Industry analysts warn that delays in federal staffing mandates could intensify strain at understaffed homes, potentially fueling more evictions if oversight doesn’t keep pace. Consumer groups continue to push for higher Medicaid rates, stronger enforcement, and clearer bed-hold rules across states.
