Columbus, Ohio — She arrived at the homeless shelter on a walker, incontinent, carrying a large bag of medications she wasn’t sure how to manage. She was diabetic. She had a tibia fracture. She had dementia tied to years of alcohol use. And according to federal inspectors, she had no idea how she’d gotten there.
That woman — identified only as Resident #83 in a CMS inspection report — had been a patient at Eastland Rehabilitation and Nursing Center in Columbus when staff decided to discharge her involuntarily after she was caught drinking beer on the premises. When no substance use treatment beds were immediately available, the facility took her to a homeless shelter instead. About 100 people were ahead of her on the waiting list. The shelter initially turned her away, leaving her outside in the late-summer heat.
Neither Eastland staff nor federal inspectors were ever able to locate her afterward.
Seven Facilities. A Growing Pattern.
A new investigative report published Monday by industry sources found that CMS has cited at least seven nursing homes in the state over the past few years for attempting to — or successfully — discharge medically fragile residents to homeless shelters, often in violation of federal law.
The findings aren’t limited to fringe cases. They reflect a pattern emerging across multiple states, as nursing homes facing tighter Medicaid payments, rising acuity and insurer disputes increasingly offload their most difficult-to-place residents through improper discharges.
“We are starting to deal with it more and more,” said Chip Wilkins, who leads the Long Term Care Ombudsman program in Dayton. “The facilities are so closely monitored on discharges, but yet they still try and send them to hospitals and not take them back. Or drop them off at homeless shelters.”
Federal law requires nursing homes to give residents at least 30 days’ notice before an involuntary discharge — except in health and safety emergencies. In several of the Ohio cases, that requirement was ignored.
22 Years. Then Gone.
One case stands out. At Laurels of Hillsboro, a man who had lived at the facility for 22 years was discharged to an emergency shelter after his insurance stopped covering his care. He was diabetic with glaucoma, cataracts and suspected autism. According to a December 2025 federal inspection, staff told him he was being moved to an assisted living apartment — not a 90-day emergency shelter. He arrived without the needles he needed, with no prescriptions, no appointments and no identification documents.
“I can’t believe they would do someone dirty like that,” his former roommate told federal inspectors.
The facility’s corporate owner, which operates 83 other long-term care facilities across multiple states, didn’t respond to requests for comment.
Shelters Aren’t Equipped for This
The homeless shelter system, advocates say, was never designed to handle medically complex patients who can’t climb to a top bunk, may take 10 to 20 medications daily and rely on walkers or wheelchairs.
“Invariably, that ends up being a horrible experience for the individual,” Wilkins said. “They’ll go to the shelter, and typically within two to three days, the shelter will send them to the hospital because they can’t meet their needs.”
A representative from Ohio’s Coalition on Homelessness and Housing said shelters are often the last line of defense — but they’re not built for it. “The emergency shelter system is often the only thing available when other interventions don’t work,” he said.
The CEO of the Ohio Health Care Association said the issue has been “growing as more residents face unstable housing” and called for state oversight and collaborative solutions — acknowledging that no single nursing home can manage it alone.
Ohio’s statewide ombudsman, Leilani Pelletier, noted that roughly 13,000 Ohioans are discharged from nursing homes every month. The vast majority of those are appropriate. But she was clear about what the law requires.
“The real issue is when people are discharged to a homeless shelter and there’s been no work or investigation done on if that would be a safe or appropriate discharge,” she said.
As Medicaid funding faces mounting pressure from federal budget negotiations, advocates worry the numbers will only go up.
