It is a stressful moment for any family when a nursing home says their loved one must leave. This fear often grows when their Medicare coverage ends, and they need to switch to Medicaid. The answer, however, is clear: No, a nursing home in Rhode Island cannot legally evict a resident simply because they are transitioning from private pay or…
The post Can a nursing home evict a resident for using Medicaid? first appeared on Kiernan, Plunkett & Redihan.
It is a stressful moment for any family when a nursing home says their loved one must leave. This fear often grows when their Medicare coverage ends, and they need to switch to Medicaid.
The answer, however, is clear: No, a nursing home in Rhode Island cannot legally evict a resident simply because they are transitioning from private pay or Medicare to Medicaid, as long as the facility is certified to accept Medicaid payments.
Why a facility cannot discharge a resident for a Medicaid switch
Under federal law (42 C.F.R. § 483.15(c)), a nursing facility may only discharge a resident for six specific, legally defined reasons:
The facility cannot meet the resident’s needs.
The resident’s health has improved to the point they no longer need the facility’s care.
The resident’s presence endangers the safety of others in the facility.
The resident’s presence creates a health hazard for other individuals.
The resident has failed to pay for their care.
The facility is closing.
When a nursing facility chooses to certify for Medicaid, it agrees to accept Medicaid’s payment rate for its residents. This means they cannot remove a resident who has lived there under private pay just because that person now qualifies for and requires Medicaid assistance.
What must the nursing home do before a discharge?
Even if a nursing home has a legal reason for a discharge, it must follow strict rules. The facility must provide you with a written notice, typically 30 days in advance. This document has to include:
The specific reason for the proposed discharge
The effective date of the discharge
Information on how you can appeal the decision
Contact information for the Rhode Island State Long-Term Care Ombudsman, an advocate for residents
The facility must also create a safe and orderly discharge plan to ensure your loved one moves to an appropriate setting.
Proactively managing the payment transition
To prevent any conflict, communicate early and often with the nursing home’s business office about the upcoming switch to Medicaid. Cooperate with them to ensure the Medicaid application is completed accurately and submitted on time.
Taking these steps can help ensure a smooth transition and protect your loved one’s right to remain in their home. If you face resistance or receive a notice of discharge, you may want to consider speaking with an elder law attorney to understand your options.The post Can a nursing home evict a resident for using Medicaid? first appeared on Kiernan, Plunkett & Redihan.
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