The call often comes at a bad time. Your parent is in the hospital after a fall, and the nursing home says it won't take them back. Or a letter arrives saying your mother must leave in 30 days because of unpaid bills while her Medicaid application is still pending. Or staff hint that your father's behavior is "too much" and suggest you find another place.
Families often assume a nursing home can ask anyone to leave, the way a landlord can end a lease. For homes certified by Medicare or Medicaid, that isn't true. Federal rules strictly limit when a home can make a resident leave and set out a process the home must follow1. This guide focuses on nursing home eviction: the notice, the appeal and the common situations behind it. For the full list of residents' rights, see our companion guide to nursing home residents' rights.
Can you be evicted from a nursing home?
Yes, but only in limited situations. Federal law calls an eviction a facility-initiated transfer or discharge. A certified home must let each resident stay unless one of these applies1:
- The home can't meet the resident's needs. The move is necessary for the resident's welfare, and the facility can't meet those needs.
- The resident's health has improved. The resident no longer needs the services the facility provides.
- Safety is endangered. The resident's clinical or behavioral status endangers the safety of people in the facility.
- Health is endangered. The health of people in the facility would otherwise be endangered.
- Nonpayment. After reasonable notice, the resident has failed to pay, or to have Medicare or Medicaid pay, for the stay.
- The facility is closing. The home is ceasing to operate.
The reason must be documented in your parent's medical record. When the home says it can't meet your parent's needs, the record must explain which needs, what the home tried and what the new place offers. A physician must document the reason in the needs, health-improved, safety and health cases1.
What a nursing home eviction notice must include
Before a transfer or discharge, the home must notify the resident and their representative in writing, in a language and manner they understand, and send a copy to the State Long-Term Care Ombudsman1. The notice must include:
- The reason for the discharge. It should match one of the six reasons the law allows.
- The effective date. The day the home plans to move your parent.
- The location where your parent will go. A vague answer like "home" or "a shelter" is a red flag.
- Appeal rights. Including who receives appeal requests, their contact information and how to get an appeal form and help completing it.
- Ombudsman contact information. Name, mailing and email address and phone number of the State Long-Term Care Ombudsman.
- Advocacy agency contacts. For residents with developmental disabilities or mental disorders, contact information for the protection and advocacy agency1.
The 30-day rule and its exceptions
The notice generally must be given at least 30 days before the move. It may be given as soon as practicable instead when safety or health of others is endangered, when the resident's health has improved enough for a quicker move, when urgent medical needs require it, or when the resident has lived there less than 30 days1. If the plan changes, the home must update the notice.
Keep the notice, the envelope and any related papers. Write down who delivered it and when.
How to appeal a nursing home eviction
Every state must provide a hearing and appeal system for residents who are being transferred or discharged2. The notice tells you where to send the request.
- Read the deadline. Appeal windows are short. File as soon as you can, ideally within days.
- File the appeal. Use the form or address in the notice. Ask the facility or ombudsman for help completing it if needed.
- Call the ombudsman. Ombudsman programs advocate for residents and can help you prepare. Find yours through the National Consumer Voice3. See what a long-term care ombudsman does.
- Request records. Ask for your parent's medical record, care plan and the documentation behind the discharge.
- Gather evidence. Notes from care plan meetings, letters from doctors, payment records and Medicaid paperwork can all matter.
- Get legal help. Legal aid offices and elder law attorneys handle discharge appeals. The Eldercare Locator can connect you to local services5.
Your parent can usually stay during the appeal
When a resident appeals, the facility may not transfer or discharge them while the appeal is pending, unless failing to do so would endanger the health or safety of the resident or others, and the facility must document that danger16. This is one of the most important protections families have, so don't delay filing.
What to put in an appeal request
Your state's form may ask for specific details, but most appeal requests cover the same points. Keep it short and factual:
- Who is appealing. Your parent's name, the facility's name and address, and your name and relationship if you are the representative.
- What you are appealing. Say that you are appealing the transfer or discharge notice, and give the date of the notice and the planned discharge date.
- Why you disagree. For example, that the home has not shown it tried to meet your parent's needs, that the planned location is unsafe, or that a Medicaid application is pending.
- A request to stay. State that your parent wishes to remain in the facility while the appeal is decided.
- Contact details. How the hearing office can reach you.
Send it the way the notice directs, keep a copy and get proof that it was received, such as a fax confirmation, an email reply or certified mail receipt. Then tell the facility in writing that you have appealed.
When the home won't take your parent back after a hospital stay
One of the most common eviction tactics is refusing readmission after a hospitalization. Federal rules address this directly1:
- Bed-hold notice. Before and at the time of a hospital transfer, the home must give written information about the state bed-hold policy and its own policy on returning.
- Right to return. If the hospital stay goes past the bed-hold period, a resident who still needs the home's services and is eligible for Medicare or Medicaid nursing facility coverage must be allowed back to the previous room if available, or to the first available semi-private bed.
- Same rules apply. If the home decides a resident sent to the hospital with an expectation of returning can't come back, it must follow all the discharge rules, including written notice and appeal rights.
If this happens, tell the hospital discharge planner right away, and contact the ombudsman. Don't sign anything agreeing to a new placement before you understand your options. Our guide to hospital discharge planning explains how to work with the hospital team.
Nonpayment and Medicaid-pending evictions
Nonpayment is a lawful reason only after reasonable notice. It applies when the resident doesn't submit paperwork for third-party payment, or when Medicare or Medicaid denies the claim and the resident refuses to pay1. For a resident who becomes eligible for Medicaid after admission, the home may charge only what Medicaid allows1.
If a Medicaid application is pending, stay in close contact with the caseworker, respond to every request quickly and give the home proof the application is moving. Federal rules also bar homes from requiring a family member to personally guarantee payment as a condition of admission or continued stay1. See the Medicaid spend-down and Medicare vs. Medicaid for long-term care.
Evictions over behavior or care needs
Homes sometimes cite a resident's behavior, often from dementia, as a safety risk. Under federal rules, the facility must document the specific danger and, where it says it can't meet needs, what it tried1. Ask what interventions the home used and whether the care plan was updated. CMS guidance says refusing treatment alone isn't a basis for discharge unless the federal criteria are met4.
Request a care plan meeting to discuss alternatives. Our guides to care plan meetings and dementia anger and aggression can help you prepare.
When the nursing home is closing
If a facility is closing, the administrator must give written notice in advance to the state survey agency, the ombudsman, residents and their representatives, along with a plan for transferring and relocating residents1. The home must also prepare and orient residents for a safe, orderly move1. Use the time to tour alternatives. See how to choose a nursing home.
Assisted living evictions are different
These federal protections apply to nursing homes certified by Medicare or Medicaid. Assisted living is regulated by states, so eviction rules depend on state law and the residency contract. Read the contract's discharge section, and ask the state licensing agency or the ombudsman, who also serves assisted living residents in most states, about your rights. Our guide to assisted living vs. nursing homes explains other differences.
