Can A Nursing Home Evict A Patient Or Resident Legally?

Yes, a nursing home can legally remove a resident, but only when the discharge complies with federal CMS rules and any applicable state statutes. The facility must give the resident or their representative a written notice as soon as practicable - often around 30 days, but the law allows immediate action for emergencies or safety hazards.

Acceptable reasons include the resident's own request, the home's inability to provide the required level of care, a documented health or safety risk, nonpayment of services, an imminent closure, or a court‑ordered transfer; states may add further safeguards. If the notice feels improper, the resident may request a review from the state health department or the long‑term‑care ombudsman program before any final eviction takes place. (See CMS discharge regulations for details).

• Non‑payment of services - After a written 30‑day notice, the nursing home may evict a resident who refuses or cannot pay for care. (We noted this earlier in 'can your nursing home legally evict you?')
• Resident's request to leave - When a resident or their legally‑authorized representative asks for discharge, the facility can honor that request promptly.
• Loss of skilled‑care need - If a resident no longer requires the level of medical or nursing support the facility provides, eviction is permissible.
• Threat to safety or health - Eviction is allowed when a resident's actions endanger staff, other residents, or the facility's health‑code compliance.
• Inability to provide appropriate care - When the nursing home lacks the staff, space, or resources to meet a resident's care needs, discharge may occur.
• Serious violation of facility rules - Persistent disregard for reasonable policies - such as repeated fire‑code breaches - justifies eviction.

All six reasons align with the federal baseline outlined in CMS regulation on nursing‑home discharge; state statutes may add or modify criteria.

Identify the red flags that indicate a nursing home is trying to evict a resident without legal authority.

Illegal attempts usually ignore state notice requirements, cite prohibited reasons, or rely on intimidation rather than documented policy (as we covered above).

• No written notice, or notice period shorter than the length mandated by the resident's state law
• Reason given falls outside the limited grounds allowed in that state, such as 'behavioral issues' when the law only permits non‑payment or safety hazards
• Staff pressure the resident or family to sign a discharge form on the spot, often under threat of loss of services
• Sudden 'transfer' order appears without a documented care‑plan review or family consent
• Unexplained fees or demands for additional payments that are not part of the original contract
• Retaliatory actions after a complaint, like reduced meal quality or restricted visitation
• Lack of a formal hearing opportunity, despite state statutes requiring an administrative review

For detailed state‑specific standards, see state nursing home eviction guidelines.

The nursing home must hand over a written 30‑day eviction notice that clearly states the specific reason for discharge. Federal OBRA rules (42 CFR §483.15) require the notice to list one of the federally mandated grounds - non‑payment, resident welfare concerns, inability to provide adequate care, facility closure, or similar state‑approved reasons.

1. Request the notice in writing.
   Send a certified letter to the administrator demanding the full 30‑day notice, referencing the OBRA requirement and the resident's right to a detailed explanation.
2. Cross‑check the cited reason.
   Compare the stated cause with the five core grounds listed in the federal regulation; any deviation signals a non‑compliant eviction.
3. Escalate to the state regulator if the notice is absent or vague.
   File a complaint with the state health department or the long‑term‑care ombudsman, attaching the resident's medical records and the administrator's response.
4. Insist on a corrected notice within a reasonable period.
   Demand a revised, compliant notice within five business days; failure to comply opens the path to a formal grievance, mediation, or civil action.

These steps turn a shaky eviction attempt into a documented demand for the legally required 30‑day notice, setting the stage for the appeal process covered in the next section.

File a civil‑court complaint the moment the eviction notice arrives. Gather the written notice period - often 3 to 30 days depending on state law - along with the resident's contract and any medical records that show the eviction lacks a legal basis. Submit the complaint within that same window; missing the deadline usually forfeits the right to a judicial review.

Request a temporary restraining order or a stay of eviction so the resident remains in the facility while the case proceeds. The court, not a health department, decides whether the eviction complies with state statutes and federal nursing‑home regulations.

If the resident's family prefers an administrative route, they may lodge a grievance with the state licensing agency or the nursing home ombudsman. These bodies can investigate the facility's practices and may provide supporting documentation for the court filing, but they lack authority to halt the eviction themselves. Medicaid or Medicare fair‑hearing petitions address payment disputes, not the legality of a removal, so they do not replace a civil‑court challenge. (For a state‑specific ombudsman directory, see National Ombudsman Program.)

Immediate action matters more than panic when a nursing home serves a non‑payment eviction notice. Federal law, via the Nursing Home Reform Act, obliges facilities to give written notice and explore payment alternatives before eviction. State statutes dictate the exact countdown - typically between 10 and 30 days - so checking local rules prevents surprise deadlines.

• Verify the notice's compliance with both federal guidelines and the resident's state; consult the state long‑term care ombudsman for exact timelines.
• Request a detailed account of the outstanding balance; errors are common and can halt the process.
• Promptly present documented proof of any payment already made or insurance coverage that should apply.
• Propose a realistic repayment schedule; many facilities accept a written plan that pauses eviction while they review it.
• Insist on a meeting with the social services director to discuss financial assistance programs, Medicaid waivers, or charitable grants that the home may administer.
• Keep a complete, dated file of all correspondence, receipts, and meeting notes; this record becomes critical if the case escalates to mediation or court.

A calm, documented approach buys time and often convinces the nursing home to reconsider, setting the stage for the next challenge - understanding transfer options when a facility closes down.

When a nursing home announces closure, it must issue a written closure notice - not an eviction notice - at least 30 days before the shutdown per federal CMS rules (CMS closure notice requirements); many states extend this period to 60 or 90 days. The notice must state the closure date, explain the reason, and outline a transfer plan that safeguards each resident's health and rights. Facilities coordinate with state agencies, but they cannot simply kick residents out; they are obligated to arrange safe relocation.

For example, a resident in California receives a 60‑day notice; the state ombudsman evaluates care needs, presents three licensed alternatives, and the family picks the one with an available skilled‑nursing unit. The original home transfers medical records, medications, and escorts the resident to the new site.

In Texas, a 30‑day notice triggers Medicaid verification, after which the long‑term‑care agency matches the resident with a nearby vacancy; the closing home handles transport and ensures continuity of care. If no suitable opening exists, the resident may stay temporarily while the state secures placement, and the closing facility covers any extra costs.

A nursing home may only evict a resident after a hospital discharge if the resident no longer meets the facility's level‑of‑care criteria or creates a safety risk. Federal law mandates a 30‑day written notice that names the specific reason, and the notice must arrive before the discharge date (federal Nursing Home Reform Act).

Request the facility's written justification, then file a grievance with the state ombudsman within the 30‑day window. If the reason appears pretextual, an attorney can seek a temporary restraining order to halt the move while the dispute is reviewed. Keep copies of every letter and phone log; they become evidence in any hearing.

Finally, explore alternative placement options and consult an elder‑law attorney to protect rights under both federal and state statutes. As we'll see in the following section on protecting dementia‑prone loved ones, early legal involvement often prevents forced transfers.

Residents with dementia cannot be expelled simply because they forget to pay or need extra assistance; federal law and most state statutes require a documented, individualized care plan before any discharge. The nursing home must give a written 30‑day notice that explains the clinical reason, outlines alternative placements, and shows that the move serves the resident's health and safety, not the facility's convenience (as we covered above). If the notice lacks these elements, the facility must seek a court order or state licensing board approval before proceeding.

Family members should request the resident's current assessment, verify that the care plan addresses cognitive decline, and file an immediate grievance with the provider's ombudsman. Asking the state health department to review the discharge ensures compliance with both federal baseline and state‑specific protections, which often forbid removal of a dementia‑prone resident without a qualified substitute‑level care arrangement.

In states that codify nursing‑home eviction, the law spells out a written notice timeframe - often 30 days, though some statutes require 7 or 60 days - and enumerates specific grounds such as unpaid fees, unsafe behavior, or non‑compliance with the resident's care plan (as we covered above). The facility must deliver the notice, grant a reasonable appeal period, and, when the resident contests the move, secure a court order before proceeding.

In states without a dedicated nursing‑home code, regulators or courts drive the process. A health‑department order can mandate discharge for safety or health reasons with only a few days' warning, and the facility must retain documentation of the justification while arranging an alternative placement. Uniform notice periods simply do not exist in these jurisdictions; compliance hinges on local administrative rulings state health‑department guidelines on resident removal.

Here's a recent case where a family stopped an unlawful nursing‑home eviction and kept their loved one in place.

The resident, Mrs. Alvarez, received a 30‑day notice citing 'failure to meet care needs.' Her son questioned the claim, noting that the facility's own assessment confirmed all required services were provided. He filed a grievance, then escalated to the state's health department and a senior‑rights ombudsman. The investigation revealed:

• the notice lacked specific deficiencies required by state law,
• the facility failed to offer an alternative placement despite the resident's inability to leave,
• the alleged grounds fell outside the handful of permissible reasons most states recognize (typically five to seven, such as non‑payment, safety hazards, or unmet medical needs).

The ombudsman ordered the home to withdraw the notice, and the court issued a temporary restraining order preserving the resident's placement while the case proceeded. Ultimately, the facility settled, paying costs and agreeing to a care‑plan review.

This outcome shows that challenging an eviction early, invoking the 30‑day notice requirement, and documenting the facility's gaps can force a reversal, as illustrated in the detailed case study.