Can a Nursing Home Kick You Out for Non-Payment?

Yes, non-payment is a legally recognized basis for discharge under both federal Nursing Home Reform Act rules and New York regulations. However, the facility must provide at least 30 days written notice, state the specific reason, inform the resident of their right to appeal, and give information about alternative placements. A discharge without following these steps is improper and potentially illegal.

Under 10 NYCRR Part 415 and federal law (42 CFR §483.15), a New York nursing home must deliver written discharge notice at least 30 days in advance. The notice must include the reason for discharge, the effective date, the location the resident is being transferred to, and a clear explanation of the resident's right to appeal through the NY Office of the Medicaid Inspector General or the Department of Health. In urgent safety situations the timeline may be shorter, but non-payment alone is never considered an emergency.

NY Public Health Law §2801-d gives nursing home residents a private right of action against any facility that deprives them of a right or benefit established under state or federal law, including the right to be free from improper discharge. A resident or their family may file a civil lawsuit for compensatory damages, plus up to 25% in additional damages if the deprivation was willful or in reckless disregard of the resident's rights. Residents can also file a complaint with the NY Department of Health.

Nursing homes that accept Medicaid are generally prohibited from discharging a resident solely because they have applied for Medicaid or are in the process of a Medicaid eligibility determination. A facility cannot use a gap in Medicaid payment caused by a pending application as grounds for discharge while the application is being processed. Once Medicaid is approved it is retroactive, and the facility must accept that payment. Improperly discharging a Medicaid applicant may violate both state and federal law.