Nursing Homes Evicting Costly Residents

Nursing home evictions of frail and ill residents are rising, according to an article in the Wall Street Journal. The U.S. Administration on Aging reports that formal complaints of eviction practices have doubled over 10 years to 8,500 in 2006, and the practice of involuntary nursing home evictions may be far more prevalent because not all residents file complaints.

"Across the board, involuntary discharge numbers have risen in recent years," says Louise Ryan, Washington state's long-term-care ombudsman. "It's a real problem."

Most vulnerable to eviction are residents with dementia or demanding families, particularly if they are on Medicaid. Nursing facilities get as little as half from Medicaid beneficiaries as they can get from residents who pay out-of-pocket, with private health insurance or using Medicare's very short-term nursing home coverage.

Nursing homes may be breaking federal law in evicting residents they no longer wish to care for, but proving this can be a difficult and protracted process. The federal nursing home law permits residents to be discharged involuntarily for only six reasons: if they are healthy enough to go home; if they need care the nursing come cannot provide; if they endanger the health or safety of others; if they do not pay their bills; or if the nursing home closes.

Although nursing homes frequently list one of these six reasons for eviction, "advocates for the elderly say it can be a stretch," the Journal reports. The article states that although facilities "rarely roll evicted residents out to the curb," they often "transfer [residents] to another nursing home or send them to a hospital or psychiatric facility for treatment and observation and then refuse to take them back." Social workers sometimes refer to this process as "nursing-home dumps."

The American Health Care Association, a nursing home industry group, says it is unaware of widespread problems with evictions, especially ones focusing on Medicaid residents

In a sidebar article, the Journal points out that the strong protections that nursing home residents have -- at least on paper -- don't apply to residents of assisted-living facilities, where those who are "dependent on Medicaid are particularly vulnerable to eviction."