When a patient is discharged from a nursing home or other care facility, it is typically because they have been fully treated for their medical condition and they can go home, or they need additional care and need to be transferred to another healthcare facility. However, sometimes wrongful discharge can apply.
In California, it’s common for nursing homes to pressure residents into leaving before they are ready, sometimes through misrepresentation or withholding critical information. However, residents have the right to receive necessary care and must understand their rights to prevent an unfair discharge.
One of the most frequent forms of eviction occurs when a resident’s Medicare coverage ends. Nursing homes often prioritize short-term Medicare patients because Medicare pays higher rates for the first 100 days of coverage. When coverage ends, many facilities attempt to discharge residents, but this practice is illegal.
Residents are not required to leave simply because their Medicare coverage ends. They have the right to appeal Medicare’s decision and remain in the facility while the appeal is pending. Facilities must provide a “Notice of Medicare Non-Coverage,” but this is not a discharge notice. If a resident loses their appeal, they must arrange an alternative payment method, such as private pay, Medi-Cal, or long-term care insurance.
Nursing homes often claim they only have short-term or rehab-only beds, but no such legal classification exists. If a facility is licensed as a skilled nursing home in California, it must offer long-term care. Similarly, some facilities falsely state they have no Medi-Cal beds available. If a facility accepts Medi-Cal, all its beds must be available for Medi-Cal residents.
These are some of the legal rights that Californians have when it comes to nursing home wrongful discharge and understanding these rights empowers residents to challenge wrongful discharge and secure the care they need.
What Can I Do?
If your loved one has been wrongfully discharged from a care facility in California, your best options are to keep detailed records of all communications, advocate for your loved one’s rights, and push back against unfair discharges. You should also work with professionals, such as ombudsmen, attorneys, and social workers, to fight for the best outcome. Here are some other things you can do to protect your loved one’s rights and ensure they continue to get the medical care they need:
Review the discharge notice. California law requires that skilled nursing facilities and residential care facilities for the elderly provide written notice before discharging or transferring a resident. The notice must include the reason for discharge, the proposed discharge date, information on how to appeal the decision, and contact information for the local ombudsman program. The notice should be given at least 30 days in advance, unless the discharge is due to an emergency, such as medical needs the facility cannot handle. Review the notice carefully and verify whether the stated reason is lawful.
Understand legal protections. Under California state law as well as federal law under the Nursing Home Reform Act of 1987, residents can only be discharged for the following reasons:
The facility is closing.
The resident’s health has improved and no longer requires care.
The resident’s needs cannot be met by the facility.
The resident poses a danger to others.
The resident has not paid (after reasonable notice).
If the discharge does not meet these conditions, it may be illegal. Facilities cannot discharge residents in retaliation for complaints or because they require a high level of care.
File an appeal. Residents have the right to appeal a discharge decision through the California Department of Health Care Services (DHCS) or the California Department of Social Services (DSS) for assisted living facilities. Steps include:
File a formal appeal immediately (instructions should be on the discharge notice).
Request a hearing with the Office of Administrative Hearings and Appeals (for skilled nursing facilities).
Stay in the facility during the appeal (unless the discharge is due to an emergency).
California law allows residents to remain in the facility while the appeal is pending, so it is critical to file quickly.
Contact a long-term care ombudsman. Ombudsmen are state-appointed advocates who help protect the rights of long-term care residents. In California, the Long-Term Care Ombudsman Program can:
Investigate wrongful discharges
Mediate disputes between the resident and the facility
Assist in filing complaints with regulatory agencies
You can contact the California State Long-Term Care Ombudsman at 1-800-231-4024 for assistance.
Seek legal advice. An elder law attorney or an advocate specializing in patient rights can:
Assess whether the discharge violates state or federal laws.
Represent the resident in appeals or lawsuits.
Demand the facility reinstate the resident if the discharge was unlawful.
Legal aid organizations like California Advocates for Nursing Home Reform (CANHR) offer free or low-cost legal assistance. You can reach them at 1-800-474-1116.
Secure immediate care. If your loved one has already been discharged:
Contact Adult Protective Services (APS) at 1-833-401-0832 if they are at risk of harm.
Work with a social worker to find temporary care in another facility.
Consider filing an emergency appeal to have them reinstated while the dispute is resolved.
Report the facility. If the discharge was illegal, retaliatory, or unsafe, report the facility to:
California Department of Public Health (CDPH) (for skilled nursing facilities) at 1-800-236-9747.
California Department of Social Services (DSS) (for assisted living and residential care).
Centers for Medicare & Medicaid Services (CMS) if the facility receives federal funding.
State inspectors can investigate and issue fines or revoke the facility’s license if violations are found.
Contact Newman Law Group Today
It is illegal for a nursing home or similar facility to wrongfully discharge a patient. Even if their health insurance is denied, they have legal rights.
Wrongful discharge is considered elder abuse. Fight back with help from a Sacramento elder abuse attorney from Newman Law Group, LLP. We can help you fight for the treatment your elderly loved one needs, as well as the compensation they deserve for their mistreatment. Schedule a consultation today by filling out the online form or calling our office at (916) 352-3181.
