Yes, a nursing home can discharge you, but only under specific legal conditions
A nursing home cannot straightforward ask you to leave because they want to. Federal law sets strict rules about when a facility can discharge a resident, and those rules exist to protect you. A nursing home must have a documented medical or safety reason, must give you advance notice, and must help you find another place to live. The discharge must be in writing, and you have the right to object and request a hearing.
That said, the reasons a home can legally discharge you are broader than many people realize — and they include situations where the facility claims it cannot meet your care needs, not just situations where you have broken a rule. Understanding what those reasons are, and what your rights are when a discharge is proposed, can make the difference between a smooth transition and a crisis.
Key Takeaways
- A nursing home can discharge you only for medical reasons, safety concerns, non-payment, or if the facility is closing — not for arbitrary reasons or because you are difficult.
- The home must give you written notice at least 30 days in advance, except in emergencies, and must document the reason in your medical record.
- You have the right to object to a discharge and request a hearing before a state official, and the home cannot force you out while the hearing is pending.
- If you cannot pay and Medicaid is covering your care, the home cannot discharge you for non-payment unless they are closing or you have genuinely exhausted all payment sources.
- Your state's long-term care ombudsman can investigate complaints about wrongful discharge and help you fight an unfair decision.
The four legal reasons a nursing home can discharge you
Medical reasons are the most common. A nursing home can discharge you if your condition has improved enough that you no longer need skilled nursing care, or if your condition has worsened so much that the home cannot safely provide the level of care you need. For example, if you recover from a hip fracture and no longer need daily wound care or physical therapy, the home may discharge you. Conversely, if you develop a condition that requires 24-hour monitoring or specialized equipment the home does not have, they may discharge you on medical grounds.
Safety and conduct is the second reason. A nursing home can discharge you if your behavior poses a genuine threat to yourself or others — for instance, if you are violent toward staff or other residents, or if you refuse to follow safety rules in a way that endangers you. However, the home must document the specific incidents and show that less restrictive measures (like moving you to a different unit, changing your medication, or offering behavioral support) have been tried first.
Non-payment is the third. If you stop paying and have no source of payment — no Medicaid, no Medicare, no family support, no private insurance — the home can discharge you. However, if Medicaid is covering your care, the home cannot discharge you solely for non-payment of the portion Medicaid does not cover. Many residents think they will be thrown out if they run out of money; in fact, Medicaid is designed to prevent that.
Facility closure is the fourth. If the nursing home is closing permanently, it must discharge all residents, but it must give at least 60 days' notice and help each resident find a new placement.
What "cannot meet your care needs" really means
The phrase "we cannot meet your care needs" is the reason you will hear most often, and it is also the one most likely to be disputed. A nursing home is required to provide the level of care that is medically necessary and that is listed in your care plan. If your needs change — for example, if you develop severe dementia and become a flight risk, or if you need dialysis three times a week and the home has no dialysis unit — the home may argue it cannot safely care for you.
The catch is that the home must prove this claim. They cannot straightforward say your needs are too complex; they must show that they have assessed your condition, consulted with your doctor, and determined that the specific care you need is beyond their staff's training or the facility's resources. If you believe the home is using this reason as an excuse to get rid of you — perhaps because you are on Medicaid and they prefer private-pay residents — you can challenge the discharge and request a hearing.
The notice and hearing process
When a nursing home decides to discharge you, they must give you written notice. The notice must include the reason for discharge, the date it will take effect, and your right to object. In most cases, the notice period is 30 days. In an emergency — for example, if you are an when ready danger to others — the home can discharge you with less notice, but they must still provide written notice and must still allow you to request a hearing.
If you object to the discharge, you have the right to request a hearing before a state official (usually someone from your state's health department or long-term care licensing agency). You do not have to move out while the hearing is pending. At the hearing, you can present evidence that the discharge is not justified — for example, medical records showing your condition is stable, or testimony from your doctor that the home can meet your needs. The home must present evidence to support their reason for discharge.
The hearing officer will decide whether the discharge is legal. If the officer rules in your favor, you stay. If the officer rules against you, the discharge can proceed, but you will have had time to plan and find another place to live.
What to do if you receive a discharge notice
First, read the notice carefully and understand the stated reason. Ask the nursing home administrator or social worker to explain it in detail. Request a copy of the relevant sections of your medical record and care plan. If the reason is medical, ask for a written explanation from your doctor about why the home cannot meet your needs.
Second, contact your state's long-term care ombudsman when ready. The ombudsman is a free advocate whose job is to investigate complaints about nursing homes. They can review your case, talk to the home on your behalf, and help you understand whether the discharge is legal. Many wrongful discharges are stopped or delayed because the ombudsman intervenes. You can find your state ombudsman through the Eldercare Locator (1-800-677-1116) or online.
Third, if you want to fight the discharge, request a hearing in writing. The notice you received should tell you how to request one and the important date (usually 10 days). Keep a copy of your request. If you cannot write it yourself, ask a family member, the ombudsman, or a legal aid organization to help you.
Fourth, start planning for alternatives. Even if you win the hearing, you may eventually need to move. Talk to your family, your doctor, and the nursing home social worker about other options: another nursing home, assisted living, home care, or moving in with family. The more prepared you are, the less stressful the transition will be.
Medicaid and discharge: special protections
If Medicaid is paying for your nursing home care, you have extra legal protections. A nursing home that accepts Medicaid cannot discharge you because you have run out of private funds and are now on Medicaid. They also cannot discharge you for non-payment of any portion of your bill that Medicaid is supposed to cover. If a home tries to do this, it is breaking federal law.
However, if you have other sources of payment available — for example, a family member who could pay, or a veterans benefit you have not yet pursued — the home may argue that you have not truly exhausted your resources. If you are in this situation, document what you have done to find payment and keep records of any denials or barriers you have encountered.
When discharge is not legal
A nursing home cannot discharge you for discriminatory reasons — for example, because of your race, religion, disability, or source of payment (Medicaid versus private pay). They cannot discharge you because you are a difficult resident, complain frequently, or ask questions about your care. They cannot discharge you because your family is litigious or because you have filed a complaint with the state.
They also cannot discharge you as retaliation for reporting abuse, neglect, or violations of regulations to the state or to an ombudsman. If you believe you are being discharged for any of these reasons, tell the ombudsman and consider contacting a legal aid organization or an attorney who handles nursing home cases.
Frequently Asked Questions
Can a nursing home discharge me if I cannot afford to pay?
Not if Medicaid is covering your care. If you are on Medicaid, the home cannot discharge you for non-payment. If you are private-pay and have no other source of funds, the home can discharge you, but they must give 30 days' notice and help you find another place. Contact your state Medicaid office or ombudsman if you are unsure of your payment status.
What happens if I refuse to leave after my discharge date?
The nursing home can pursue eviction through the court system, but they cannot physically remove you or lock you out. This process takes time and gives you opportunity to find another placement or appeal the discharge. Contact your ombudsman or a legal aid attorney when ready if you reach this point.
Can the nursing home discharge me if my doctor says I should stay?
Your doctor's opinion matters, but it does not automatically stop a discharge. However, if your doctor has documented in your medical record that you need the care the home provides, that is strong evidence in your favor if you request a hearing. Bring your doctor's statement to the hearing.
How do I find my state's long-term care ombudsman?
Call the Eldercare Locator at 1-800-677-1116 and tell them you need the ombudsman in your state. You can also search online for "[your state] long-term care ombudsman." The service is free and confidential, and the ombudsman can investigate your complaint even if you are still living in the home.
What if the nursing home closes — do I have to leave?
Yes, but the home must give at least 60 days' notice and must help you find another facility. They cannot straightforward shut down and leave residents without a plan. If a home is closing and you are not being helped to relocate, contact your ombudsman and your state's health department when ready.