Can a difficult/disruptive patient be forced to leave a nursing home against his or her wishes?

Legally, a nursing home resident cannot be moved unless he or she

  • endangers the safety or health of other individuals,
  • has medical needs that no longer can be met by the facility,
  • has recovered his or her health significantly so that care is no longer necessary,
  • has failed to pay for services, or
  • the facility closes.

There are other circumstances that result in the involuntary or abrupt moving of a resident, such as loss of certification by the facility or a strike by its staff. In these cases, special arrangements are usually made to transfer the residents to other housing accommodations.

If there is a planned transfer, the residents must be given 30-days written notice, which informs them of the reason(s) for the move, and the mechanism for challenging the proposed move. Hearing procedures differ from state to state, but the resident always has a right to appeal a decision to discharge him or her. During the appeal, the facts of the case will be reviewed.

There are circumstances where a nursing home can move a patient. For example, if the patient is loud, offensive, or violent to the other patients to an extent that this behavior disrupts the sleep, activities, or well-being of the other patients, the nursing home can claim that the patient is a danger to the others. The facility can also claim that it lacks the staffing or skill to deal with the patient’s personality difficulties, and so can no longer provide adequate care for the patient.

A nursing home is not allowed to use restraints unless absolutely necessary or to overmedicate a patient simply to quiet him or her. To do so could result in a lawsuit, so a nursing home may have little other recourse than to move an unusually difficult patient to a facility with adequate mental health services. On the other hand, a nursing home cannot move a patient just because of a personality conflict with nursing home staff or because the patient has asserted his or her rights.