Top Twenty Problems with Skilled Nursing Facilities (Part Four of Four)

At Weatherby & Associates, PC, we encourage our clients and their families to “be the squeaky wheel” and to never hesitate to advocate for patient rights for nursing home residents. That is one of the overall recommendations outlined in the 2005 Justice in Aging piece called “20 Common Nursing Home Problems—and How to Solve Them.” For more details on this report, visit This is the fourth and final blog on our site which will outline the top 20 problems they have identified.

#16 Refusal to Readmit from Hospital. After becoming a resident of a nursing home, there can be instances in which residents need to be re-hospitalized. State laws require that the nursing home hold a resident’s bed while they are away at the hospital for a certain amount of time (usually about two weeks). The bed hold time period is paid privately if the resident is paying privately, and covered by Medicaid if the resident is currently on Medicaid. Even if the bed hold time period has been exceeded, a Medicaid-eligible resident has the right to be re-admitted to the next available Medicaid-certified bed. This section of the Nursing Home Reform Law aims to protect continuity of care and avoid a resident being moved to a new nursing home.

#17 Excessive Charges. It is inappropriate for nursing homes to charge extra for items such as catheter supplies and incontinence products for residents covered by Medicare or Medicaid because the nursing home must accept payment from both as payment in full. A resident is only financially obligated to pay any deductibles and co-payments authorized by law. Notification of all separate charges should always be made in the initial admission agreement. A nursing home should thus limit their separate charges to the ones authorized by the admission agreement.

#18 Refusal to Support Resident and Family Councils. A nursing home is obligated to provide private meeting space to resident and family council groups. These councils can be great forums to discuss any issues or problems. They also designate one employee as a liaison. The nursing home employee should not run or control the meetings. The nursing home must consider and respond to any complaints or recommendations made by the groups.

#19 Eviction Threatened for being ‘Difficult.’ Nursing Home Reform Law clearly states six limited reasons for eviction and “being difficult” is not one of them. They include failure to pay, no longer needing nursing home-level care, needs are no longer being met, presence which endangers others’ safety, presence which endangers others’ health, and the nursing home itself going out of business. If a notice of eviction is given, it must list a phone number for a state agency which inspects and licenses nursing homes. Residents can always request an appeal of the eviction from this agency, in response to which a hearing is held. Many cases have revealed that the nursing home simply did not do adequate care planning and inappropriately tried to evict the resident when they became difficult.

#20 Eviction Threatened for Refusing Medical Treatment. Like all individuals, a nursing home resident has the right to refuse medical treatment. This reason alone is not grounds for eviction. One situation in which a resident might refuse treatment is if they are terminally ill and do not want to take steps to extend their life. It is important to note the reasons why refusal of treatment does not endanger others and why a higher level of care is not needed.

The report concludes with a word on being vocal. All residents of nursing homes are deserving of high-quality care. It is the responsibility of the residents and their advocates to demand to be heard. At Weatherby and Associates, PC we are advocates for our clients and we work hard to make sure our clients are finding ways to thrive in their current living environments. For more information on life care planning, call us at 860-769-6938.


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