Being Evicted from the Nursing Home? Hunh?

[traumaRUs, MSN, APRN]

So...was reading this article and wondered what others are seeing in their corner of the US? My experience with NH in my area evicting my pts comes when they have prolonged hospital stay and then have trach/G-tube or require more care than the NH can provide.

I have had two young pts evicted after "bad behavior" ie, having/using drugs at NH, one was found in bed with an employee but thought these were isolated situations but maybe not...

Evictions from Nursing Homes on the Rise

Complaints about seniors and younger disabled adults being evicted from nursing homes was the top-reported problem about long-term care facilities in Ohio in 2015.

That's how it's been for years.

"It's a real problem because they're often the people who need the services the most," said Beverley Laubert, the state's long-term-care ombudsman. The concern is that facilities are increasingly getting rid of residents they view as too challenging or costly, she and others say.

No one tracks evictions specifically, but there were 805 complaints in Ohioabout involuntary discharges or transfers last year, the majority of which — 653 — involved nursing homes, Laubert said.

It's a troubling trend nationwide that is poised to get worse as the number of older adults grows, advocates say.

Discharge complaints are up about 57 percent since 2000, with 11,331 complaints logged with ombudsman across the country in 2014, according to an Associated Press analysis of federal data.

[RNBearColumbus, BSN]

I read that same article this morning. I can only recall 3 instances where a patient in a NH where I worked was transferred / discharged. All were cases where the facility could not care for the patient in their current condition. ( Ex: Exit seeking behavior but no locked unit in the facility, inappropriate sexual behavior etc.) I've never seen a patient evicted due to cost or complexity of care.

I also found it interesting that the one facility mentioned by name in the article has a (much) less than stellar reputation in our area. (I'm willing to bet that the patient that was discharged is now also receiving better care at the new facility. ) I wonder, if evictions / transfers are a way for troubled facilities to to free u space to improve case mix or have space for less complex patients that won't cause too many problems come state survey time.

[MisMatch, LPN]

I have worked at a county run, 300+ bed LTC facility for over 5 years and do not recall any resident ever being "evicted". The facility has a locked dementia unit and a respiratory unit to accommodate trachs/vents. Over the years, I have experienced and witnessed staff being intimidated, harassed and abused by alert & oriented residents who know they can do as they please without ramifications. Many residents are unable to control their behavior due to their disease process. Others are well aware that their behavior is inappropriate/abusive and equally aware that there are no consequences for their behavior other than an occasional "counseling" by management or a doctor. There are several residents who, IMHO, should be evicted but never will because as a county facility we are obligated to care for them. There is nowhere else for them to go.

[LadysSolo]

I know of two, one who had family/friends bringing in illegal drugs which the person was taking, and the other was after the police had to be called several times for the person threatening others (in neither case was the person asked to leave mentally challenged - both were "alert and oriented x 4.") In both cases the nursing homes had to ensure the safety of the other residents.

[purplegal]

I haven't actually seen any residents evicted so far. We often have some that take up a considerable amount of time, but they stay until they are discharged officially. No one has ever been sent away because they require too much care. We did have an instance where two residents were kissing each other, but they were moved into separate units, not evicted.

[lindseylpn]

I've seen 3 people evicted- 1 for selling drugs (crack) out of his room, 1 for continued destruction of property (he liked to shatter windows with chairs) and 1 who liked to start fights with staff and refused care from most of the nurses (he wasn't necessarily evicted, just highly encouraged to find himself an intensive rehab facility which is what he needed).

[downsouthlaff, LPN]

As an LPN in Long Term Care I have seen a few residents rightfully given a 30 day eviction notice and rightfully so. 1. Young resident, drug problem, selling drugs to other residents, threatening to stab nurses and doctors who didn't give pain meds when requested. And thank god that nursing homes have the right to do so. Think about your elderly mother in a nursing home. Her home Wich is supposed to be peaceful, is now subject to street like, drug seeking, violent behavior. Completely inappropriate. It is only my opinion and an opinion alone but young people who have drug problems and mental health problems should not be mixed in with sick and frail elderly in long term care. There are already licensee nursing homes who have dedicated there operation to those with psychiatric behaviors and aversive behaviors which are better staffed and equipped to house mental health residents long term with aggressive behaviors. There needs to be a push for more specialty pysch nursing homes. We must not imho allow vulnerable frail residents safety to be compromised by aggressive behavior of younger drug seekers/violent behavior/aggressive mental health disorders.

[CapeCodMermaid, RN]

There are some people we just can not take care of in nursing homes. I've been in the business for 25+ years and can count on one hand the number of residents sent out and not let back in. All of these were violent or very behavioral and put the rest of the residents and staff at serious risk. In Massachusetts we're supposed to take them back if they have MassHealth. The DPH can cite us if we don't but most good facilities and administrators would rather take a tag for not letting someone back in than risk an injury to another resident or staff.

Technically we can also issue a 30 day notice of discharge if they don't pay the bill. It might sound harsh but care isn't free.