# Nursing homes can't evict over unpaid bills during Medicaid wait

> Federal law protects residents with pending Medicaid applications from discharge notices, but most families don't know their rights.
- Title: Nursing homes can't evict over unpaid bills during Medicaid…
- Summary: Federal law protects residents with pending Medicaid applications from discharge notices, but most families don't know their rights. A pending Medicaid…
- Keywords: nursing homes, medicaid, patient rights, discharge notices, elder law, federal regulation, long-term care, nonpayment, medicaid application, ombudsman, Nursing, homes
- Source: 24/7 Wall St. — https://247wallst.com/personal-finance/2026/09/19/the-nursing-home-sent-dad-a-30-day-discharge-notice-for-nonpayment-while-his-medicaid-application-sat-federal-law-says-they-cant-most-families-dont-know-that
- Author: Gerelyn Terzo
- Published: 2026-09-19T12:30:20+00:00
- Read time: 2 min
- Topics: nursing homes, medicaid, patient rights, discharge notices, elder law, federal regulation, long-term care, nonpayment, medicaid application, ombudsman
## The discharge notice arrives
Dad's Medicare coverage ends after a hip fracture. His daughter files for Medicaid long-term care and gets a case number. Three weeks later, the nursing home sends a 30-day discharge notice for unpaid bills.
## Federal law says they can't
Federal regulation 42 CFR 483.15 lists only six lawful grounds for discharge. Nonpayment applies only when residents refuse to submit required paperwork or reject a denied claim. A pending Medicaid application doesn't qualify.
## Why Medicare and Medicaid matter
Medicare pays for short skilled nursing stays after hospitalization. Medicaid pays long-term custodial care once residents spend down assets. When Medicare ends and Medicaid is still processing, the facility faces a pending third-party claim, not a refusal to pay.
## CMS guidance protects applicants
CMS surveyor guidance tells facilities to help residents complete Medicaid paperwork, not punish them for state processing delays. If the application is submitted and requests are answered, the facility cannot blame the county's backlog on the family.
## Two boundaries still apply
Residents must still pay their required patient-pay amount from Social Security or pension. If Medicaid denies the application and the patient cannot pay, the home can discharge. The protection holds only while the claim is actually pending.
## What a valid notice requires
A proper discharge notice must arrive at least 30 days before discharge, state the specific reason and effective date, explain appeal rights, name the state hearing entity, and include the Long-Term Care Ombudsman's contact information. The facility must also send the ombudsman a copy.
## How to appeal the discharge
File a formal appeal with the state hearing entity named in the notice. The ombudsman can help gather records and connect families to legal aid but doesn't decide the case. Once an appeal is pending, the facility generally cannot discharge unless keeping the resident endangers health or safety.
## Build your documentation packet
Assemble the Medicaid application receipt, case number, all submitted forms, proof of responses to information requests, records of patient-pay amounts paid, and the discharge notice. Written confirmation from Medicaid that the application is pending is the most valuable page.
## Know what's illegal
The facility cannot require the daughter to use her own money or guarantee Dad's bill as a condition of staying. An emergency room visit cannot be used to discharge through the back door. If Dad remains eligible for Medicaid, the home must return him to his previous room or the next available bed.
## Key takeaway

A pending Medicaid application blocks nonpayment discharge. Families should document everything and appeal any improper notice to their state hearing office.