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Nursing facility residents deserve the best of care, but for far too long they have been neglected by both facilities and government inspection agencies. Justice in Aging works at multiple levels to improve the lives of facility residents. At the federal level, Justice in Aging advocates in Congress for improvements to federal law, while also pushing the Centers for Medicare and Medicaid Services (CMS) to improve regulatory standards and inspection procedures. Also, through written guides, public presentations, and webinars, Justice in Aging educates both professionals and consumers on how to advocate for both individual facility residents and broader systemic improvements. In all these ways, Justice in Aging serves as an important national voice for older Americans living in nursing facilities.
Hundreds of thousands of persons — both consumers and professionals — have used this guide to advocate for better care. For each of 25 recurring problems, this guide identifies facility falsehoods, explains relevant law, and offers step-by-step instructions for protecting resident rights and securing better care.
Improper evictions are a long-standing problem in nursing facilities across the country. Federal law allows eviction only for six narrow reasons, but facilities often evict residents for various invalid reasons, including being “difficult,” needing one-on-one attention, switching from Medicare to Medicaid payment, and not complying with treatment plans. Advocates and consumers can use the materials in the toolkit below to fight back.
Learn about the six valid reasons for evictions and get a basic introduction to fighting illegal evictions in this short fact sheet, The Basics of Nursing Home Evictions.
Below are summaries of seven common types of evictions, ways to recognize them, and tips for fighting them. Suitable for use by legal services offices and ombudsman programs.
Challenging a Nursing Home Eviction: Facility Claims That the Resident Has Refused Health Care
Challenging a Nursing Home Eviction: Nursing Home Claims That Resident Has Broken Facility Rules
Challenging a Nursing Home Eviction: Facility Claims That Resident Is Endangering Others
Below advocates can access, download, and adapt five sample briefs developed by Justice in Aging for defending residents at eviction hearings.
Facility Alleges Nonpayment for Charges Incurred Prior to Resident’s Medicaid Coverage
Facility Bases Transfer/Discharge on Supposedly Endangering Safety of Others
Facility Bases Transfer/Discharge on Supposed Need for Higher Level of Care
Facility Alleges Nonpayment While Resident’s Medicaid Application is Pending
Facility Bases Transfer/Discharge on Resident’s Refusal of Treatment
One common way that nursing facilities evict residents is by refusing to allow them to return after hospitalization. Below are three sample complaints for seeking injunctive relief that advocates can download and adapt.
Kentucky Sample: Complaint When Seeking Injunctive Relief to Allow Nursing Facility Resident to Return to Facility from Hospital (Can be adapted for use in states other than Kentucky.)
New Mexico Sample: Application for Immediate Injunctive Relief to Allow Nursing Facility Resident to Return to Facility from Hospital (Can be adapted for use in any state that uses a four-part injunctive relief test similar to the test used in New Mexico.)
Kansas Sample: Application for Immediate Injunctive Relief to Allow Nursing Facility Resident to Return to Facility from Hospital (Can be adapted for use in any state that uses a five-part injunctive relief test similar to the test used in Kansas.)
In February 2022, President Biden announced a set of reforms to nursing facilities to improve the safety and quality of nursing home care. Justice in Aging will be working to inform the implementation of those reforms.
Issue Brief: Improving Care Compare Website to Empower Consumers, November 2022
Issue Brief: Racial Disparities in Nursing Facilities—and How to Address Them, September 2022
Issue Brief: Understanding CMS’s New Nursing Facility Guidance, July 5, 2022
Justice in Aging Comments on CMS Request for Information on Minimum Staffing Levels in Nursing Facilities, June 10, 2022
With nearly half of all COVID-19 deaths tied to nursing facilities, Justice in Aging has engaged in aggressive advocacy aimed at keeping residents safe by pushing policymakers to institute and enforce strong consumer protections.
Imbalanced Commission Report Does Not Do Enough to Make Nursing Homes Responsible for Resident Safety and Quality of Life, September, 2020
Statement to the House Select Subcommittee on the Coronavirus Crisis in Nursing Facilities, June, 2020
Letter to CMS re Ongoing Problems in Response to COVID-19 Emergency in Nursing Facilities, June, 2020
Letter to Senate Leadership Opposing Immunity for Nursing Homes During COVID-19, May, 2020
Statement Calling on CMS to Publish Guidance on Transparency for Nursing Facilities, April, 2020
Hurricanes, wildfires, and now COVID-19 have all hit nursing home residents hard, shining a spotlight on the inadequacy of disaster planning in most nursing facilities. After twelve people died in Florida after the air conditioning failed in their nursing home and photos of nursing home residents in Texas sitting in several feet of water awaiting rescue shocked the nation, we released an issue brief offering seven recommendations for federal state and local governments to ensure the safety of nursing home residents in emergency situations. Those are still relevant today as COVID-19 has shown that threats to nursing home residents remain serious.
Issue Brief: Why Many Nursing Facilities Are Not Ready For Emergency Situations, September, 2017
In September 2016, the federal Centers for Medicare & Medicaid Services (CMS) issued revised nursing home regulations that had been thoughtfully developed over four years to promote residents’ health and safety. Now, however, under the current administration, CMS is backtracking and weakening resident protections.
Starting in January 2017, nursing home lobbyists began urging CMS to eliminate or delay enforcement of some of the revised regulations, and to significantly reduce penalties imposed when a nursing home violates the law. Disturbingly, CMS too often has followed the lobbyists’ recommendations.
Protections have been weakened since January 2017, and, the current administration’s actions suggest an intent to further undermine these protections.
Read the issue briefs below for more detailed information:
Analysis: Federal Court Upholds Limits on Nursing Facility Arbitration Agreements, April, 2020
Series: Don’t Abandon Nursing Home Residents June, 2018
Amicus Brief:
Northport Health Services of Arkansas LLC, et al., v. United States Department of Health and Human Services et al. (11/1/2019)
This amicus was filed in the United States District Court for the Western District of Arkansas Fayetteville Division in support of the federal regulation limiting pre-dispute arbitration in nursing facilities.
The opportunity to live with dignity, regardless of financial circumstances—free from the worry, harm, and injustice caused by lack of health care, food, or a safe place to sleep. By using the power of law to strengthen the social safety net, and remove the barriers low-income seniors face in trying to access the services they need, we work to ensure the future we all envision for our loved ones and ourselves.
© 2022 JUSTICE IN AGING
