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Your Rights in Florida Nursing Homes: Medicare to Medicaid Transitions
When Medicare coverage for nursing home care ends, many Florida families face pressure from facilities wanting to move their loved ones. This article explains your legal rights during this transition and the limited reasons a nursing facility can actually require someone to leave.
The Medicare Coverage Limit
Medicare only covers up to 100 days of nursing facility care. Before these days run out, it's essential to plan for continued long-term care if needed. For many families without substantial financial resources, this means applying for Medicaid to help cover nursing home costs.
The "Medicare Bed" Myth
Many nursing homes prefer Medicare patients because reimbursement rates are higher than Medicaid. When Medicare coverage ends, some facilities might tell you:
"You can't stay in this facility because this is a Medicare room/bed and it's not registered under Medicaid."
This is false. There is no such thing as a "Medicare-only" bed that can't be used for Medicaid patients. Medicare certification does not prevent a room or bed from being used by someone paying privately or through Medicaid.
The Six Legal Reasons for Nursing Home Eviction in Florida
Under federal law (Medicare Nursing Home Reform Act), nursing facilities can only evict residents for six specific reasons:
- Improved condition: If you no longer need nursing facility-level care and could safely live at home with home care or in an assisted living facility.
- Different care needs: If you require care that's different from what the nursing facility provides (such as primarily psychiatric care).
- Safety concerns: If the resident endangers the safety of other residents or staff members.
- Health risks: If the resident endangers the health of others (for example, with a contagious condition requiring hospitalization).
- Non-payment: The facility has the right to be paid. However, they cannot evict you simply because you're switching from Medicare to Medicaid or from private pay to Medicaid.
- Facility closure: If the nursing home is going out of business.
Protecting Your Rights During the Transition
If you need to stay in a nursing facility beyond Medicare's 100-day limit, start planning early:
- Begin the Medicaid application process before Medicare coverage ends
- If the facility claims you must move because of payment source changes, firmly remind them this is not a legal reason for eviction
- Know that facilities can get beds certified for Medicaid without requiring resident relocation
Get Help With Your Florida Medicaid Planning
For more information on protecting your assets while qualifying for Medicaid, check out our comprehensive guide: Let Medicaid Pay for Some of Your Long-Term Care Expenses
Next Steps
If you're facing pressure to leave a nursing facility when transitioning from Medicare to Medicaid, contact us for personalized guidance. Our Florida elder law attorneys can help you assert your rights and manage the application process.
Visit our websites for more information:
Remember: A change in payment method from Medicare to Medicaid is not a valid reason for eviction from a nursing facility in Florida.
