Florida Nursing Home Resident Rights Before Discharge

A Florida nursing home cannot discharge or transfer a resident whenever it wants. It must give 30 days written notice, and it may only do so for five reasons set out in state law. If you disagree, you have the right to a fair hearing, and the timing of your request is what matters most. You may request a hearing any time within 90 days of receiving the notice, but requesting within 10 days is what stops the discharge from happening while the appeal is pending. If Medicare rather than the facility is ending coverage, that is a separate and much faster process handled by a different agency, with a deadline measured in hours rather than days.

If a discharge notice is in your hands right now, two calls matter. The Florida Long-Term Care Ombudsman Program is 1-888-831-0404. If the notice says Medicare coverage is ending, call Acentra Health, Florida's Medicare appeals organization, at 1-888-317-0751 before noon the day after you receive it.

The Deadlines That Decide Everything

Families often lose the ability to stop a discharge by missing a deadline they did not know existed. These are the numbers that matter, and they do different jobs.

When Medicare Covers Skilled Nursing Care

Under Medicare's skilled nursing facility benefit, Medicare Part A will cover skilled nursing care when two conditions are met. Skilled nursing care or skilled therapy must be needed, per Medicare standards, to improve a condition or to maintain the current condition and prevent or delay it from getting worse. And you must have had a qualifying hospital stay, meaning an inpatient stay of three consecutive days or more, shortly before entering the skilled nursing facility.

That first condition deserves emphasis, because facilities get it wrong constantly. Plateauing is not, by itself, a good reason for discharge. Medicare covers skilled care needed to maintain a condition, not only care that produces measurable improvement. If you are told coverage is ending because your loved one has stopped progressing, that reasoning is not automatically correct.

The Only Five Reasons a Florida Nursing Home May Discharge You

Under Florida Statutes Section 400.0255, a facility may transfer or discharge a resident only for these reasons.

●    The resident's welfare cannot be met at the facility

●    The resident's health has improved sufficiently so the resident no longer needs the services the facility provides

●    The health or safety of individuals is endangered

●    The resident has failed, after reasonable and appropriate notice, to pay or to have paid under Medicare or Medicaid for residence at the facility

●    The facility closes

Anything outside that list is not a lawful basis for discharge. The Long-Term Care Ombudsman Program investigates violations of Florida nursing home resident rights, including complaints of premature discharge or transfer. For a deeper look at how these disputes actually play out, including what happens when a facility argues a new reason at the hearing that was not in the notice, see our article on Florida nursing home evictions.

How to Request a Hearing and Stop the Discharge

The notice and the form

A nursing home must give residents 30 days written notice before discharge or transfer. The notice itself must include the form you use to request a hearing. A resident who believes their rights have been violated, whether to avoid premature discharge or regarding other rights such as private communication, visitation, refusing treatment, being informed of their medical condition and proposed treatment, or being treated courteously and with dignity, requests a hearing in writing using that form.

Where to send it

The request goes to the Office of Appeal Hearings at the Department of Children and Families, 1317 Winewood Boulevard, Building 5, Room 203, Tallahassee, FL 32399-0700. The office can be reached at 850-488-1429, and requests may also be emailed to appeal.hearings@myflfamilies.com.

The 10 day rule that matters most

You may request a hearing at any time within 90 days after receiving the notice. But requesting within 10 days is what stays the proposed transfer or discharge pending the hearing decision. When you file within that window, the facility may not take action and the resident may remain in the facility until the outcome. File on day 40 and you still have a hearing, but nothing stops the facility from moving your loved one out while you wait for it.

What happens at the hearing

The burden of proof is on the facility, and the standard is clear and convincing evidence, which is a demanding one. A hearing decision must be rendered within 90 days after the request is received. If the decision favors a resident who has already been transferred or discharged, the resident must be readmitted to the facility's first available bed. The hearing officer's decision is final, though any aggrieved party may appeal to the district court of appeal in the appellate district where the facility is located.

The ombudsman review

A resident may also ask the local ombudsman council to review a discharge notice, and the council must do so within 7 days of the request. The nursing home administrator must forward that request to the council within 24 hours. If the facility fails to forward it within 24 hours, the running of the 30 day advance notice period is tolled until it does. Residents can reach the Long-Term Care Ombudsman Program at 1-888-831-0404.

The proof you will need

To appeal a premature or early discharge, you need the physician who ordered the care to explain why the case continues to be medically reasonable and necessary. That documentation is usually the difference between winning and losing, so request it early rather than the day before the hearing.

About the Florida Long-Term Care Ombudsman Program

The Long-Term Care Ombudsman Program is a division of the Florida Department of Elder Affairs. It operates through local councils across the state that investigate and resolve complaints made by, or on behalf of, residents of assisted living facilities and nursing homes. The service is free, and it does not require a lawyer.

Appealing When Medicare Says Services Are Ending

A different process with a much shorter deadline

If you believe services are ending too soon at a Medicare covered skilled nursing facility, a Medicare covered outpatient rehabilitation facility, a Medicare covered home health agency, or a Medicare covered hospice, you can request a fast appeal. This is separate from a facility initiated discharge under Florida law, and the timing is far tighter.

Ask for a fast appeal no later than noon of the first day after you receive a Notice of Medicare Non-Coverage from the facility. That notice is your trigger, and the window is measured in hours.

Who to call in Florida

Medicare fast appeals are handled by a Beneficiary and Family Centered Care Quality Improvement Organization, or BFCC-QIO. In Florida, that organization is Acentra Health, which was formerly known as KEPRO. The beneficiary helpline is 1-888-317-0751. The phone number is also printed directly on the notice you receive, so you do not need to guess.

Once Acentra Health has the complete file, a physician reviews the medical record and a decision typically issues within about 24 hours. This right applies whether you have Original Medicare or a Medicare Advantage plan. CMS maintains the current BFCC-QIO assignments if you need to confirm which organization covers a given state.

Key Takeaways

• A Florida nursing home must give 30 days written notice and may discharge only for the five reasons listed in Fla. Stat. 400.0255.
• Request a hearing within 10 days and the discharge is stayed. Wait longer, up to 90 days, and you keep the appeal but lose the protection.
• The facility carries the burden of proof by clear and convincing evidence, and a resident who wins must be readmitted to the first available bed.
• The local ombudsman must review a notice within 7 days, and the facility must forward your request within 24 hours or the notice period tolls.
• Plateauing is not by itself a lawful reason to end Medicare skilled coverage. Medicare covers care needed to maintain a condition.
• Medicare fast appeals go to Acentra Health at 1-888-317-0751, by noon the day after you receive a Notice of Medicare Non-Coverage.

Frequently Asked Questions

Q. How much notice must a Florida nursing home give before discharging a resident?

A. Thirty days written notice, and the notice must include the form used to request a hearing. There are limited emergency circumstances where notice may be shorter, but a facility cannot simply decide to move someone out without notice and a lawful reason.

Q. How do I stop a nursing home discharge in Florida?

A. Request a fair hearing in writing within 10 days of receiving the notice. Under Fla. Stat. 400.0255, a request filed within that window stays the proposed transfer or discharge, meaning the resident stays in the facility until the hearing is decided. You may request a hearing up to 90 days out, but only the 10 day filing stops the move.

Q. What are the only reasons a Florida nursing home can discharge someone?

A. Five. The resident's welfare cannot be met at the facility, the resident's health has improved so the services are no longer needed, the health or safety of individuals is endangered, the resident has failed to pay after reasonable notice, or the facility closes. Anything else is not a lawful basis.

Q. Who do I call if Medicare says my rehab coverage is ending?

A. Acentra Health, Florida's Medicare Quality Improvement Organization, at 1-888-317-0751. It was formerly called KEPRO. Ask for a fast appeal no later than noon of the first day after you receive the Notice of Medicare Non-Coverage. A physician reviews the record and a decision usually comes within about 24 hours.

Q. Can a nursing home discharge my parent for not paying while Medicaid is pending?

A. Nonpayment is a lawful discharge reason only after reasonable and appropriate notice, and payment made under Medicare or Medicaid counts. Medicaid pending status, where an application has been filed but no decision has issued, is a common source of these disputes, and it is worth involving an elder law attorney rather than assuming the facility is right.

Q. What happens if I win the hearing after my parent was already moved?

A. The facility must readmit the resident to its first available bed. A decision must be rendered within 90 days of the hearing request, and either party may appeal to the district court of appeal in the district where the facility is located.

Do Not Let the Clock Run Out on a Discharge Notice

Discharge fights are won or lost on timing, and most families do not realize a 10 day window exists until it has closed. If a notice has arrived, act on it the same week rather than waiting to see whether the facility follows through. A good first step is to gather the discharge notice itself, the admission paperwork, any Notice of Medicare Non-Coverage, and a note from the treating physician explaining why continued care remains medically reasonable and necessary. Call the ombudsman at 1-888-831-0404, since that review is free and fast, and file the hearing request inside the 10 day window even if you are still assembling your evidence. Where our firm helps is the part underneath the discharge, which is usually payment. If the dispute involves nonpayment, Medicaid pending status, or a facility pressing a family to private pay, our Florida Medicaid planning attorneys can address the underlying eligibility problem while the appeal proceeds. If you need someone with authority to act for a resident who cannot act for themselves, that usually starts with a properly drafted durable power of attorney. To talk through where your family stands, schedule a consultation with our Florida elder law team.