Imagine getting this call...Dad’s being kicked out of Assisted Living. Some of the most distraught calls we get come from caregivers in this situation. We hope this never happens to you, but we’re here to help if it does. Our knowledge and experience can help you prevent the situation or understand the best ways to deal with it. Read on for some common reasons for getting kicked out of an ALF, how to minimize the risk, how to intervene, and what to do if it’s too late.
How Can an Assisted Living Kick Out a Resident?
A facility can’t just kick you out because they feel like it. They need to document certain reasons. These include issues like an unpaid bill or the facility going out of business. Because you agree to certain rules in the admissions agreement you could be thrown out for contract violations. A facility can also kick out a resident who needs more help than they can provide or who’s endangering others’ health or safety. These last categories are the most commonly cited and wide ranging.
Remember, the facility has a responsibility to residents’ rights, dignity, and well-being. However, that means ALL residents. A resident causing trouble, breaking rules, acting out, or taking up excessive staff time is a red flag. In order to give an eviction notice, the facility needs to cite particular reasons, but it’s not hard to do in many cases.
Assisted Living Eviction Rules
Florida law allows an ALF to relocate or terminate a resident if the administrator provides a 45-day notice and documents the reason. The 45-day notice can be waived if the resident is certified by a physician to require an emergency relocation to a facility providing a more skilled level of care or the resident engages in a pattern of conduct that is harmful or offensive to other residents.
Quick Ways to Get Kicked Out of Assisted Living
- Smoking in the facility/outside of designated areas
- Violence towards other residents or staff
- Frequent falls
- Acting out (yelling, paranoia towards other residents, wandering into others’ rooms, etc.)
- Refusal to adhere to set rules/schedule
- Challenging dementia symptoms (elopement, medication/care refusals, paranoia)
- Certain sexual behavior/harassment
- Increased need for care
Some of these may be obvious, though the solutions might not be. You’ve probably heard a news story or two about a senior housing fire caused by resident smoking. Safety becomes a clear issue if a resident is physically violent.
However, many families are surprised by the facility’s handling of increased care needs or dementia behaviors. Even facilities specializing in dementia may inform you they can no longer manage your loved one. We’ve attended numerous facility-family meetings to address concerns about sexual behavior. And, even when the need for more care may only be temporary (after an illness or hospital stay), you may find yourself in a bind. It can all be quite confounding to the family who’s turned to a facility for help.
There’s a lot of controversy over what often seems like arbitrary reasons for Assisted Living evictions. For example, the Florida Ombudsman Program investigated 75 inappropriate ALF eviction complaints and 72 fear of retaliation complaints during 2010-11. An even greater number of arbitrary discharges likely occurred but were not reported. When a resident is relocated from an ALF, the facility isn't obligated to report its action to any governmental entity.
How Can You Prevent Getting Kicked Out?
Early Prevention: Minimizing Risk
Prevention begins with choosing the right facility. We highly recommend an independent assessment. Remember the facility may be highly motivated to fill their rooms. Have someone independent take a good look at your loved one and give you an honest opinion of the level of care needed. A care manager’s experience with facilities will be invaluable in evaluating who can best meet your needs.
Be clear on policies and procedures before moving in. Get to know the staff, and build rapport. (Special hint: treats don’t hurt! ALF staff work hard and often don’t get much appreciation.) They’ll be more likely to alert you of issues. The staff will know you’re concerned and care. It makes them want to work with you if they encounter difficulties. Also, if you check in regularly you can spot potential changes. You can work with care providers to address them problems they blow up. If you can’t be there regularly or want someone with expertise navigating assisted living, hire a care manager.
When Problems Arise: Intervention
If the staff alerts you of an issue (or you notice something), be proactive. Work with providers to figure out what’s going on/root causes. If your loved one’s acting out, is something agitating him? Could there be an underlying infection? If Mom’s falling, is there an inner ear problem or medication issue?
Set up a care plan meeting with appropriate facility contacts and providers. There may be simple things staff and other care providers can do to keep the problem from escalating. We have intervened in such cases as a client/family liaison many times. Years of experience (especially with “tough cases”) provide us with a battery of creative solutions. Many times this is not only a relief for the family but for the facility. We understand their perspective and limitations, while advocating for you.
Solutions might start with a medical, psychological, or physical evaluation. Medications, physical therapy, or some assistive technology might be needed. These changes could allow your loved one to remain in their current home longer.
We’ve found simple, creative solutions work in most cases. It might be a matter of a schedule adjustment. Or, providing a quiet, private space for Mom and her boyfriend to be intimate. There are also many products for solving various problems. Coming to the care plan meeting with solutions shows the facility you’re working with them. They may tell you they can’t do certain things. But, you can negotiate options and show your willingness to help.
Whether temporary or ongoing, a private caregiver commonly helps resolve many issues. They can provide support/extra care targeted to the concerns. If your loved one with Alzheimer’s gets restless after dinner, the caregiver can keep her busy and calm during those hours. Perhaps Dad needs someone to take him for walks and remind him to smoke outside when he tends to forget in the morning.
What To Do When It’s Too Late
If you’ve already received a 45-day notice (or, worse, an emergency eviction), you should still try to talk to the Administrator. We’ve intervened in some cases to find a resolution, or buy more time. If you have concerns about the way the situation’s been handled, you can contact the Ombudsman program.
Otherwise, the next step is figuring out where to move. Obviously, you want to make sure the next assisted living or nursing home can handle your loved one’s needs. It is essential to get an independent assessment. You may have some difficulty finding a good facility to take your loved one. A care manager can help you lay out the case. What’s been done to resolve or manage the problems? How is this facility a better fit?
Next, it’s time to plan the move and ensure a smooth transition. This is a tough time in the best of circumstances. Make a plan. Get support. How can you keep your loved one calm and reassured during the move? In many cases, a family member or private caregiver should be with the client throughout the transition. You may want to hire a caregiver for a period of time to help with orienting to the new facility.
Start off on the right foot. Now’s the time to be extra cautious about checking in. Go back and revisit our early prevention advice above.
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