When it comes to choosing a nursing home for a loved one, the last thing families expect is financial or legal trouble. Yet many people don’t realize there are things nursing homes aren’t allowed to do—and when these rules are broken, it’s not just a health concern it can be a costly mistake.
From illegal evictions to improper billing, families often end up footing the bill for a facility’s wrongdoing. Understanding these forbidden practices is essential not only for your loved one’s dignity but for protecting your family’s finances. In this guide, we’ll break down the major red flags that could impact your budget and your peace of mind.
1. Evicting Residents Without Due Cause
One of the most alarming practices is forcing residents out without proper notice or justification. Legally, nursing homes must follow a strict eviction protocol—including a 30-day notice and valid reason. If they skip this, families may be hit with unplanned relocation costs, lost deposits, and even legal fees to challenge the eviction. It’s not just wrong—it’s expensive.
2. Charging for Services Not Provided
Upselling services that aren’t delivered—like late-night care or additional dietary monitoring—is unfortunately common. These hidden charges can inflate monthly bills by hundreds, even thousands of dollars. Keeping an eye on itemized statements is crucial for avoiding these unnecessary expenses.
3. Withholding or Tampering With Mail
Residents have a legal right to receive their mail promptly. Yet some facilities intercept mail for convenience or to manage billing. Delay or tampering could lead to missed payment due dates, creating late fees, credit-impacting delinquencies, and extra financial burdens.
4. Violating Privacy Regulations
Medical privacy is protected under HIPAA. When a nursing home improperly shares personal health or financial data, families could suffer identity theft or financial scams. Repairing the damage might involve credit monitoring services, legal consultations, and serious costs to restore privacy.
5. Neglecting Required Staff Levels
Understaffing leads to poor care—and potentially expensive medical complications. If residents suffer from untreated infections or falls, families can face emergency hospital bills, rehabilitation costs, and even lawsuits. Inadequate staffing may seem like a cost-saving measure, but it often backfires—hard.
6. Denying the Right to Manage Their Own Funds
Residents may designate a person to manage their money, but some homes unfairly strip that right away. The consequence? Exploitation, mismanagement, and sometimes outright fraud. Families may need to hire attorneys and forensic accountants to reclaim stolen funds, which can be a huge financial drain.
7. Failing to Maintain Common Areas
Slippery floors or broken furniture may seem minor—but injuries from these hazards can lead to hefty medical bills. If a fall happens in a common area, the facility may be liable—but only if families act quickly. Waiting too long can nullify compensation, leaving you to cover hospital and rehab costs alone
8. Charging for Unnecessary or Substandard Upgrades
Some homes push “enhanced amenities” that don’t improve actual care—like premium channels or decorative upgrades. Unfortunately, they then tack these onto bills despite no real benefit. Careful budgeting and questioning every line item helps protect against this markup scam.
9. Withholding Visitation Rights
It may seem unrelated to your wallet, but restrictions on visitation can delay family oversight. During that period, poor care or unethical financial practices might go unnoticed—until it’s too late.
10. Misapplying Medicaid or Medicare Rules
Facilities are required to apply government funds correctly. But misbilling can occur—costing residents thousands in penalties or missed reimbursement. It’s not just confusing; it’s expensive. Accurately monitoring which charges apply to Medicaid/Medicare is vital.
11. Overcharging for Medical Supplies
Markups on bandages, incontinence products, and add-on medications are common. These small extras can add up to a significant monthly fee. Proper budgeting means reviewing supply usage reports and refusing add-ons that aren’t necessary.
12. Requiring Unlawful Pre-Payments
Some homes may request large upfront deposits or “retainers.” Legally, these must either be fully refundable or placed in escrow. Insisting on fairness helps families avoid taking a hit if the resident moves or passes away.
True Cost of Violations
When these 12 nursing home no‑go zones are violated, financial fallout can be severe:
- Drained savings from hidden charges
- Legal costs to reclaim funds or challenge evictions
- Medical bills from injury or neglect
- Opportunity cost of funds tied up or misused
- Compounding stress and disruption in care
In our current economic climate—where long-term care can already cost $6,000–$10,000 per month—such practices can push families into debt or threaten the stability of a carefully built retirement plan.
How to Protect Your Wallet
- Read the contract carefully. Don’t sign anything without understanding every clause.
2. Track monthly charges. Compare them against actual services received.
3. Visit often—unexpectedly. In-person oversight discourages shady behavior.
4. Keep copies of every document and receipt. Paper trails help if billing disputes arise.
5. Use a third party. A trusted advisor or advocate can spot red flags you miss.
6. Seek legal help when needed. If you encounter any of the 12 prohibited practices, consult someone familiar with elder-law and financial recovery
Final Word
Nursing homes are meant to support and comfort your loved ones during their golden years—but hidden financial missteps can turn that support into a burden. By educating yourself and staying vigilant, you safeguard not just care quality but also family wealth and peace of mind.
If you’re worried a facility is crossing one of the 12 lines residents aren’t allowed to cross, act now. Understanding your rights and watching the finances can mean the difference between misplaced trust and thoughtful protection
