Can nursing homes refuse Medicaid residents?

Can nursing homes refuse Medicaid residents?

Short answer: A facility that does not take Medicaid can refuse. A Medicaid-certified facility can limit its Medicaid beds but must follow federal rules once someone is a resident.

Figures change periodically. Double-check current amounts before relying on them.

Nursing homes choose whether to participate in Medicaid, and certified facilities may certify only part of their beds.

  • Facilities that do not take Medicaid can refuse Medicaid residents, and a private-pay resident who runs out of money may have to move.
  • Certified facilities may consider payment source in admissions in some states, but must follow federal and state rules, including the ban on requiring private-pay periods.
  • Once admitted, a resident of a certified facility who becomes eligible for Medicaid generally cannot be discharged simply because they switched to Medicaid, if they are in a Medicaid-certified bed. Some states give extra protections.

Tips when choosing a facility:

  • ask whether it is Medicaid-certified and whether the resident’s bed is certified;
  • ask whether residents can stay after switching from private pay;
  • get answers in writing.

Getting help

Every situation is different, and small facts can change the answer. If this question affects a real decision, especially with a spouse at home, a home, gifts or a trust, a Certified Medicaid Planner can apply your state’s rules to your situation. As a rough guide, published fees for help with an application range from about $500 to $6,000, and hourly help from about $150 to $600.

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.

Scroll to Top