What are the rules about ALF/Memory Care facilities rejecting their residents after hospital/rehab stays?

Well, I know of cases where an assisted living facility has told residents that they can no longer stay there but they gave them time to find a new facility.

It’s awful that you are in this situation.

What exactly did they tell you? Do you think there is any wiggle room for negotiations?

Others will chime in to help.

Best wishes to you and your family.

What state is your dad living in? To know whether what they did was ethical or legal you will need to find the paperwork that was signed when he was admitted to the MC home. When you find the paperwork you can compare what they did to what their documents say, and then square it with any rules of his state that govern elder care and facilities.

I don’t know that there are standard rules or regulations state federal or otherwise. Maybe just corporate policies. In my case, my dad was in a memory care facility, fell and broke a hip, had surgery then spent two weeks in rehab. The policy at his place was that residents had to have at least minimal mobility to help staff transfer them, bathing etc. they told me they could probably not bring my dad back that he needed skilled nursing care now.

As it turns out, it was an easy surgical fix and he recovered very well. I could have pressed the issue and probably gotten him back in his old place. But I was out of state, getting too old to make the 12 hour drive for each crisis so I moved him to a nice nursing home near me. It was so much easier.

You need to read the contract. MCs and ALs are private. They are not equipped or have the staff to care for someone who now may need skilled nursing. Aides are not skilled nursing.

There are few rules for ALF and MC. They are a business and are not under nursing home regulations, cannot supply one on one care. So they have a right to say that they can no longer accept a resident back, that he or she requires more care than they are capable of providing. You should contact Social Services in the rehab at once to discuss.

After her last stay in rehab, the AL would not accept my mother back into her apartment b/c she no longer fit their criteria for residence there. Their facility, their rules. I had to get her placed in their Memory Care bldg across the parking lot instead. I could have looked elsewhere for another ALF with different criteria, but I chose to move her into their MC instead.


The 'rules' relating to ALFs and MCs are up to the facilities themselves. If they are unequipped to properly care for your father, why would you want him to go back there anyway??? They may take him back if YOU hire an aide to be with him 24/7, which would be SO costly, but it would release them from the fall liability and the 1 on 1 care your dad now requires. If you are in a financial position to hire an extra aide, ask the MC if they'd agree to such an arrangement. Otherwise, it sounds like your dad needs Skilled Nursing now. My mom is right there too, where she's needing a SNF nowadays and not a Memory Care anymore.

It is what it is. What we want is the best level of care for them in a place that's equipped TO care for them in the best possible way, right?

Good luck!

The facility applies to the state to be licensed to provide a certain maximum level of care, generally based on their intended population’s mobility and assistive needs. Within that, the facility can determine who they are able to provide service for. So in my state, assisted living’s can apply to be the highest level of AL care, taking care of non-weight bearing residents requiring a 2 person assist, but no lifts, as that is considered nursing care. My Mom’s is licensed for weight-bearing 1 person assists. And they vary as to dietary needs too- some consider a patient who is transitioning to pureed foods as skilled nursing, some do not. Some consider hand over hand feeding ok, but will not handle a patient that needs to be fed, but others do. I think the dietary cutoffs are more facility based and determined by staffing. Generally the contract will define what they can provide, but it can be based on their judgement as to what level the resident can function or if they have the staff to handle that level of care. So there is some subjectivity. If the resident’s need has changed then the facility may not be able to take them back. You can review licensing information for most places out on the state’s website, including inspection reports ( may vary by state, I’m in VA).

Thanks, all. We actually found another memory care place for him. I am in Florida; First he needed Rehab (we did that) then once he was walking we were then told that he wandered too much and possibly going into other memory residents rooms. It just kept changing..
He is a place where he can wander and walk around without issues... appreciate the responses.