In Ohio, federal inspectors have documented cases in which nursing home residents were discharged to homeless shelters, despite concerns that shelters are not equipped to manage the medical and daily-care needs of people who are older, poorer, and medically fragile.
The disclosures stem from inspections tied to the Centers for Medicare and Medicaid Services, which administers much of the funding for nursing home care through Medicare and Medicaid. In one case described by inspectors after an Aug. 3, 2023 visit, a resident identified as “Resident #83” was sent to a homeless shelter after Eastland Rehabilitation and Nursing Center in Columbus sought to discharge her from care. The inspection materials said the shelter staff called the fire department after the resident arrived in circumstances that did not make clear what her placement would be.
According to the inspection account, the woman arrived using a walker, incontinent, carrying “a large bag of medications,” and she was described as diabetic and managing a tibia fracture and alcohol-related dementia. Inspectors wrote that a staff member told them the resident was “unclear of what was going on, scared, and not sure who dropped her off there,” after she reached the shelter. The shelter initially declined to admit her, leaving her outside in late-summer heat, before staff later allowed her into the lobby while they brought in city “rapid response” help that included a social worker and the fire department.
The inspectors’ report also said neither Eastland nor the CMS inspection team could locate the woman by the time the report was published. The inspection document said, “In addition, the events of what occurred at the addiction recovery center or how/why Resident #83 ended up at the homeless shelter … could not be determined as the facility was unable to provide any additional information regarding Resident #83.” It also said the administrator at Eastland declined to return phone calls about the inspection, and that facility staff did not provide contact information for Garden Healthcare, the corporate owner of the nursing home.
Across the state, officials and advocates said the practice can reflect a failure point where discharge rules and real-world capacity do not align. Chip Wilkins, who leads the city of Dayton’s Long Term Care Ombudsman program, said his office has been dealing with more of these situations. He said the nursing facilities are “so closely monitored on discharges,” yet residents still can be sent to hospitals and not taken back, or “drop[ped] off at homeless shelters.” Wilkins also said homeless-shelter discharges are priority cases because they are almost always unsafe for residents’ medical needs and stability.
Wilkins said shelters typically cannot handle the range of care nursing home residents require, including managing multiple daily medications and assisting people who rely on wheelchairs or walkers. He described a pattern in which, after a shelter admits a medically fragile resident, the shelter often sends the person to a hospital within “two or three days” because it cannot meet their needs. He attributed some of the driving pressure to insurers, including Medicaid and Medicare, that cut off benefits, as well as to facilities’ reasons such as aggressive behavior or substance use.
Leilani Pelletier, the statewide ombudsman, said her office gets copies of every involuntary discharge from nursing homes in Ohio and checks the proposed discharge location. Pelletier said homeless-shelter discharges can become a safe and appropriate move in fact-specific circumstances, depending on residents’ care needs and shelter capacity, and that ombudsmen focus on whether facilities did the work to determine safety and appropriateness. Pelletier emphasized that such discharges against residents’ wishes are rare, while estimating that about 13,000 Ohioans are discharged from nursing homes each month.
The incidents described by inspectors also highlight how nursing home discharge planning can run into legal notice requirements. In a separate case tied to a Dec. 29, 2025 CMS inspection, a resident at a facility in Hillsboro was reportedly not given the required 30 days’ notice before an involuntary discharge, according to the inspection account. Federal law generally requires at least 30 days’ notice for nursing home discharges absent health or safety emergencies. The CMS review said the resident told inspectors staff never told him he was being taken to a homeless shelter and that a facility representative described the destination differently—according to the resident’s former roommate, staff said he would be going to an assisted living apartment rather than an emergency shelter.
In the same Hillsboro case, the inspection materials said the resident was not prepared with what the person would need to establish housing or employment, including a driver’s license and birth certificate, and that he arrived at the shelter without needles to manage medical needs. The CMS review described the resident as diabetic and struggling to manage blood sugar, and noted other health history including glaucoma and cataracts, as well as a 22-year stay at the facility. The facility, later sold in July 2025 and rebranded, declined to comment when contacted for the inspection coverage, but said it was in “substantial compliance” with the state, according to a receptionist who did not provide her name.
Other CMS inspections discussed in the report described alleged failures around medication transitions and notice timing during involuntary discharges to shelters. Meadowbrook Manor in Trumbull County was described as seeking to discharge a patient with multiple long-term illnesses and a history of substance use and homelessness; inspectors said a 30-day notice was provided but the discharge to a shelter occurred 20 days later. In that case, the CMS account said the resident received two weeks’ worth of medications but no prescriptions, medical appointments, or care plan, and that the shelter identified a “mismatch” because the resident had trouble walking and could not climb a ladder to reach a top bunk. Inspectors also described alleged issues at New Lebanon Rehabilitation and Healthcare Center, where the report said a woman received roughly 24 hours’ notice before a discharge to a homeless shelter after her insurer issued a termination letter for treatment related to neural and spinal disorders, depression, and arthritis.
The Ohio Health Care Association, an industry trade group, said facilities are facing a broader challenge that extends beyond individual cases. Scott Wiley, the group’s chief executive, said in a statement that the issue has been growing as more residents face unstable housing and that state oversight and resources are needed for long-term solutions, adding that a single provider cannot manage the problem alone.
At the same time, advocates argued that shelters often end up acting as a last resort when other pathways fail. Marcus Roth, director of communications for the Coalition on Homelessness and Housing in Ohio, said emergency shelters, “to the extent we have a system,” are often the only option when other interventions do not work, while shelters are then put into a position they are not designed to handle medically fragile individuals.
As the reported inspections show, the central question for advocates is whether nursing homes match discharge destinations to what residents need and whether they follow the notice and planning rules required under federal law. For ombudsmen, the proposed destination is often the first checkpoint; for shelters, the practical challenge is whether a shelter can deliver day-to-day care for residents who may need medications, mobility support, and medical oversight that go beyond what emergency shelter programs can provide.