Most of the nursing home residents involved in recent inspections and ombudsman complaints are older, poorer and medically fragile, and many have limited support networks, long-term care advocates said. In Ohio, inspectors from the Centers for Medicare and Medicaid Services have documented cases in which nursing homes placed residents with serious medical needs in homeless shelters, settings that are not designed to provide daily medication management or other skilled care.
The AP reporting based on those inspections described one case at Eastland Rehabilitation and Nursing Center in Columbus, where a resident was discharged after staff said they faced problems arranging substance-use rehabilitation beds. The inspectors wrote that the resident—identified only as Resident #83—arrived at a homeless shelter using a walker, incontinent and carrying a large bag of medications, and that the woman was diabetic, managing a tibia fracture and alcohol-related dementia.
The inspection said Eastland staff did not call a county psychiatric bed board to find an appropriate placement. Instead, the woman was taken to the shelter, where about 100 people were ahead of her on a waiting list. Shelter staff initially declined to admit her, leaving her outside in late-summer heat until they relented and let her sit in the lobby with cold water while a city rapid response team was summoned, including the fire department and a social worker.
In a statement quoted from the inspection report, the inspectors said, “The staff member (said) Resident #83 was unclear of what was going on, scared, and not sure who dropped her off there,” after an Aug. 3, 2023 inspection. Neither the nursing home nor the inspectors could locate the resident by the time the report was published, and 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.”
The federal inspections are part of a broader pattern described by ombudsman and housing advocates as an increasingly common discharge pathway for vulnerable nursing home residents. Chip Wilkins, who leads the city of Dayton’s long-term care ombudsman program and acts as a legal advocate for long-term care patients, said his office is seeing the issue more often. He said facilities remain closely monitored on discharges, but that the decisions sometimes still shift residents out of the health system and into shelters.
Wilkins described why shelters can become the default destination even when they cannot provide the kind of care residents require. He said many of these individuals may be unable to manage the 10 to 20 medications they need each day and may rely on wheelchairs or walkers. In his account, the result is frequently a short path to another emergency: “Invariably, that ends up being a horrible experience for the individual because they’ll go to the shelter, and typically, within two to three days, the shelter will send them to the hospital because they can’t meet their needs,” he said.
Leilani Pelletier, Ohio’s statewide ombudsman, said the office does not have ready access to statewide data that would confirm an uptick across the state. She also emphasized that involuntary discharges to homeless shelters against residents’ wishes are rare, while adding that the scale of overall discharges remains large: she estimated that about 13,000 Ohioans are discharged from nursing homes each month. Pelletier said nursing facilities have legal obligations to make sure discharges are “safe and appropriate,” and she said it is not up to nursing homes to unilaterally decide where someone should go.
A housing and homelessness advocate described the tradeoff faced by shelter staff when they are placed in the role of last resort. Marcus Roth, director of communications of the Coalition on Homelessness and Housing in Ohio, said shelters are forced to handle a population they are not equipped for, while also functioning as a de facto safety net. “The emergency shelter system, to the extent we have a system, is often the only thing available when other interventions don’t work,” Roth said.
Pelletier said the safety-and-appropriateness question is fact-specific, depending on a resident’s care needs and what a shelter can handle. She said ombudsmen focus on whether discharge planning and investigation check that fit, warning that problems arise when nursing homes discharge residents to shelters without doing that work. “The real issue is when people are discharged to a homeless shelter and there’s been no work or investigation done on if that would be a safe or appropriate discharge,” she said.
The inspections also described failures involving notice and medication planning in additional Ohio facilities. In one case cited by federal inspectors in a Dec. 29, 2025 inspection, a nursing home wanted a patient out after insurance stopped paying, according to the inspection narrative, and the patient told inspectors he was not told he would be going to a homeless shelter. The federal law requires at least 30 days’ notice before a discharge except in health-and-safety emergencies, but the inspection narrative said the patient was not given any notice, and it described staff misrepresenting the destination as an assisted living apartment rather than an emergency shelter.
The AP report also described cases where additional care requirements were not matched to shelter capabilities, including a situation where a facility provided two weeks’ worth of medications but did not provide prescriptions, medical appointments or a care plan, and another case where a facility gave a woman roughly 24 hours before discharge after an insurer termination letter. In those accounts, federal inspectors described mismatches between residents’ medical and mobility needs and what shelters can accommodate, along with allegations that staff declined to take residents back once they arrived.
Scott Wiley, CEO of the Ohio Health Care Association, said the challenges facing nursing facilities reflect broader pressures as more residents face unstable housing. In a statement, Wiley said the issue has been growing and that “State oversight and resources are needed to help tackle the issue on a larger scale to find meaningful, long-term solutions for Ohioans who struggle with homelessness,” adding that it would require a collaborative approach.
The AP story also said the Eastland administrator declined to return phone calls about the inspection and that facility staff declined to provide contact information for Garden Healthcare, the corporate owner of the nursing home that operates several other facilities. The report described the case as part of CMS’s broader enforcement history involving discharge practices to homeless shelters.