Doris Engdahl, forced to move. —Photo by Shaun Heasley

When Doris Engdahl, 86, moved to a Fremont, Neb., assisted living facility in 2003, she expected to be there for the rest of her life. But four years later, Engdahl’s daughter, Gloria Turner, was told that her mother needed to leave within two months. The reason: Engdahl paid with Medicaid—and the facility’s parent company, Assisted Living Concepts, would no longer accept funding from the government program.

Eng­­dahl moved to another assisted living facility in Fort Calhoun, Neb. But the transition has been difficult. “She keeps asking, ‘Why can’t I be where I used to be?’  ” Turner says.

Over the last three years Assisted Living Concepts has stopped accepting Medicaid—or announced its intention to stop—in the 20 states in which it does business. In some states residents already receiving Medicaid were able to stay, though new Medicaid recipients were not admitted. But in states such as Nebraska, the company ended its state contracts, which meant all Medicaid recipients had to go. Now, New Jersey’s Department of the Public Advocate is investigating the discharge practices after receiving about two dozen complaints.

Laurie Bebo, president and CEO of Assisted Living Concepts, blames the situation on limited funding from Medicaid, which typically pays 30 to 40 percent less than private-pay residents. “Without more money in the assisted living system from Medicaid, we can’t continue to be a provider,” she says.

Michelle Diament is a freelance writer based in Memphis.