Skilled Nursing Facility Coverage: Notices, Appeals, and Patient Rights

Adapted from Medicare Coverage of Skilled Nursing Facility Care, Centers for Medicare & Medicaid Services. The selected guidance concerns Medicare coverage and payment, not a recommendation for medical treatment. Numbered page references below refer to the linked source publication.

Coverage can depend on medical necessity, the setting, provider participation, and your plan’s rules. Use the cited publication for the full conditions and check the plan year when comparing costs or enrollment choices.

Your Rights & Protections

What are my rights in a skilled nursing facility (SNF)?

Under federal law SNF residents have the right to:

• A facility free from discrimination—SNFs don’t have to accept all applicants, but they must comply with laws that don’t allow discrimination based on race, color, national origin, disability, sex, age, diagnosis, severity of your condition, payment source, or religion under certain conditions. If you believe you’ve been discriminated against, call the Department of Health & Human Services, Office for Civil Rights at 1-800-368-1019. TTY users can call 1-800-537-7697.
• Respect—You have the right to be treated with dignity and respect. You have the right to make your own schedule, including when you go to bed, rise in the morning, and eat your meals. You have the right to choose the activities you want to go to.
• A facility without abuse and neglect—You have the right to be free from verbal, sexual, physical, and mental abuse, involuntary seclusion, and misappropriation of your property by anyone. This includes, but isn’t limited to: SNF staff, other residents, consultants, volunteers, staff from other agencies, family members or legal guardians, friends, or other individuals.

If you feel you’ve been abused or neglected (your needs were not met), report this to the SNF, your family, your local Long-Term Care Ombudsman, or your State Survey Agency. It may be appropriate to report the incident of abuse to local law enforcement and the Medicaid Fraud Control Unit (their phone numbers should be posted in the SNF).

• Deny restraints —Physical restraints of any manual method, or physical or mechanical device, material, or equipment attached to or near your body that you can’t remove easily. Physical restraints prevent freedom of movement or normal access to one’s own body. A chemical restraint is a drug that’s used for discipline or convenience and isn’t needed to treat your medical symptoms.

It’s against the law for a SNF to use physical or chemical restraints, unless it’s necessary to treat your medical symptoms. Restraints can’t be used to punish or for the convenience of the SNF staff. You have the right to refuse restraint use except if you’re at risk of harming yourself or others.

• Information on services and fees —You must be informed in writing about services and fees before you move into the SNF. The SNF can’t require a minimum entrance fee as a condition of residence. You can’t be charged by the SNF for items or services that you didn’t ask for, and you can’t be required to ask for extra services as a condition of your continued stay at the SNF.
• Money —You have the right to manage your own money or to choose someone you trust to do this for you. If you ask the SNF to manage your personal funds, you must sign a written statement that allows the SNF to do this for you. However, the SNF must allow you access to your bank accounts, cash, and other financial records. Your money (over $50 if you have Medicaid and over $100 if you have Medicare) must be placed by the SNF in an account that will pay interest. They must give you quarterly statements. The SNF must protect your funds from loss by buying a bond or other similar protections.
• Privacy, property, and living arrangements —You have the right to privacy, and to keep and use your personal belongings and property as long as they don’t interfere with the rights, health, or the safety of others. SNF staff should never open your mail unless you allow it. You have the right to use a phone and talk privately. The SNF must protect your property from theft. This may include using a safe or having cabinets with locked doors. If you and your spouse live in the same SNF, you have the right to share a room (if you both agree to do so).
• Medical care—You have the right to be informed about your medical condition, medications, and to visit your own doctor. You also have the right to refuse medications and treatments (but this could be harmful to your health). You have the right to take part in developing your care plan. Care plans are explained on page 14. You have the right to look at your medical records and reports.
• Visitors —You have the right to spend private time with visitors at any reasonable time, as long as you respect the rights of other residents. You don’t have to see any visitor you don’t wish to see. Any person who helps with your health or legal services may visit you at any reasonable time. This includes your doctor, representative from the health department, your Long-Term Care Ombudsman, and others.
• Social services —The SNF must provide you with any needed medically-related social services, including counseling, help solving problems with other residents, help in contacting legal and financial professionals, and discharge planning.
• Complaints—You have the right to make a complaint to the staff of the SNF, or any other person, without fear of punishment. The SNF must resolve the issue promptly. Go to “How can I report and resolve problems?” on the next page.
• Protection against unfair transfer or discharge—You can’t be sent to another SNF, or made to leave the SNF you’re in unless:
• It’s necessary for the welfare, health, or safety of you or others.
• Your health has declined to the point that the SNF can’t meet your care needs.
• Your health has improved to the point that SNF care is no longer necessary.
• You don’t pay for the services you’re responsible for.
• The SNF closes.

A SNF can’t make you leave if you’re waiting to get Medicaid.

• Involvement of your family and friends—Family members and legal guardians may meet with the families of other residents and participate in family councils.

By law, SNFs must develop a plan of care (care plan) for each resident. Care plans are explained on page 14. You have the right to take part in this process, and family members can help with your care plan with your permission. If your relative is your legal guardian and in line with state law, he or she has the right to look at your medical records and make important decisions on your behalf.

How can I report and resolve problems?

If you have a problem at the SNF, talk to the staff. For example, if you have a problem with your care, talk to the nurse or Certified Nurse Assistant (CNA). The staff may not know there’s a problem unless you tell them. If talking to the staff doesn’t resolve your problem, ask to talk with the supervisor, the social worker, the Director of Nursing, or your doctor.

All SNFs must have a procedure for complaints. If your problem isn’t resolved, follow the procedure for complaints. You may also want to bring your problem to the resident or family council.

The SNF must post the name, address, and phone number of state groups, like the State Survey Agency, the State Licensure Office, the State Ombudsman Program, the Protection and Advocacy Network, and the Medicaid Fraud Control Unit.

If you feel you need outside help to resolve your problem, call the Long-Term Care Ombudsman or the State Survey Agency for your state. You can visit theconsumervoice.org/get-help/ to find resources in your area.

What if I think my SNF charges are wrong?

If you have Original Medicare, you’ll get a “Medicare Summary Notice” (MSN) from Medicare that shows the services you got at the SNF. If you think these charges are wrong, call the phone number on the notice.

Note: If you’re in a Medicare Advantage Plan, call your plan if you have questions about your bills.

Source and further reading

Medicare Coverage of Skilled Nursing Facility Care — Centers for Medicare & Medicaid Services. Public domain U.S. government educational material, accessed October 28, 2026. Fynoptic has selected sections, removed print navigation, and reformatted the text for this guide. The agency does not endorse Fynoptic.