When a Resident Dies: What a Care Home Owes the Family
The short answer: when someone dies in a nursing home, the staff will confirm the death, call you, and wait for the funeral home you choose β you can ask for time to sit with them first. Within 30 days, a Medicare- or Medicaid-certified nursing home must return any money it was holding for them, with a final accounting. You can ask for their belongings, their medical records and the names of the staff who cared for them. And unless you personally signed as a guarantor, the family is usually not responsible for the final bill β the estate is. Assisted living works differently because it is regulated by each state, so check the contract.
It is easy to feel like a visitor in this moment, even after years of visits. You are not. There are things the facility owes you, and things you are entitled to ask for, and knowing them in advance makes the first day less of a blur.
The First Hours
Most deaths in a care home happen in one of three ways: expected, on hospice; expected but not on hospice; or unexpected.
If they were on hospice, the hospice nurse usually comes to confirm the death and handles the call to the funeral home. Hospice staff often stay with the family for a while. The last days: what hospice families wish they had known covers the days leading up to this.
If they were not on hospice, a nurse or physician confirms the death and the facility notifies the family. If the death was unexpected β after a fall, for example, or with no recent illness β the medical examiner or coroner may need to be told before the body is released. That is routine, not an accusation.
Then the facility will ask which funeral home to call. If you have not chosen one yet, it is fine to say so. Most facilities cannot keep a body for long because they have no cold storage, but "a few hours" is usually possible. How to choose a funeral home has the questions to ask quickly.
Ask for time. You can ask staff to leave the room as it is so you and other family members can sit with them before the funeral home arrives. Most facilities will make that happen. Some have a tradition of lining the hallway as the body is taken out β if they do, and you want to be there, ask when it will be.
What They Must Give Back
Their money. Many nursing home residents have a personal funds account held by the facility β spending money for haircuts, snacks, outings. Federal rules for Medicare- and Medicaid-certified nursing homes require the facility to convey those funds, and a final accounting of them, within 30 days of the death, to whoever is administering the estate under state law. If you do not receive it, ask the business office in writing.
Their belongings. Everything they had in the room is theirs, and passes through their estate like anything else. Ask for:
- Clothes, including anything in the facility's laundry
- Glasses, hearing aids and dentures, which are easy to overlook and can be expensive to replace for someone else
- Photographs and anything on the walls or bulletin board
- Jewelry β ask whether any was kept in a safe
- Their phone, tablet or radio, and chargers
Facilities often ask families to clear the room quickly, sometimes within a day or two. Read the contract; if you need longer, ask. Staff can usually box things up and hold them briefly. What to do with a loved one's belongings covers what to do once you have them home.
Their records. The executor or personal representative of the estate can request medical records under federal privacy law. You do not need a reason. If you have questions about what happened in the last weeks, the records β nursing notes, medication logs, care plans β are where the answers are.
The Final Bill
This is where families are most often surprised, in both directions.
Who pays. The resident's estate pays what is owed. A federally certified nursing home cannot require a family member to personally guarantee payment as a condition of admission. Many families signed the admission papers as "responsible party," which usually means agreeing to use the resident's own money to pay the bill β not agreeing to pay it yourself. If you are being asked to pay from your own funds, ask to see exactly what you signed. Do you inherit their debt? covers the wider picture, including Medicaid estate recovery, which can apply to someone who received Medicaid-funded care after age 55.
Charges after death. Medicare coverage ends on the day of death. Whether the facility can charge for days after that, or must refund part of a month paid in advance, depends on the contract and state law. Read the discharge and refund sections of the admission agreement, and ask for an itemized final bill before paying.
Assisted living is not covered by federal nursing home rules. The contract is the main source of what is owed and what is refunded, so start there.
If You Have Questions About Their Care
Sometimes a death raises questions: a fall nobody mentioned, a decline that seemed too fast, a bedsore you saw for the first time at the end. You are allowed to ask.
- Ask for a meeting with the director of nursing or the administrator. Ask what happened in the last days and who was with them.
- Request the records in writing.
- Contact the Long-Term Care Ombudsman for your state. Every state has one; it is a free, independent advocate for residents and families, including after a death.
- File a complaint with the state survey agency that inspects nursing homes, if something seems seriously wrong. Their past inspection reports are public on Medicare's Care Compare site.
Asking these questions is not ungrateful. Most care home staff would rather families ask than leave wondering.
The People Who Were There Every Day
In a long stay, the aides, nurses and kitchen staff may have seen your parent more often than anyone in the family. Many of them grieve too, and few are ever told.
Things families often wish they had done:
- Asked who was with them. Was anyone in the room? What were the last good days like?
- Written down the names of the aides and nurses they talked about.
- Told staff about the funeral. Many would like to go, or to send a card, and will not ask.
- Said thank you in writing β to the staff by name, not just "the facility." A card on the nurses' station is read by everyone. Funeral thank-you notes has wording.
- Thought about the roommate, if they had one. Losing a roommate is a death too.
Staff also hold memories the family does not: the song they hummed at breakfast, the resident they looked out for, the joke they told every shift change. If you ask, people will tell you.
The Next Few Days
From here, most of what follows is the same as after any death: the funeral, notifying people and agencies, the estate. What to do when someone dies has the full order, and who to notify when someone dies has the list.
One difference is worth noting. When someone has lived in a care home for a long time, many of the people who knew them best in their last years are not on any family contact list. They are the staff and the other residents. When it is time to share the funeral details or a memorial, ask the facility to pass them on.
On GetMemorial
If you create a memorial page on GetMemorial and set it to public, anyone with the link can visit, and visitors who sign in can leave a message. That makes it a natural place to collect the stories staff tell you. Photos in the albums are added by the person who created the memorial, so if staff have pictures from activities or birthdays, ask them to send them to you.
Quick Answers
How quickly does a nursing home have to return money after a resident dies? For Medicare- and Medicaid-certified nursing homes, within 30 days, with a final accounting, to whoever administers the estate.
Do I have to pay my parent's nursing home bill? Usually not from your own money. The estate pays. Check whether you personally signed as a guarantor; certified nursing homes cannot require it as a condition of admission.
How long do we have to clear the room? It depends on the contract. Facilities often ask for a day or two. If you need longer, ask; most will store belongings briefly.
Can I see their medical records? Yes, if you are the executor or personal representative of the estate. Request them in writing.
This page describes general practice in the United States and is not legal advice. Nursing home rules here apply to Medicare- and Medicaid-certified facilities; assisted living is regulated by each state.
GetMemorial helps families build lasting online memorials, a place where the people from their last years can add what they knew too. When you are ready, create a digital memorial for them.
