Two North Carolina nursing homes have agreed to stop automatically denying admission to people with substance use disorder, in a landmark settlement that could pave the way for expanded health care access at a nursing home or other long-term care facility to North Carolinians who use, or have used, drugs.
Two nursing homes in the Triangle, Sunnybrook Rehabilitation Center in Raleigh and Treyburn Rehabilitation Center in Durham, denied admittance to a North Carolina man based on his recent drug use. When Disability Rights NC got wind of his predicament, they filed a joint lawsuit with the Legal Action Center against these nursing homes under the Americans with Disabilities Act — and won.
The settlement requires the adoption of an anti-discrimination policy for people who currently use drugs or receive medication-assisted therapy for addiction, like methadone or suboxone.
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“I just want to be able to get the care that everyone else gets,” said the subject of the lawsuit, who has chosen to remain anonymous.
“I want to be treated with dignity. I was sick and needed help after being in the hospital, but the nursing homes said no. It was really hard for me, and it didn’t feel fair. I’m very glad this case is settled and that the nursing homes are changing their rules. Now, other people like me won’t have to go through what I did.”
Disability Rights NC believes it to be the first case of its kind in the country. Activists hope that nursing homes and health care facilities across North Carolina will adopt similar policies in the wake of the suit, expanding access to care for those struggling with substance abuse.
The man, who suffers from a range of health issues including diabetes, was hospitalized multiple times over a two-year period. Each time, he needed to be discharged to a skilled nursing facility. The hospital searched for an opening at any nursing home in a 50-mile radius, and Treyburn and Sunnybrook both had space. When the man disclosed his relationship with drugs, the homes revoked their offer to take him.
Even though the facilities had available beds, he was denied admission to Treyburn and Sunnybrook based on his substance use disorder, resulting in long hospital stays and repeated hospitalizations. Before his third stint, he slipped into a coma.
Carolina Public Press attempted to reach the facilities for comment but they did not respond in time for publication.
“The rights of people who have substance use disorder are very poorly understood,” Holly Stiles, assistant legal director at Disability Rights NC, told CPP.
“People in active (drug) use or with any history of use are still entitled to health care. If you are in recovery, then you’re a person with a disability, and you’re entitled to protections — you can’t be discriminated against by public and private entities. Most people don’t know that substance use disorder is considered a disability at all. People in current use have an absolute right to health care. These people need medical care, just like everyone else.”
In addition to the anti-discrimination policy, the nursing homes must pay out $55,000, train staff on the new non-discrimination requirements, implement a way to enforce the policy and monitor all admission denials for people with substance use disorder.
This case proves that it isn’t just people receiving treatment for addiction that have a right to health care, but those who are actually engaged in current drug use. That population is so used to being treated as less-than, said Sarah Harrington, attorney at Disability Rights NC. She hopes this case can give them hope.
Substance use is a prevalent issue in the older populations that nursing facilities typically serve, according to Elyse Powell, executive director of NC Harm Reduction Coalition.
“It is way too common that health care providers will not serve someone when they find out that they have substance use disorder, or suddenly start treating them differently,” Powell said.
“It’s unfortunately incredibly common to see that kind of discrimination. I’m hopeful that other facilities will use the anti-discrimination policy as a model. If we keep preventing people who use drugs from receiving health care, it only gets harder and harder to help them.”
The fear for these nursing homes is that people who use or have used drugs could be disruptive or dangerous.
But now, the man at the center of the lawsuit is thriving in a nursing home, according to the folks at Disability Rights NC. He is a well-liked, active member of the residence committee there.
“All the fears, all the speculation, all the stereotypes were proven to be untrue,” Stiles said. “That’s the importance of cases like this: you have to give people a chance.”
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