Can a nursing home charge my mother for a ride to the dentist?

It depends on how she pays and on her state. The home must tell residents, at or before admission, which services cost extra and how much, and must give 60 days' written notice before changing those charges. It may bill only for a service the resident asked for, after saying out loud and in writing that there is a charge and what it is. For a Medicaid resident, the home cannot charge for anything the state counts as part of nursing facility care. North Dakota's manual says an in-state home may not charge a Medicaid resident for rides it provides, and Indiana counts those residents' non-ambulance rides as part of the daily rate.

Does Medicare pay for a wheelchair van from the nursing home to the doctor?

No. CMS states that Original Medicare covers no form of non-ambulance transportation under Part A or Part B, including wheelchair vans. Ambulance coverage requires a condition that makes every other kind of vehicle unsafe for the resident. When Medicare will not pay for a ride, the home has to tell the resident about the charge under its notice rules.

Does a staff member have to go with my father to his appointment?

No federal rule requires a staff member on every outside trip. Whether someone goes along should follow your father's needs and care plan, so ask the home how it decides. New York's Medicaid program says a nursing home cannot charge Medicaid residents or their families when its staff ride along, and cannot order a higher level of vehicle just to fit the staff member.

What can I do if appointments keep getting cancelled because no ride was arranged?

Put it in writing to the home's grievance official first, since every home must have one and must try to resolve grievances promptly. If that fails, contact the State Survey Agency or the long-term care ombudsman, whose details the home must post. Surveyors are told to check whether cancellations over transportation, including its cost, came from the home's own procedures.

My mother lost her hearing aid at the nursing home. What does the home have to do?

Help her replace it. CMS guidance says that when a resident loses a vision or hearing device, the home must help find a way to pay for a new one, make the appointment, and arrange the ride. The home does not have to buy the device itself, but it is responsible for the steps that get her to the provider who can replace it.

How fast must a nursing home act when dentures are lost or broken?

Within 3 days. Federal rules require the home to refer a resident with lost or damaged dentures for dental care within 3 days. If the referral takes longer, the home must document what it did to make sure the resident could still eat and drink well while waiting, and why the delay happened.

Do Nursing Homes Provide Transportation to Appointments

Arranging the ride is required, paying for it is a separate question

A nursing home that takes Medicare or Medicaid has to help residents reach certain outside care, and that help includes setting up the ride. The federal rules in 42 CFR Part 483 talk about arranging transportation, and CMS reads that narrowly. In its guidance on lab and x-ray rides, it tells surveyors the rule does not require the home to “defray or cover the costs of transportation.”

So families usually get two answers to “do nursing homes provide transportation.” The home must make the calls, book the appointment, and line up a vehicle when the resident needs that help. Who pays for the vehicle is settled somewhere else: by the resident’s coverage, by the state’s Medicaid design, and by the charges the home disclosed at admission.

The appointments federal rules name

Five kinds of outside care come with a written duty to help with transportation. Each row below is a separate federal requirement, and each has its own survey tag, the code a state inspector cites when the home falls short.

Care	Federal rule and survey tag	What the home must do
Vision and hearing	42 CFR 483.25(a), F685	If necessary, help make the appointment and arrange a ride to the eye or hearing specialist or device provider
Foot care	42 CFR 483.25(b)(2)(ii), F687	If necessary, help book a qualified person, such as a podiatrist, and arrange the ride
Dental	42 CFR 483.55(a)(4) and (b)(2), F790 and F791	If necessary or if the resident asks, help make appointments and arrange rides to the dentist
Laboratory	42 CFR 483.50(a)(2)(iii), F774	Help arrange rides to and from an outside lab when the resident needs help
X-ray and other tests	42 CFR 483.50(b)(2)(iii), F778	Help arrange rides to outside radiology and diagnostic services when the resident needs help

Two details in these rules come up often with families:

Lost devices. CMS guidance says the home does not have to buy glasses or hearing aids. When a resident loses one, the home must still help find a way to pay for a replacement, book the appointment, and arrange the ride.
Dentures. A resident with lost or damaged dentures must be referred for dental care within 3 days. A later referral has to be explained in the record, along with how staff made sure the resident could still eat and drink.

The duty reaches past those five rows. CMS guidance on dialysis says the home must help make sure a resident has safe transportation to and from an outside dialysis unit. Its guidance on social services adds that when Medicaid does not cover a service a resident needs, the home must still try to get it, and it names arranging transportation as an example.

What “arranging” means to an inspector

That same guidance tells surveyors to weigh the resident’s clinical, physical, mental, and financial condition when judging whether a home really helped. It gives a plain example: putting a resident with limited funds in a taxi when cheaper options exist is not real assistance. For dental trips, the guidance asks the home to keep the cost to the resident down by finding the lowest-cost or no-cost ride available.

Inspectors also check missed care. If appointments were cancelled because of transportation problems, including what the ride cost, the surveyor looks at whether the home’s own procedures caused it. A home whose procedures leave residents without rides can be cited, even though no rule makes it buy a van.

For families, that gives a useful standard to hold the home to. Ask who books the rides, how far ahead, and what the home does when a resident cannot afford the option it found.

Who pays for the ride

The payer depends on the resident’s coverage on the day of the trip and on the state.

A Medicare stay after a hospital visit

Original Medicare pays for no wheelchair van, stretcher van, or other non-ambulance ride. CMS says so plainly in its claims manual: Medicare “simply does not provide any coverage at all” for those vehicles. It then points to the notice rule. When a resident may owe for something Medicare does not cover, the home must say so before or at admission and during the stay. Ambulance trips during a covered skilled nursing stay follow their own billing rules, explained in our guide to skilled nursing facility transportation.

Long-stay residents on Medicaid

Each state decides whether a resident’s rides come through the Medicaid ride program or out of the home’s daily rate. Three state manuals show how far apart they are:

Colorado. Health First Colorado’s ride program will not pay to take a nursing facility or group home resident to medical or rehab care that is part of the facility’s own program. The exception is a facility with no vehicle free for the trip. Otherwise the facility claims the expense on the cost report it files with the state.
North Dakota. The manual, updated January 2026, says an in-state nursing facility may not bill Medicaid or charge a Medicaid resident for rides the facility provides. Medicaid does cover a medically necessary ride from a hospital to the nursing facility the member chooses. For members living in Minnesota nursing facilities, North Dakota pays their rides separately from the daily rate.
Indiana. Since July 1, 2023, nursing facilities book and pay the ride company for their Medicaid residents’ non-ambulance rides, and the cost counts as part of the daily rate. Medically necessary ambulance trips are still billed to the state by the ambulance provider. The Indiana guide has the details.

If your parent’s state is not one of these, ask the business office whether resident rides go through the state’s ride program, a Medicaid health plan, or the home’s own budget. Our guide to what Medicaid transportation covers explains the member side.

Private-pay residents and anything outside the rate

Charges for rides have to be disclosed. Under 42 CFR 483.10(g)(18), the home tells each resident before or at admission, and from time to time after, which services are available and what they cost, including anything Medicare, Medicaid, or the daily rate does not cover. A change to those charges needs written notice at least 60 days before it starts.

The home can bill a resident only for a service the resident asked for, and only after telling them, orally and in writing, that there will be a charge and how much it is. It cannot make asking for an extra service a condition of admission or of staying.

Medicaid residents get one more protection. A home may charge them only for items and services the state plan does not count as nursing facility services, and it must give each Medicaid resident a written list of what is included and what costs extra. North Dakota’s manual applies this directly to rides: an in-state home may not charge a Medicaid resident for transportation it provides.

Who goes along on the trip

No federal rule puts a staff member in the vehicle for every outside appointment. Whether someone rides along should follow the resident’s needs and care plan, so ask the home how it decides.

When a staff member does go, New York’s Medicaid transportation manual gives an example of how a state can handle it. A nursing home cannot charge Medicaid residents or their families when its staff ride along to provide personal care or help the resident talk with the doctor. The home also cannot book a higher level of vehicle just to make room for the staff member. The same manual says the driver does not have to stay through the appointment to relay information to the home, or go into the exam room to lift the resident onto the table.

Medicaid’s own rules allow a transportation attendant when one is necessary. Under 42 CFR 440.170, travel expenses can include the attendant’s ride and meals, plus a salary when the attendant is not family. Family members who want to ride along should say so when the trip is booked, because some vans have few seats. Our guide to medical escorts for seniors covers hiring a companion, and the escort and attendant entry explains how ride programs treat them.

When rides keep falling through

Start inside the home. Every nursing home in Medicare or Medicaid must have a grievance official and a written grievance policy, must make prompt efforts to resolve complaints, and must give a written decision when the resident asks for one. A grievance can be spoken or written, and it can be anonymous.

If the home does not fix it, two outside offices can help:

The State Survey Agency. Residents may complain to it about any suspected violation of state or federal nursing home rules, and the home must post its contact details. A home that fails to help arrange the rides described above falls under those rules.
The long-term care ombudsman. Every state has an Office of the State Long-Term Care Ombudsman, run under the Older Americans Act, which works to resolve problems for people living in nursing homes, assisted living, and similar settings. The Administration for Community Living lists each state’s office.

If the problem is a Medicaid ride that never showed up, the complaint goes to the ride program as well. Our guide to filing a Medicaid transportation complaint walks through that process.

Questions to ask at admission

Who books outside appointments and rides, and how much notice does staff need?
Are rides included in the daily rate, billed to Medicaid, or charged to the resident, and at what price?
Which vehicle does the home use for a resident who rides in a wheelchair or on a stretcher?
When does a staff member go along, and is there any charge for that?
How does the home handle a dentist, eye, or hearing visit that needs a specialist outside the building?
Who should the family call when a ride is late or an appointment is missed?

Keep the answers with the admission agreement, since the charges the home quoted there are the ones it must give 60 days’ notice to change.

For the ride company the home calls

Nursing home staff book a lot of rides and field a lot of “where is the van” calls from families. Companies that run on HealthRide give facilities their own portal to request rides, follow the vehicle live, and pay invoices online, and each rider or facility can get a text link showing when the driver will arrive. See how the live map works.

Do nursing homes arrange rides to appointments? The federal duty, who pays, and who goes along