Sometimes the nursing home's assessment is correct - that the patient probably shouldn't return home. But other times it appears that the decision is based on the fact that the nursing home has a low census and needs patients. This is especially true when a patient requires expensive treatments and he has the ability to pay for them - such as g-tube feedings or specialty beds which can cost hundreds of dollars extra per day. I've seen patients pay close to $15,000 per month for a shared room, which would pay for 24-hour care (and then some) in the patient's home.
Patients don't realize that they have the right to self-determination, which means that they have the right to return home if they wish. EPS can't remove a patient from his home as long as he is able to make decisions and appears well-cared for. We all have the right to make decisions unless a court says otherwise.
If the nursing home refuses to discharge your family member, it's always possible to call your primary physician for a Home Health referral, prescriptions and equipment. For additional information, buy a copy of The Nursing Home Survival Guide.