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I've read on this forum of people advising the hospital (the discharge planner particularly, I think) that there will be no one at the home available to take care of the parent. That it will be an "unsafe discharge" (using those words exactly).

Hopefully more knowledgeable folks will have more info about this for you.
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So, the answer is " it depends". I really don't know the legalities of all this and I suspect it depends upon State regulations, etc. But...
1. Hospitals are charged with making sure it's a " safe discharge".
2. If a person with Medicare has been in the hospital for 3 midnights as an admitted patient, you can explore the idea of discharge to rehab, rather than home.
3. It helps if your parent is on board with the idea of not going back to your home. Unless they've been declared incompetent, they can sign for their own discharge.
4. I've been blessed to have worked with a really good discharge planner who made it really clear what our options were and how mom's ability to private pay for two years would allow us to a better grade of NH that would accept her as a Medicaid patient when/if her money ran out.

Can you tell us more about your situation?

I'm told that in some places, you will be guilted into taking your parent back home. That never happened to us, mainly since mom never lived with us. I think the trick is to stand firm and not be swayed by guilt if you know that you can no longer safely caregiver. 

If they say " the State will become her guardian" or " well have to send her to a psychiatric hospital", view these as offers of help, not threats.  And say " yes, please".
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What are your reasons for not taking the parent back. Care becoming too much? For me I am in a split level and my Mom couldn't do stairs and couldn't understand why she couldn't. After almost 2 yrs living in my home I place her in an AL. She had the whole building to walk around.
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As I understand it, yes, you can refuse to take her back. If I were you, I would come up with an alibi for "why not", since she was living with you before the hospital admission.

If he/she has dementia, you could say that schedules have changed and there is no one to watch him/her during work hours and no money to pay for hired help.

Also, if the parent is combative, you have small children or grandchildren in your home and it would be a danger to them.

If your parent has mobility issues you could say that you have a bad back and that it's flared up and you can't lift or reposition.

Do you get the drift?
Be forewarned that the hospital social worker will try very trick in the book to get you to take them back. Stand firm. State the reason over and over (like a broken record) if you have to. They will be forced to find placement for them, as I understand it.

Be prepared to go through a bunch of questions like your parents' finances, state of health (mental and physical), other family members ability to take him/her in, etc. In essence, prepare to spend a long time with the Social Worker.
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