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Caring for loved ones can take an emotional toll. When your parent or another loved one requires constant care from you and others around them, it can be taxing on your mental and physical being. If your loved one is in a nursing home and leaves it for a period, how long will they hold the bed?
How long a nursing home holds a bed for residents depends on the nursing home, as they each have their own bed-holding policies. Some states allow bed holds, while others do not. It also depends on the resident’s medical coverage. The facility determines Medicare, Medicaid, and privacy policies.
This article will explore a few topics related to this question in great detail, including law-specific bed-hold policies, state bed-hold policies, and Medicare and Medicaid patient rights and protections for nursing homes. Let’s get started!
Are Nursing Homes Required To Hold a Bed for Residents?
Nursing homes are not required by law to hold a bed for residents. However, some nursing homes may choose to do so as an option to keep the facility running smoothly and expenses low. However, this will depend on the facility and the care plan you have with them.
According to the LTC (Long-Term Care) Ombudsman, most private insurers, including Medicaid and Medicare, do not cover bed holds. The nursing home can refuse to hold a bed for a private pay resident if their insurance doesn’t pay for it.
This means that if you want your loved one’s bed to be reserved for them while they’re away from the nursing home, you will have to pay for it privately. However, depending on the state in which the care facility is located, this policy may vary.
What Are State Bed Hold Policies?
Whenever a nursing home patient has to leave their nursing home for treatment in a hospital or another facility that is not available at the nursing home, a bed-hold policy applies, and the patient is expected to return to the same nursing facility after leaving.
This policy varies by state and medical coverage.
If your loved one has Medicaid coverage, they are allowed a certain length of absence, but this depends on the state. For example, Alabama Medicaid allows residents uncharged bed reservations for the first four days, and California residents receive a bed reservation for seven days.
If you are a Florida-based private pay resident, your bed is guaranteed for up to 30 days due to a single hospitalization. Of course, this is only if the nursing facility has been paid.
In states like Hawaii, a bed hold is possible upon returning, but the resident might have to stay in another room. The availability of beds, as well as the type of medical coverage (Medicare or Medicaid) a resident has, will determine this.
Can I Return to a Nursing Home If My Bed Isn’t Kept?
In some states, depending on the length of time residents were away and their medical coverage policy, nursing homes have a legal obligation to provide a bed for you if there is no other available room in the facility. Some states, however, do not pay to reserve a resident’s bed when they are away on non-medical leave.
To determine if a nursing home is required to hold a bed for you, contact the state agency that licenses the facility. If you need a bed within 48 hours of your arrival, ask the facility’s administrator to make an immediate request for a bed.
Medicaid vs. Medicare Bed Hold Policy Costs
Medicaid is a publicly funded healthcare program for low-income individuals and families. Medicare is a government insurance program that provides health services to people over the age of 65 and younger people with certain disabilities.
When comparing Medicaid and Medicare, it is important to understand the different types of coverage offered by each program.
Another thing to consider when comparing Medicaid and Medicare is the financial burden each program places on individuals. While there are no monthly premium costs associated with either program, individuals must pay out-of-pocket for any medical expenses not covered by their insurance plan.
In summary, deciding between Medicaid and Medicare can be a difficult decision for individuals who want to understand all their options before committing to a type of coverage.
There are pros and cons to every type of coverage, but it’s worth remembering that they are not mutually exclusive; you could have both Medicaid and Medicare simultaneously!
Here is how Medicaid and Medicare differ in their bed hold policy costs:
Medicaid Bed Hold Policy
Medicaid differs from Medicare in that it applies only to low-income individuals and families (those earning less than $1,300 a month and with less than $7,000 in savings).
In addition, Medicaid covers a wider range of benefits, including hospitalization and prescription drug coverage.
If a nursing home resident leaves to be treated in a hospital, Medicaid will pay to reserve the bed for a maximum of 15 days. They will also cover bed reservation costs for up to 21 days annually if the resident leaves the nursing home for non-medical purposes.
Medicare Bed Hold Policy
Medicare, on the other hand, covers both low-income individuals and families as well as high-income individuals who have certain disabilities. It also provides longer hospital stays and more comprehensive prescription drug coverage.
In terms of the bed hold policy, Medicare doesn’t pay nursing facilities to hold beds.
Do Medicaid and Medicare Cover Carehome Costs?
Medicaid and Medicare nursing home beds are available to low-income people. In most cases, their beneficiaries qualify for free or sliding-scale care. However, some states limit the number of Medicaid and Medicare-funded bed days a patient can receive, leading to gaps in coverage.
Bed hold policies vary by state and can affect how quickly you can access care. Policies that prioritize emergency admissions may result in longer delays when it comes to getting into a bed, while those that focus on need may allow you to get a bed sooner. In addition, these policies can be difficult to navigate and understand.
For instance, some places require you to show proof of income before enrolling in Medicaid or have enrollment windows that close early. To find out what policy is in place for your state, contact your local Medicaid office or search online for your state’s Medicaid bed hold policy.
Many nursing homes have a policy of accepting people who don’t have secondary insurance or don’t have the funds to pay for private pay care. Nursing homes in some states are legally required to accept Medicare and Medicaid patients.
Medicaid
As of May 2019, the Department of Health has announced that Medicaid nursing home residents won’t receive reimbursement for hospitalization bed holds. Exceptions apply if the resident is a minor or receiving end-of-life care.
However, nursing home residents are entitled to ten days of therapeutic leave annually, and this is reimbursed at 95% of Medicaid’s bed hold rate.
Medicare
The Medicare program covers short-term rehabilitative stays only if they are medically necessary. To be eligible for coverage and depending on the facility’s policy, the nursing home resident must be hospitalized for a minimum of three days.
If the resident is not receiving in-patient care, Medicare will not provide coverage. This means that if the resident leaves the facility for non-medical reasons without hospitalization, they must pay for the bed themselves.
Residents who take overnight leaves of absence must pay for any uncovered days of service privately.
Private
If private residents need to stay in the hospital for more than a few days, they may be asked to continue paying for a bed. This is because they are likely to need care for an extended period. The fee can be set by the state or private medical policy or the company that owns the care home.
Sometimes nursing homes refuse to take patients because of several reasons. Click on the link to learn more about the reasons and alternatives to a nursing home. Could a Nursing Home Refuse to Take a Patient?
Conclusion
Nursing homes are not required to hold beds for residents unless paid for privately. You may request a leave of absence from a nursing facility if your loved one receives care there. To be sure that your plans are compliant with the state’s regulations, it’s recommended that you check with the facility first to see if they have any bed hold policies or other regulations.
The Long-term Care Ombudsman Resource Center has compiled a fact sheet that gives consumers some of this information.
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