Case Management

Tip: Familiarize yourself with Medicaid bed hold policies

Case Management Weekly, March 21, 2012

Discharge planners must be aware of nursing facility bed hold policies.

Nursing home residents admitted to a hospital usually want to return to the nursing facility – preferably to the same bed and room – when they are discharged from the hospital. This is known as bed hold status.

The Conditions of Participation provide information about bed hold policies for patients admitted to hospitals from a nursing facility. The nursing facility gives Medicaid patients or their representatives a notice of bed hold status before transferring the patient to a hospital.

This notice must specify the duration of the bed hold policy under the state plan, during which residents may return to the same nursing facility. A nursing facility must establish and follow a written policy that allows residents whose hospitalization exceeds the bed hold period to return to the same nursing facility.

The policy must state the circumstances under which a patient may be readmitted to the facility. This includes admission to the first available bed if the patient still requires the level of care the facility provides and remains eligible for Medicaid nursing facility services.

Note that a state-funded bed hold policy applies to Medicaid patients. States administer Medicaid, so there is variation from state to state.

Discharge planners should contact their state Medicaid agency for information about the policy and learn what hospitals must do to ensure that patients don’t lose their beds.

This week’s tip is adapted from Discharge Planning Guide: Tools for Compliance, published by HCPro, Inc. For more information about this book or to order your copy, visit the HCMarketplace.

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