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A Closer Look at the Revised Nursing Facility Regulations
Return to Facility After Hospitalization
Executive Summary Introduction
On September 28, 2016, the Centers for
Bed hold rights are set by state law. Federal law Medicare & Medicaid Services (CMS) released
complements state law by requiring facilities to revised nursing facility regulations. These
notify residents of those rights. Notice of bed regulations govern most aspects of nursing facility
hold rights must be provided at two separate operations, and apply nationwide to any nursing
times: in advance of a hospitalization, and at facility that accepts Medicare and/or Medicaid
the time of transfer to a hospital. The advance reimbursement.
notification must include the resident’s right to a
bed hold, whether the state’s Medicaid program Bed Holds
pays for a bed hold, and the facility’s bed hold
policies (which must be consistent with state and Bed Hold Basics
federal law). The time-of-transfer notification Bed holds may be available when a resident is
must describe the resident’s bed hold rights under hospitalized or takes an overnight visit with family
the facility’s policy. or friends (such a visit is termed a “therapeutic
Federal law also establishes a resident’s right to leave”). The basics of bed hold law — whether a
return to the facility even if a bed hold period bed hold is required, the length of any mandatory
has been exceeded, or if the resident did not bed hold, and the availability of Medicaid payment
have a bed hold. The resident can return to her for a bed hold — is determined by state law, and
previous room if available, or to the next available thus varies from state to state.
room if the previous room is not available. The As discussed in this issue brief, however, federal
regulations specify that the resident can request a law requires facilities to issue certain notices
transfer/discharge hearing if the facility refuses to regarding bed holds. Specifically, a nursing facility
accept her back. must give written notice of the facility’s bed hold
policies to the resident (or resident representative)
Acknowledgements on two separate occasions: 1) before the resident is
Justice in Aging, the National Consumer Voice hospitalized or takes a therapeutic leave and 2) “at
for Quality Long-Term Care, and the Center for the time of transfer … for hospitalization” or at the
Medicare Advocacy created this issue brief in time of taking a therapeutic leave.
collaboration. This brief is the eight of a series Note that the Medicare program cannot cover
explaining important provisions of the revised
regulations. a resident’s temporary absence from the nursing
Office of the LTC Ombudsman
Version 1.0 September 2020
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