As readers of My Elder Advocate Blog are well aware, we often speak about the grave danger to elders who are evicted from Nursing Homes, Assisted Living Facilities, and Adult Homes. A nursing home eviction often leads to disorientation, loss of identity, depression, and death.
Nursing home residents who need to be treated in a hospital usually want to be able to return to the same bed and room in the nursing home as soon as they are discharged from the hospital. New York State many years ago had established a policy for Nursing Home residents, called the “bed hold” policy. These regulations were established to reimburse a nursing home for “holding” a bed vacant for the return of a temporarily absent Medicaid recipient that the facility would otherwise likely have been able to fill with another patient admission.
This bed hold policy applied regardless of how many hospitalizations there were in a year. In 2010, the policy changed. Nursing home residents are allowed only 14 days a year. How do you go from no limit to only 14 days? It does not have to make sense; it only has to save money… or make money!
Medicare will not make any payment to the nursing facility to reserve a bed for a Medicare beneficiary.
Medicaid will make bed reservation payments for up to 15 days if you are hospitalized. Medicaid will also pay for up to 21 days per year if you are temporarily absent for other reasons, such as short visits to family or friends on holidays. Once these payments have been exhausted, you, your family members, or others cannot be required to pay to continue to reserve your bed, but may do so voluntarily at the Medicaid per diem rate to assure that you can return to your bed.
Mary B. had a good life in one of the finer nursing homes in New York City. She had been a resident of this facility for three years. She knew the staff well. They loved Mary, too. Like many nursing home residents, if Mary had to go to the hospital, she and her family knew that when she got better she would be going back to her bed at the nursing home. She hated the hospital stays. The care was very inferior to her care at the nursing home. The nurses did not seem to care as much. All her family would hear is “when can I get back to my home?”
I was at the facility on one occasion, when Mary returned from one of her hospitalizations. It was like she had returned from a vacation. I saw her cry with joy as staff members gathered around to welcome her back. Mary was hungry. Although it was past lunchtime, a warm tray of food suddenly appeared. After lunch her nurse reviewed her hospitalization discharge paperwork to see what changes in her care had to be made. Some of Mary’s prescriptions changed so the pharmacy had to be notified. Mary was checked for bedsores. She had lost five pounds in the hospital. The dietician asked the doctor to order a nutritional supplement.
I asked Mary what she would do if there were no bed hold policy. She told me that she would not be so quick to report illness to the staff for fear of going to the hospital and not being able to return. In other words, out of fearing the loss of her bed, she would not report being sick.
That’s the choice residents are given: Seek care only if you are willing to lose your bed in the nursing home. Imagine all the neglect and abuse that this policy will lead to. This new policy is not fiscally responsible but will cost many, many lives.
This new policy is dangerous, arbitrary, and will require a great amount of vigilance on behalf of families. Even with unlimited bed holds, many facilities are abusing the bed hold rule, and using bed holds to illegally evict what they categorize as undesirable residents.
My Elder Advocate has a 100% success rate in preventing evictions and/or in returning residents to their original facilitiesonce they have already been evicted.
My Elder Advocate has over 36 years of experience in nursing home administration, and dealing with operators who abuse the elderly.
If you suspect that the nursing home is planning to remove your elder family member from their nursing home, call us immediately at 212-945-7550. The time to nip this in the bud is BEFORE the eviction occurs.