Legislature Set to Abolish 10-Day Bed-Holds for Nursing Home Residents Temporarily Discharged or under Hospitalization

For many years, the Massachusetts Legislature has provided funding for MassHealth to keep a nursing home resident’s bed empty for up to ten days during a period of hospitalization or temporary discharge- “bed-hold”. In 2010, the benefit was used in Massachusetts 28, 854 times. However, the State Senate recently concluded that Massachusetts cannot afford to maintain this policy.

The MassHealth bed-hold-policy now permits an individual in receipt of MassHealth to leave a nursing home to seek outside medical treatment or time with family and friends for a period of ten consecutive days without incurring any private pay cost. The policy also assures that if a MassHealth recipient returns to a long-term care facility within ten days, their own bed and room will be held free until their return.

Cuts would most significantly affect persons suffering from dementia and other cognitive impairments. For these individuals, a certain routine and comfort with the attending staff and surrounding residents are particularly significant. People with advanced dementia may suffer fright, disorientation and distress with any move – they have lost their home and may have trouble processing why.

Young people in nursing homes would also be seriously affected. The Boston Globe  remarked on the case of a 31-year-old man who needs round-the-clock care after being permanently disabled in a car accident. Without bed-hold funds he will be unable to attend a summer camp without losing his place.

Although the Patrick administration has publicly declared that an average of 10 empty beds are present in a facility on any given day, so that a nursing home is usually able to retain an individual’s bed following a hospitalization or temporary illness, residents that live in homes specializing in a specific type of care face a greater amount of competition for beds.

Significantly, the financial limit for a single MassHealth recipient is $2,000. Given that private nursing home rates differ between $250-$350 per day, if recipients want their bed to be held by the facility, they will be expected to pay out of pocket.

The current MassHealth bed-hold policy also provides for non-medical leaves of absence for up to 10 days per year. Generally, this allows a recipient to leave a nursing home to attend family gatherings without putting his or her bed in jeopardy. Eliminating the bed-hold policy would force individuals to pay privately for their beds if they wish to temporarily leave the facility for a wedding or holiday function.

Disallowing residents the financial freedom to attend such events would undoubtedly result in compounded isolation from family members and the outside world.

Fortunately, advocates for upholding the MassHealth bed-hold policy have persuaded the postponement of the elimination of the policy from July 8, 2011 until July 22. Elder law advocates seek to secure the signatures of as many legislators as possible in opposition to the policy to dissuade the Executive Office of Health and Human Services Secretary, Judy Ann Bigby, from abolishing existing policy. If you are interested in fighting to maintain the 10 day bed-hold policy, contact your local legislature.

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