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Revised Nursing Home Regulations and Returning to Facilities

Late last year, the Centers for Medicare & Medicaid Services (CMS) released revised nursing facility regulations, including those that address a patient’s return to a facility following a period of hospitalization. This issue deals with bed holds, or the timeframe within which a facility must accept a patient back after hospitalization. State law determines bed hold policies, but federal law requires facilities to notify patients of their bed hold rights, both before a patient is hospitalized and at the time that a patient is transferred to a hospital. Federal law also specifies other patient rights as they relate to bed holds.

Notice prior to the transfer of a patient, which typically occurs during the admissions process, must include a description of the applicable state law on bed holds and the ability of the state’s Medicare program to pay for a bed hold. Federal law requires that the notice be given to the patient well in advance of any transfer. The same information must be given to the patient at the time that he or she is actually transferred.

Federal law also protects a patient’s right to return to a facility, even if the hospital stay has exceeded the bed hold, no bed hold was available, or the patient did not request a bed hold. This right, however, is available only to patients with Medicaid or Medicare coverage and a need to return to the nursing facility; it is not an available option for private pay patients. This right allows the patient to return to his or her previous room, if available. If that room is unavailable, the patient is entitled to the next bed available in a semi-private room with a roommate of the same sex.

If a facility denies a patient the right to return to the facility following a hospitalization, claiming that the facility can no longer meet the patient’s needs, the patient has a right to appeal. However, as a practical matter, it is time-consuming to appeal a refusal, particularly in light of the fact that the facility is likely to continue to refuse to admit the patient and the hospital is likely to pressure the patient to leave. Under the newly revised nursing home regulations, the facility must comply with transfer/discharge procedures if it is choosing to deny the patient readmission.

All too often, care between nursing facilities and hospitals is inconsistent, which can result in harm to your loved one; medication errors and other interruptions in consistent care can be deadly to a senior citizen. The Wisconsin elder abuse lawyers of Boller & Vaughan know how devastating it can be when you entrust your loved one to the care of others, only to have that trust completely betrayed. Our attorneys are dedicated to protecting your rights and those of your loved ones in all types of circumstances. We handle nursing home abuse and neglect cases on a daily basis, and we know how to get the relief to which you may be entitled. Don’t hesitate to fight back against a neglectful or abusive nursing home, assisted living facility, or hospital that has caused harm to your loved one. Contact us today and see how we can help.