This week The Center for Medicare Advocacy issued a timely reminder: patients in a Nursing Home may leave the facility to enjoy the holidays with family without losing their Medicare coverage. Medicare’s own Policy Manual instructs facilities not to tell patients that if they leave the facility they will lose their coverage.
If a nursing home resident leaves the facility for the day, but returns by midnight, the facility can bill Medicare for that day. If the resident leaves the facility, but does not return by midnight, that day will not be billed to Medicare, and is considered a temporary leave of absence.
The facility is allowed to charge the patient to hold their bed – called a “bed-hold” fee -during a temporary leave of absence. But, the facility must tell the patient ahead of time that they will be charged, tell them the cost of holding their bed, and the patient must elect to make the payment. Most of the time the bed-hold fee is worth paying. If a patient is well enough to leave the facility overnight, it is comforting for families to know their loved one can go back to the same bed, in the same facility, without having to go through any readmission process.
Center for Medicare Advocacy: You Can Leave the Nursing Home: Home for the Holidays (November, 2013)