Follow
Share

If a Medicaid patient in a nursing home is sent to the hospital, does the NH have to take the patient back to the NH after hospital treatment?

This question has been closed for answers. Ask a New Question.
Could you be more specific about why they were taken to the hospital? Do they have some condition that the nursing home cannot deal with? Did they pay for a bed hold?
Helpful Answer (0)
Report

Not necessarily. Could you be more specific about what has happened and what the next steps are that you're hoping for?
Helpful Answer (0)
Report

Is there a reason why the NH may not want the patient back?
There is usually a waiting list for NH beds especially Medicaid ones it is not in the NH interest to leave a bed empty. It could probably be arranged if you are prepared to pay the daily rate.
When i was in rehab and readmitted to the hospital, they offered to hold my bed at a cost of $182 peer day which was the medicare rate.
Helpful Answer (0)
Report

the NH doctor recommended going to the ER which he said would result in being admitted to the hospital.
Helpful Answer (0)
Report

My understanding is that their status at the hospital will make a difference.... if they sent from NH to hospital/ER & are at the hospital under “observation” they are technically not hospitalized & not an inpatient so NH has to keep a Bed hold as Medicaid will pay their R&B to the NH for the observation period (like under 48 hrs).
But if they are actually hospitalized, then no bed hold payment to the NH from Medicaid (no room & board daily payment) but upon being discharged from the hospitalization of more than 3 days they can get discharged for “rehab” to the NH with rehab as a 100% Medicare paid benefit.

If you want them to return to the old NH, there needs to be a clear discussion with the NH regarding the gap to pay the non revenue days. If NH has a long waiting list for Medicaid beds, then family is going to need to pay the gap. But if the NH continuously has 4-5 open Medicaid beds, they can hold one for your elder for a bit of time. Having a good relationship with NH staff will come in handy to get this done smoothly. Keep in mind that the rehab Medicare paid bed will pay like 2 or 3 times the day rate of a Medicaid bed. So holding a bed for a few days knowing that they are returning with 21 days paid by Medicare is oodles more income.

My mom at her 1st NH was sent by ambulance (which the NH arranged for) from NH to hospital ER after she had a TIA. Around 36 hr observation. & then back to NH via ambulance transport arranged by hospital discharge planner. Happened twice; very stressful. It was one of the reasons why I moved her to another NH a few weeks later. Btw she had more TIAs while at the 2nd NH and she remained there in her bed, getting lots of rest/hydration with extra nursing staff oversight. When I went looking for a new NH, I asked pointe blank how they dealt with TIAs, uti’s, CDeff, falls. To me, it was apparent that some NH will ship them out to hospital/er if it looks like the resident will require more than the minimum nursing care. Family has to be very proactive in their care plan & reminding facility of their responsibility.
Helpful Answer (1)
Report

This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter