He-E 802.15 - Temporary Absence from the Nursing Facility

He-E 802.15. Temporary Absence from the Nursing Facility

(a) A facility shall establish and follow a written policy regarding bed-hold periods which is consistent with RSA 151:25 and which indicates that when a facility has not received payment for a period of temporary absence or when the absence is longer than 10 days:

(1) The resident shall have the option to return to the facility to the next available bed; and

(2) If more than one person has a right of readmission, vacancies shall be allocated on a first request made, first request honored basis, and without regard to the source of payment.

(b) If a resident leaves the nursing facility for any reason and there is reason to believe that the resident might be absent during the next midnight census, then the following shall apply:

(1) The facility shall provide to the resident and his/her legal representative the facility's written policy regarding bed-hold periods;

(2) The nursing facility shall document the notification in the resident's record, along with the resident's and legal representative's written agreement to pay, or rejection of the option to pay, for the bed-hold period;

(3) The nursing facility shall not charge an amount in excess of the Medicaid rate to hold a bed for a resident who is on Medicaid; and

(4) If a nursing facility refuses to readmit a resident following an absence for medical treatment or therapeutic leave then a transfer or discharge will have been deemed to have occurred and the facility shall follow the transfer discharge requirements found in He-E 802.16.

(c) When a resident leaves the nursing facility for medical treatment, the facility shall communicate with the hospital or facility providing the medical treatment to the extent reasonably necessary in order to plan for the resident's safe and orderly transition back to the nursing facility.

(d) When a resident is absent from a nursing facility due to therapeutic leave, the facility may bill for reserved bed days pursuant to 42 CFR 447.40, subject to the following conditions:

(1) Such days shall be specified in the resident's plan of care;

(2) The plan of care shall describe provisions for continuity of care while the resident is out of the facility;

(3) Such days shall not be for hospitalization or for transferring to another facility;

(4) The facility may not bill for more than 30 reserved bed days per resident per state fiscal year; and

(5) When a recipient is on reserved bed day status, the department shall not pay separately for any services covered as part of the facility's rate pursuant to He-E 806.

(Amended by Volume XXXIX Number 16, Filed April 18, 2019, Proposed by #12741, Effective 3/20/2019, Expires 9/16/2019.)

#7751, eff 8-17-02; amd by #8466, eff 10-28-05; amd by #9786, INTERIM, eff 9-20-10; ss and renumbered by #9888-A, eff 3-19-11 (formerly He-E 802.14)

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