Home for the Holidays: Leaving the Skilled Nursing Facility During a Medicare-Covered Stay

Residents in Skilled Nursing Facilities often want to participate in outside events but may worry they will lose Medicare coverage if they leave the facility to do so. Residents and their families and friends can put their minds at ease. According to Medicare law, skilled nursing facility residents may leave their facility for family events without losing their Medicare coverage. However, depending on the length of their absence, beneficiaries may be charged a “bed hold” fee by some skilled nursing facilities (SNF).

The Medicare Benefit Policy Manual recognizes that although most beneficiaries are unable to leave their facility, “an outside pass or short leave of absence for attending a special religious service, holiday meal, family occasion, going on a car ride, or for a trial visit home, is not, by itself evidence that the individual no longer needs to be in a SNF for the receipt of required skilled care.”

Medicare Benefit Policy Manual, Pub. 100-02, Ch. 8,

The Oklahoma Long-term Care Ombudsman Program advocates for quality of life and care for residents in nursing homes and assisted living facilities. Federal and state authority mandates ombudsmen supervisors to identify, investigate and resolve complaints made by, or on behalf of, residents and to provide services to help in protecting health, safety, welfare and rights. Information and assistance in choosing the most appropriate living residence is also a valuable service. State Long-Term Care, Certified Ombudsmen serve residents, their families and friends.

 

Ombudsman Supervisor, Darin Terry at 580-736-7974, email terr_da@ascog.org

Ombudsman Supervisor, Dacia Nix at 580-736-7975, email nix_da@ascog.org