Bed-holds continue to be a controversial subject kicked around the long-term care industry for too many years.

Just what is a “bed-hold”?

bed hold:

A reservation that allows one to stay in, or return to, a care facility. The reservation is usually made just before relocation to the facility or during furloughs away from it (e.g., in hospital or on family visits).

Medical Dictionary, © 2009 Farlex and Partners

But who pays?

It’s particularly troublesome in state-run veterans nursing homes.

The subject gets sticky because you have two government agencies with conflicting goals. On the one hand, you have the federal government trying to ensure that the veterans are getting quality care, and the state-run Medicaid footing the bill.  Sometimes the regulations overlap, sometimes they don’t. Often, one hand doesn’t know what the other is doing.

The issue boils down to one of money. Someone has to pay for the empty space, or so it would seem. All too often, this responsibility falls to the individual resident—to pay for the privilege of returning to a familiar place—a place of comfort and tranquility—a place called home.

Let’s go back for a moment and examine the intent of the federal regulations. Clearly stated:

Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.

42 CFR § 483. 42 CFR § 483.25 Quality of care.

The federal government takes into consideration the bed-hold and continues to pay its portion of the empty room during the veteran’s short absences from the nursing home.

(c) Per diem will be paid under §§ 51.40 and 51.41 for each day that the veteran is receiving care and has an overnight stay. Per diem also will be paid when there is no overnight stay if the facility has an occupancy rate of 90 percent or greater. However, these payments will be made only for the first 10 consecutive days during which the veteran is admitted as a patient for any stay in a VA or other hospital (a hospital stay could occur more than once in a calendar year) and only for the first 12 days in a calendar year during which the veteran is absent for purposes other than receiving hospital care. Occupancy rate is calculated by dividing the total number of patients in the nursing home or domiciliary by the total recognized nursing home or domiciliary beds in that facility.

On the contrary, the state of Virginia makes no provisions to cover the bed-hold for anyone—including veterans.

The residents at the veterans’ care centers have taken the time and what limited resources that are available to them, to decorate their rooms. Rooms filled with cherished memories—memories from a lifetime of accomplishment, service, and sacrifice, only to have it all taken away by an unexpected medical event requiring only a brief stay in an acute care hospital.

The Virginia Department of Veterans Services must submit to the state legislature a request for funding to provide deserving veterans the peace of mind they deserve—that they will not be uprooted once again and will be able to return their home.


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