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LeadingAge NY Comments on Proposed Bed Hold Regulations

LeadingAge NY filed formal written comments earlier this week strongly opposing Department of Health (DOH) proposed regulations that would modify the State’s policies on reserved bed days for residents of nursing homes. Of greatest concern is a proposed requirement for nursing homes to reserve the same room and bed for a resident who is temporarily hospitalized, even when Medicaid does not pay the facility to hold the bed.

Specifically, the proposal would modify regulations at 18 NYCRR Section 505.9(d) to (a) provide that reserved bed payments for residents age 21 and over who are temporarily hospitalized are only available for those residents who are receiving hospice services in the facility; (b) “clarify” that nursing homes must reserve the same bed in the same room, unless medically contraindicated, for a specified number of days during a Medicaid recipient’s temporary absence even if Medicaid does not pay for the bed hold; and (c) remove language incorrectly stating that Medicaid reserved bed payments for leaves of absence are only available if the leave is for therapeutic purposes.

The final 2017-18 State Budget revised Public Health Law § 2808(25), effectively eliminating Medicaid coverage of hospitalization bed holds for residents age 21+ who are not on hospice. DOH issued a Dear Administrator Letter (DAL) in May 2017 discussing the law change and signaling DOH’s position that this change did not eliminate the current regulatory requirement that Medicaid-enrolled nursing homes hold the same bed in the same room for such hospitalized patients for a period of 14 days. The DAL also indicated that implementation of the new law would be delayed until DOH adopted regulations, and that nursing homes would continue to be reimbursed for reserved bed days under the law as it existed before April 1, 2017. It is currently unclear how long this policy will continue, in light of the proposed regulations.

Following enactment of the 2017-18 budget, the Legislature passed a bill supported by LeadingAge NY, A.8338 (Gottfried)/S.6559 (Hannon), which would have undone the elimination of Medicaid reimbursement for hospitalization bed holds. The Governor vetoed the legislation in December, suggesting that the upcoming budget process would be the appropriate forum for this issue. However, this issue was not addressed in the recently finalized 2018-19 budget.

We will keep members apprised of our plans and further developments on this issue.

Contact: Dan Heim, dheim@leadingageny.org, 518-867-8866