Nursing Home Bed Hold - Emergency regulations published

DOH has published the emergency rules on bed hold in the Jan. 23 NYS Register (pages 9-11).
Although they are published as emergency rules that expire on April 1, 2013, DOH intends these
to become permanent regulations at a future date. The emergency regulations took effect July
1, 2012. Among the “highlights” are the reduction of Medicaid payment from 95 percent to 50
percent for reserved days related to hospitalization and the availability of an aggregate of 14
days for both hospitalization and therapeutic leave. The regulations reference an aggregate of
10 days for “other leaves of absence.” DOH has not defined what is meant by “other leaves.” It
does appear that the definition of therapeutic leave has been modified in the new rules and is
defined as “leaves for a visit to a health care professional that are expected to improve the
patient’s physical condition or quality of life…”

How bed hold days utilized prior to July 1 are to be treated and whether as of July 1 all
residents begin the new count under the revised rules, are all questions that have previously
been posed to DOH by LeadingAge NY and remain unresolved at this time. DOH has indicated
that a Dear Administrator letter is forthcoming and it is hoped that these questions along with
others submitted by LeadingAge NY will be addressed. The new rules do not apply to
individuals under age 21 and maintain payment at 95 percent for therapeutic leave.

Contact: Elliott Frost, efrost@leadingageny.org, 518-867-8832
(Jan. 2013)