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Nursing Home Dumps Patients
Jan L. Warner & Jan Collins

Question: After suffering a series of strokes, my mother was admitted to the hospital last month. Once she was stabilized, I was told she needed rehabilitation, and the hospital discharge staff found her a bed in a nice nursing home. Mom has Medicare and a supplemental policy, so we thought we were covered.

Two weeks into her therapy, the nursing home administrator asked about Mom’s finances and how she was going to continue paying for her care when her Medicare ran out, which was estimated to be in another 10 days (when she would be at “reached maximum improvement,” as they put it.)

I told them she owned a small home ($60,000) and had $20,000 in the bank. Her Social Security income is less than $900 monthly. They asked if I was planning to sell her house to pay for her care, and I said I had not thought about it because my father had died just last year.

Three days later, the nursing home people said that Mom had developed some complications and needed to be taken back to the hospital by ambulance. During the next three days, she received every test in the book, and the doctors gave her a clean bill of health and recommended discharge back to the nursing home. But the nursing home had given Mom’s bed to someone else and wouldn’t take her back! The hospital discharge people have tried to find Mom a bed for the past week, without success, and her hospital bills are piling up. I would take her home with me, but I work two jobs to take care of my disabled daughter (Down’s syndrome) and husband (congestive heart failure, diabetes, etc). The head nurse told me privately that she did not believe Mom needed re-hospitalization, and that the nursing home had “dumped her” back in the hospital to get rid of her. I thought that the nursing home had to keep her bed for her. Is there anything I can do?

Answer: Unfortunately, only Medicaid residents, not Medicare residents like your mother, have “bed hold” privileges -- that is, the right to return to their facility after being absent due to hospitalization or therapeutic leave.

Had your mother been on the Medicaid program (funded by both federal and state dollars and used for long-term care by so many seniors today), the facility would have been required to hold her bed open for a specified period of time. And, had her hospital stay exceeded the bed-hold period and had she still needed the facility's services, the nursing home would have been under a legal obligation to give her the first available bed in a semiprivate room.

But since Medicare has no such requirement, the nursing home was free to “dump” her back into the hospital after she used up her Medicare nursing home days. Since she was nearing maximum improvement, and based on the proximity in time between your visit with the administrator and Mom’s trip back to the hospital, we agree with the nurse that your mother was denied readmission because she did not have enough money to pay privately, and someone with money was waiting to take her bed. At the same time, the hospital could not discharge her until an appropriate placement could be made – during which time her bills are escalating, and what Medicare does not pay, can be collected from your mother’s assets.

Taking the NextStep: We believe that passage of “Medicaid reduction” legislation now pending in Congress, called HR 4241, will not only decrease funding to the states – and therefore to nursing homes and hospitals – but also increase the economic and emotional burdens of American families like yours.

If this legislation passes, we believe that more seniors like your mother will be “dumped” into hospitals as nursing homes turn out those who can’t pay in favor of those who can. And because hospitals will not be reimbursed for the extra days your mother stays, we believe those costs will be shifted to those in the private sector who consume health care and pay insurance premiums.

Call your representative and senator about this bill today, as your loved one could be next.



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