<%@LANGUAGE="JAVASCRIPT" CODEPAGE="28591"%> Nursing Home Facts

 

Helpful Facts About Nursing Homes

By Jill Burzynski

Nursing Homes Cannot Limit Visiting Hours for Family Members
Federal law prohibits nursing home from restricting visiting hours for immediate family members or other relatives. As long as the resident wants the visitor, the facility cannot restrict visits to certain times of the day or night. If a resident lacks mental capacity, decisions regarding visitors can be made by the resident’s representative. Guidelines to the law recommend that late night visits should be made in a location where other residents’ rest is not disturbed, such as a common room.

Medicare Days Do Not End Because the Patient has Reached a Plateau
According to law, Medicare therapy should be provided if the therapy improves the resident’s condition, maintains the resident’s condition, or slows the decline of the resident’s condition. Nursing homes are under pressure from the Medicare program to insure that they do not continue receiving Medicare funds after the usefulness of therapy has stopped. Due to this pressure the facilities sometimes fail to consider whether the therapy is needed to maintain the resident’s condition or slow the decline of the resident’s condition. They seem to focus only on the improvement to the resident’s condition. When the facility issues the Notice of Non-Payment the patient can force the facility to bill Medicare for the service so that Medicare will have to make a decision about the discontinuation of therapy.

Facilities Have to Follow Strict Guidelines Regarding Readmission to the Facility After a Hospitalization
Florida law requires that the residents be informed of the facilities bed hold policy prior to a hospitalization. A private pay resident’s bed may be reserved for a period of up to 30 days. A Medicaid resident’s bed will be reserved for up to 15 days by the state. However the state will not reimburse the facility if it is medically determined by the agency that the resident will not need the bed or it determines that the facilities occupancy rate ensures that the bed will be available. If a Medicaid resident’s hospitalization exceed the time that the state reserved the bed and the facility has no available properly certified beds, the Medicaid recipient is entitled to the next certified Medicaid bed.