Bed Hold Policy

Angie Szumlinski
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August 17, 2023
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I sat in on an interesting NADONA/PharMerica webinar on Survey Activity State by State: A Town Hall with DONs and Administrators and it was great! Thank you to the speakers and organizations for sharing this important information with us! There were several take aways, some shocking, one state had 55% of buildings cited for Accidents and Incidents (689) at a level G or higher since January! Wow, that’s a huge number. They also discussed an uptick in Immediate Jeopardy citations which isn’t surprising. 

Another interesting area, surveyors in some parts of the country are focusing on bed hold policies and citing facilities for not adhering to regulatory guidance. What are bed hold requirements? These are set by state law, however the federal law complements state law by requiring facilities to notify residents of the facilities bed hold policy in advance of hospitalization and at the time of transfer to a hospital. Federal law also establishes a resident’s right to return to the facility even if a bed hold period has been exceeded or if the resident did not have a bed hold. What is being cited most frequently is the notice at the time of transfer. 

At the time of transfer, the facility must provide written notice that a bed hold is available up to the number of days required by state law. The notice must also be shared with the resident’s legal representative if the resident is not competent. So how do you do this when you are in the throes of a resident decline that requires hospitalization? The same way we do everything in our centers, we collaborate, we call on others in the center to assist us, and we have bed hold documents readily available at the nursing station. Lots of information but what a “low hanging fruit” citation! Look at your systems, consider putting a binder together with packets of bed hold policies, bed hold notices and case manager envelopes – imagine how much easier your nurse’s shift just got! Stay well and stay tuned!  

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