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Elderly Nursing Home Residents are sometimes concerned that they will lose their Medicare benefit if they leave the facility to participate in family Christmas or Chanukah celebrations. These residents should rest assured that their benefits are not at risk because the Medicare Benefit Policy Manual makes explicit that family visits are allowed. Specifically, it says:

“an outside pass or short leave of absence for the purpose of attending a special religious service, holiday meal, family occasion, going on a car ride, or for a trial visit home, is not, by itself evidence that the individual no longer needs to be in a SNF for the receipt of required skilled care.”

However, a facility may charge a resident for a bed hold fee, depending upon how long the resident is absent. If the resident leaves the facility and returns home before midnight, the same day, Medicare will be charged for the day. If the resident returns home the next day, a bed hold may legally be charged to the resident. While the law is not clear, such a family occasion should not extend past a couple of days. The bed hold is necessary in order for the nursing home resident to maintain his or her personal effects in the room.

Families should not only consider the legal implications of a nursing home resident leaving the facility for a holiday celebration, they should also consider the medical needs of the resident. The social benefit of attending a family celebration must be balanced against the ability of the family to provide the needed care for their elderly loved one.   The family must ensure that medications are properly administered, that toileting needs are considered and that the senior’s needs for rest are considered.

Please call Burzynski Elder Law at (239) 434-8557 if you need help understanding elder law or assistance in advocating for an elder family member.