I am 27 years old in a skilled nursing facility and my friend wants to take me on vacation for several weeks, I have been here a year a need a break. The facility has openings so there is no wait list, and I am aware they can't hold my bed or room but this is what I found online... they said I'm still considered a resident and they have to give me a bed when I get back even if there is a wait list when I return. Does anyone have any experience with therapeutic leave and Medicaid?
NH has a good bit of discretion as to whether bed hold fee will happen. My mom’s did not charge it & it was discussed at care plan meeting. Mom was what would be considered an easy care resident, higher than average SOC, bills paid on time, involved family.... things that a NH kinda wants. Also I think where you live makes a difference on how a facility approaches leave, at both the NH my mom was in had residents who were from ranch families from the surrounding TX hill country or the Valley. A few went on therapeutic leave back to ranch pretty often. The NH didn’t find it unusual & as long as everybody played by the fixed rules & clearly communicated with NH, it was ok.
The facility is required to take you back if they have an "available bed". If there is a wait list, that usually means there is not an available Medicaid bed. It may not be in the same wing; it may not be a window bed if you have a preferred spot.
The facility is not required to store your personal items like clothing, pictures, etc. If you are planning to be gone for "weeks", where will your possessions go? Are you willing to risk them being lost or disposed of? Can you pay for storage somewhere? If you are on Medicaid, your share of cost will only leave you with a small personal needs allowance and usually isn't enough to rent storage or arrange packing and transfer.
If you are on medications, you have to make arrangements to sign for and take them with you. If you are traveling out of state, your Medicaid stops at the state line. If you require emergency hospital stay, it could be a real cluster getting admission and payment in a new state as your coverage with Medicaid doesn't follow you. If you go out of the country, your meds may not be able to be transported with you. If pain meds or controlled substance, you run the risk of problems with authorities if you don't have paperwork with you.
Some states have more therapeutic leave days available, but restrict the amount of time you can use together without being required to re-qualify for Nursing Home need and Medicaid coverage. The premise being that if you need that level of care and support, you really aren't able to be out and traveling with others for an extended period unless you have specific assistance. Texas has a 3 day time limit for therapeutic leave. The facility then has the right to discharge you as a patient; and you have to get re-accepted. The nursing home should have a written policy that states what your rights are under therapeutic leave and how many days you have available and what constitutes "available bed".
EVERY STATE IS DIFFERENT. MAKE SURE YOU GET THE INFO FROM YOUR FACILITY FOR YOUR LEGAL SITUATION.
I didn’t know Medicaid would even consider such a thing. Very interesting ! I am pleased to know that government woukd think out of the box & would even recognize the need for a patient to need a break as well. Thank you!
facility can charge a bed hold fee.
I’d be very concerned that going beyond the # of days (or coming close) will trigger an evaluation of your eligibility for even needing LTC in a facility. Can you afford to be determined ineligible for LTC? If you could not live in the NH could you live on your own in the outside world? At 27, your really young to be in a NH, is there possibily another common living option that your state will pay for?
I took my mom out on therapeutic leave for a family wedding in another city 3+ hrs drive away. Discussed at mom care plan meeting in advance. A 72 hr leave was fine BUT I had to arrange to get her medications from nurses station in advance (did day before and had paperwork) and figure out getting mom into my SUV on my own (unlike when the NH took residents out on field trips & had staff help). My mom was still good on her ADLs so transferring not an issue; she had a Hugo style walker as well as a footed cane. I had our in middle school son with me so he acted as a “spotter” & shadow & thank goodness as mom was very confused at the hotel & at the reception. She had Lewy Body dementia and it can have visual spacial issues which for her it did. She left NH after AM bed census (so totally good medicaid payment for that day) and back before dinner bell on Sunday. Over 48 hrs but not 72. No medicaid issues & no bed hold payment needed either. When another family event happened, I did not even think about taking her as she was pretty anxious & confused for days after the return to her NH plus she was more frail.
If your issues are physical, I’d suggest you try a short trip to see how challenging outside world is.