A) Leave of Absence / Bed Hold Policy
There are times that it may be necessary for you to leave the nursing home. Reasons for leaving might include hospitalization, or a visit with family or friends.
Our bed hold policy is as follows:
We will work closely with the hospital, your physician and your financial representative to keep abreast of your progress and your continued need to be at our facility. If you are hospitalized for ten (10) days or less, we will hold a bed for your return. If your hospitalization is greater than ten (10) days, please let us know and we will be able to indicate whether we will be required to enforce the ten (10) day policy.
If we cannot hold the bed when you are hospitalized more than ten (10) days, you have the right to return to the first available bed, providing we can continue to meet your needs.
2. Therapeutic Leave
When the leave is for reasons other than hospitalization, such as a visit with family or friends, it is considered a “therapeutic leave”.
• Private Pay
Private paying residents will be required to pay for each day of therapeutic leave that they are away.
Medicaid will pay for thirty (30) days per year (July 1 – June 30) for recipients receiving Medicaid. All days away from the facility in excess of the thirty (30) days allowable by the Medicaid Program will have to be paid by the resident in order for us to hold the bed.
• If you are away from the facility on therapeutic leave on a routine basis, a review of the frequency and number of days will be considered and evaluated when assessing your continued need to be in this facility.
B) Services covered in your Medicaid Board & Care Payment
1. 24 hour nursing care
2. Meals including special diets and supplements
5. Medical supplies (dressings, stock supplies)
6. Television with cable connection in resident lounges
7. Stock toiletry items
8. Physicians services
9. Social services
12. Use of equipment (wheelchairs, walkers, etc…)
13. Dietary counseling
14. Oxygen therapy
15. Non- surgical dental services
C) Services NOT covered in your Medicaid Board & Care Payment
1. Personal clothing, shoes
2. Personal television, radios, batteries, TV cable, personal telephone in room
3. Repair costs of personal items
4. Beautician/barber shop
5. Stamps, outside shopping, tobacco products
6. Eye glasses (cost uncovered by Medicare/Medicaid)
7. Hearing aides ((cost uncovered by Medicaid/Medicaid)
8. Funeral expenses
D) Services covered in your Private Pay Board & Care Payment
1. Daily Rate:
The daily Private Pay Rate is designed to include all necessary routine services with the exception of physician and pharmacy charges. The private rate would include the following:
2. Board (to include special diets)
5. Physical Therapy
6. Transportation (Van)
7. Stock Medical Supplies (dressings, etc)
8. Stock personal supplies (soap, shampoo, etc)
9. Stock medical equipment (bed, wheelchair, etc)
10. 24 hour nursing care
11. 11) Oxygen
12. Non-surgical dental care & dentures
E) Services NOT covered in your Private Pay Board & Care Payment
1. Physician charges (to include specialties such as podiatrist)
2. Pharmacy charges
3. Special medical equipment
4. Eye care & eye glasses
5. Ear care & hearing aides
6. Barber & beauty shop
7. Personal telephone
8. Cable television
10. Hospital costs
11. Personal clothing
F) Requirements and Procedures for Establishing Eligibility for Medical Assistance
When you are admitted to this facility, we must tell you what the basic requirements are for establishing eligibility for medical assistance, and we must also tell you how to apply. We must inform you how income and assets that apply to you are treated if you have a spouse living in the community.
1. Basic Requirements
You must have a medical need for nursing facility care;
Your monthly income must be under the rate that the Division of Human Services allows you for your care; and your assets, that the Division of Human Services counts, such as bank accounts, stocks and bonds, and certificates of deposit, cannot be more the $2,500.
Note: If you have a spouse or dependent living in the community, your income and assets may be treated differently.
2. Procedures for Medicaid Eligibility
You or your representative must have an eligibility interview with the local Division of Human Services District Office and furnish proof of your income and resources and other information requested by the District Office.
3. Rights to Resource Assessment
If you are married, and your spouse lives in the community (community spouse), you are entitled to a resource assessment. When an individual who enters a nursing facility for the first time on or after September 30, 1989 has a community spouse, the couple has a right to request that a resource assessment be done by the Division of Human Services District Office.
You have a right to a resource assessment if you are going to need nursing facility care for 30 or more consecutive days. The resource assessment is a procedure in which the District Office verifies and totals the couple’s resources that are available as of the first continuous period of nursing facility care, and then determines a share for each spouse. A portion of the combined resources will be “protected”. This “protected” resource amount will be considered to be your spouse’s assets and will not be counted in determining your eligibility for medical assistance.
The “protected” resources do not have to be spent for your care. The resource assessment may be done at the time of admission or any time up to and including the date you apply for medical assistance. There is no penalty for delaying the assessment, but it may be more difficult to document proof of assets if the assessment is delayed. Your Division of Human Services District Office will explain the resource assessment process to you in greater detail when your assessment is done.
4. Income Allowance for Your Spouse and/or Dependent
If you receive medical assistance, you may voluntarily give part of your income to your spouse if his or her monthly income does not exceed allowable limits set be federal law. You may also, under certain circumstances, give or be required to provide part of your income to individuals who are considered to be your dependent or legal dependent. The Medical Assistance Program will offset the difference in the monthly amount of income that you apply to your nursing facility bill. If you have any questions about this notice, please ask our Social Service Director for further information.
G) Resident Fund Account
For your convenience the home maintains an interest bearing resident fund account with a local bank. Should you choose to take advantage of this account along with our other residents you can be assured that your money is safe and protected. The business office will pay your ancillary bills from this account such as hairdresser, newspaper delivery, or provide you with cash upon request.
You will receive a quarterly statement which accounts for all transactions made on your behalf.