Bed-hold policy change upends vulnerable lives

Punishing a nursing home resident for needing urgent hospital care just isn’t fair. Yet New York is implementing a change to nursing home reimbursement that could have devastating consequences for tens of thousands of nursing home residents.

Until recently, state law required nursing homes to hold beds for residents who were admitted to the hospital for up to 14 days. To support this practice, the state provided a payment to the nursing home to compensate for the overhead and other costs associated with holding the bed. That payment and the statutory requirement to hold the bed ended last spring, leaving nursing home residents and their families in an uncertain position.

Imagine your mother has had a stroke and is rushed from her nursing home to the hospital. She’s admitted for several days and when she’s ready to go back to the nursing home, you are told that her room — where she had hung family photos on the walls, made friends and had trusted caregivers — is no longer available. Where does she go now?

In addition to upending lives, the bed-hold policy change could impede timely and coordinated health care. It could lead to potential medication errors, infections, changes in functional and cognitive status, extended hospital stays and hospital readmissions. It will affect the nursing home resident’s overall quality of experience and sense of stability. For the 47.8 percent of nursing home residents with dementia, continuity and consistency of care is even more crucial.

The elimination of the reimbursement also harms our state’s nonprofit nursing homes. Many of these facilities operate on razorthin margins and depend on a payment for holding an empty bed to ensure continuity of care for the residents who have come to regard these facilities as their homes.

This policy change was scheduled as part of the 2018 state budget, but wasn’t implemented. Recently, however, the state announced a retroactive discontinuation of the payments. The claw-back adds insult to injury. In some instances, nursing homes have been holding scarce beds for weeks with the expectation that they will be paid.

This change will have a destabilizing effect on nursing homes and residents. State officials should reconsider it. ▶ Bea Grause of Glenmont is president of the Healthcare Association of New York State.