WAG 20-08-12.
When a client leaves an LTC facility for a hospital stay, consider them to still be a resident of the facility if they are gone 10 days or less. This applies even if the facility does not qualify for bed reserve payments.
An LTC facility is required to hold a bed for up to ten days when an absence is due to hospitalization. An LTC facility is not required to hold a bed for a resident on a home visit.
The facility must repay HFS the costs of any extra hospital stay when:
- the facility refused to take the client back into the facility after a hospital stay of up to 10 days; and
- HFS has to pay the hospital because the facility did not take the client back.
If the client stays in the hospital longer than necessary because the facility will not take them back, HFS pays the hospital. The facility must pay HFS the difference between the facility's per diem rate and the amount paid to the hospital for the
extra stay.
