Bed Hold Policy

According to the Centers for Medicare & Medicaid Services (CMS) Requirements of Participation (RoP) Admission, Transfer, and Discharge Rights, CFR 483.15, (Federal Register/Vol.81, No.192) before a resident is transferred to the hospital or goes on therapeutic leave, the facility must provide written information to the resident or representative regarding bed hold policy, duration, and reserve bed payment policy.

Skilled nursing facilities must also comply with WAC 388-97-0120 which requires the facility to develop and implement a bed-hold policy. This policy must be consistent with any bed-hold policy that the department develops.  The bed-hold policy must be provided in written format, to the resident and a family member before the resident is transferred or goes on therapeutic leave.


At a minimum the policy must state:

  • The number of days, if any, the nursing home will hold a resident’s bed pending return from hospitalization or social/therapeutic leave;
  • That a Medicaid-eligible resident, whose hospitalization or social/therapeutic leave exceeds the maximum number of bed-hold days, will be readmitted to the first available semi-private bed provided the resident needs nursing facility services. Social/therapeutic leave is defined under WAC388-97-0001. The number of days of social/therapeutic leave allowed for Medicaid residents and the authorization process is found under WAC 388-97-0160; and
  • That a Medicaid-eligible resident may be charged if he or she requests that a specific bed be held, but may not be charged a bed-hold fee for the right to return to the first available bed in a semi-private room.

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