Reviewed by Laurence P. Banville, Esq.How long must a nursing home hold a bed in New York?
Under New York Medicaid regulations, a certified nursing facility must reserve a Medicaid resident’s bed for up to 10 days during a hospital stay. During that window the facility receives a reduced bed-hold rate — a daily Medicaid payment that compensates the home for keeping the space open. Private-pay residents and those covered by Medicare or commercial insurance are governed by their individual admission agreements, so the written contract controls for non-Medicaid residents.
What is a Medicaid bed-hold?
A Medicaid bed-hold is the reservation a nursing home must maintain for a Medicaid-eligible resident who is temporarily absent — most commonly because of a hospital admission. The bed-hold prevents a vulnerable resident from losing a hard-won placement simply because they needed acute care. New York requires facilities to provide written notice of their bed-hold policy at admission and again each time a hospitalization triggers it. The notice must explain the daily bed-hold rate and the resident’s right to return.
Does a resident have the right to return after hospitalization?
Yes — and that right extends beyond the bed-hold period. Federal Nursing Home Reform Act protections, reinforced by New York’s Public Health Law §2801-d, give a Medicaid resident the right to return to the first available bed in the facility even if the 10-day hold has elapsed and the original room was filled. The two protections work together: the bed-hold preserves the specific room; the right to return guarantees re-entry to any available bed of the same level of care. A facility may not simply fill a former resident’s spot and then permanently bar re-entry.
Can a nursing home refuse to take a resident back?
A nursing home may refuse readmission only on very narrow grounds: the resident’s clinical needs now exceed the facility’s licensed scope; the facility is closing; the resident poses a direct threat to others that cannot be managed with reasonable accommodations; or the resident has an outstanding balance after proper notice. Administrative convenience, a preference for a different resident, or a general vacancy concern are not lawful reasons. When a refusal does not fit one of the permitted categories, it is treated as an involuntary discharge and triggers the full set of procedural protections owed to the resident.
When is refusing readmission an illegal discharge?
Under federal regulations at 42 C.F.R. §483.15 and New York’s implementing rules, any involuntary discharge outside the narrow permitted reasons is unlawful. Families who face an improper refusal have several avenues:
- File a complaint with the New York State Department of Health, which licenses and surveys nursing facilities.
- Contact the Long-Term Care Ombudsman Program, an independent advocate for nursing home residents.
- Request an expedited Administrative Fair Hearing through the New York State Office of Temporary and Disability Assistance to challenge the Medicaid discharge decision.
- Consult an attorney about a private lawsuit under Public Health Law §2801-d, which gives residents a right of action against a facility for deprivation of their rights.
What to do if a facility refuses to readmit your family member
Time is critical. Request a written explanation of the refusal before the hospital discharge date is set. Preserve every communication, including the admission bed-hold notice, any letters from the facility, and discharge paperwork from the hospital. An attorney familiar with New York nursing home residents’ rights can often intervene quickly — sometimes before a discharge is finalized, which is far easier than reversing one after the resident has been moved to a less appropriate placement.
Frequently asked questions
How long does a nursing home have to hold a bed in New York?
New York Medicaid rules require a nursing home to hold a Medicaid resident's bed for up to 10 days during a hospital stay and pay the facility a reduced bed-hold rate for that period. Private-pay and insurance residents are governed by their admission agreements, so the written contract controls for non-Medicaid residents. The facility must give the resident written notice of the bed-hold policy at admission and again whenever a hospitalization triggers it.
What is a Medicaid bed-hold?
A Medicaid bed-hold is the reservation a nursing home must maintain for a Medicaid-eligible resident who is temporarily away from the facility, most often due to a hospital admission. It prevents the resident from losing their placement while receiving acute care. New York requires facilities to notify residents and their representatives of the bed-hold period, the daily rate, and their right to return.
Can a nursing home refuse to take a resident back after the hospital?
A nursing home may only refuse readmission on narrow grounds set by federal and state law: the resident's needs exceed the facility's licensed scope, the facility is closing, the resident poses an unmanageable direct threat, or there is an outstanding balance after proper notice. Any other refusal is treated as an involuntary discharge and must follow required procedures including written notice and appeal rights. Administrative or financial convenience is not a lawful basis for refusal.
What is the right to return in a nursing home context?
The right to return means a Medicaid nursing home resident who is hospitalized is entitled to re-enter the facility in the first available bed, even if the 10-day bed-hold period has elapsed and the original room was filled. It is rooted in the federal Nursing Home Reform Act and reinforced by New York Public Health Law. The right to return is separate from the bed-hold: the hold preserves a specific room, while the right to return guarantees re-entry to any available bed of the appropriate level of care.
Is refusing readmission an illegal discharge?
Yes, when a nursing home refuses to readmit a returning hospitalized resident without a lawful reason under 42 C.F.R. § 483.15 and New York's implementing rules, that refusal constitutes an improper involuntary discharge. The resident is entitled to written notice stating the reason, 30 days' advance notice in most cases, and the right to appeal through an Administrative Fair Hearing. A facility that skips these steps or acts on an unlawful basis may face regulatory action and a private lawsuit under New York Public Health Law § 2801-d.