Attn: PNMI and Residential Care Facilities, Clarification on New Limits to Therapeutic and Bed Hold Days

March 26, 2013

On Friday, March 8, 2013, MaineCare sent a listserv to Hospital and Nursing Facility providers regarding new limits to therapeutic and bed hold days. This change ONLY applies to hospitals and nursing facilities. PNMIs and Residential Care Facilities are not affected by this change. MaineCare was required to send a letter about the change to all MaineCare members due to the potential that they could be admitted to a Nursing Facility or hospitalized and waiting placement to a Nursing Facility in the future.

Below, is the original listserv message:

Attn: Section 45 (Hospital) and 67 (Nursing Facility) Providers

Effective March 25, 2013, there will be new limits to therapeutic and bed hold days. The changes are as follows:

  • Therapeutic leave days have been reduced from 36 days per year to one (1) day per State Fiscal Year (SFY). This applies to Hospitals and Nursing Facilities.

  • Hospital bed hold days have been reduced from ten (10) days per hospitalization to four (4) days per SFY. The new limit applies to hospital admissions starting on or after March 25, 2013. If a member is admitted on or after March 25, 2013, four bed hold days will be allowed. For admissions prior to March 25, 2013, previous rules apply and ten hospital leave days are allowed. This applies to Nursing Facilities only. These changes are pursuant to LD 250, An Act To Make Supplemental Appropriations and Allocations for the Expenditures of State Government and To Change Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Year Ending June 30, 2013.