Can You Leave a Nursing Home?

For families with loved ones residing in nursing homes, planning outings or holiday visits can be both an exciting and intimidating process. Whether it’s a simple day out or an overnight stay, navigating nursing home rules and logistics is essential for a smooth experience. If you’re wondering whether it’s possible to take your loved one out, how Medicaid or Medicare policies apply, or how to plan such an outing, this guide simplifies everything you need to know.

Can I Take My Loved One Out of Their Nursing Home for an Outing or Holiday Visit?

Yes, in most cases, nursing home residents can leave for outings or visits with family. However, since nursing homes are regulated facilities providing medical care, there are procedures to follow to maintain the resident's safety and well-being.

Here’s what you need to do:

• Speak with the Nursing Staff: Inform the staff of your plans and discuss your loved one’s care needs, any required equipment, and potential risks.
• Sign Out and Communicate Clearly: Most nursing homes will ask you to “sign out” the resident and provide details about the outing, including the expected duration and timing. Keep the staff informed about any changes during the visit.
• Understand Your Loved One’s Needs: Ensure you have a good understanding of your loved one’s current condition. If you're unfamiliar with handling their care alone, the nursing home can provide advice or assistance.

Whether it’s a family holiday gathering, a special event, or even a short break to enjoy the outdoors, outings can be a valuable way to keep your loved one connected with their family and community.

Massachusetts Medicaid Rules for Holding Nursing Home Beds

When planning an overnight visit or a longer outing, the financial aspect of holding a nursing home bed becomes an essential factor to consider. Medicaid has specific policies around “bed hold” days, which differ by state. Here's how Massachusetts handles this:

• Medical Leave (20 Days or Fewer): Masshealth pays nursing facilities to reserve a bed during a medical leave of up to 20 days, as long as the resident still requires nursing care upon their return.
• Non-Medical (Therapeutic) Leave (10 Days per Year): For non-medical, therapeutic visits (e.g., going home for the holidays), MassHealth covers up to 10 days per year per resident. Each night away counts as one day. However, absences of less than 24 hours do not count toward this total.
• Additional Coverage or Costs: If the resident exceeds the Medicaid limit for therapeutic leave, they or their family can pay privately to hold the bed. If holding the bed isn’t an option, the nursing facility must readmit the individual to the first available Medicaid-approved bed.

Important Note: Facilities must provide their bed-hold policies in writing, both at admission and when planning any extended absence. Check with your nursing home for details specific to your loved one’s case.

Medicare Skilled Nursing Coverage and Leaving the Nursing Home

If your loved one is temporarily in a skilled nursing facility (SNF) under Medicare coverage, you may wonder if holiday outings or short visits interfere with their care plan. The rules depend on the type and duration of the visit.

• Day Outings: Medicare allows SNF residents to leave during the day (returning before midnight) without losing coverage for that day.
• Overnight Stays: If a resident stays away overnight, Medicare generally doesn’t cover that day, meaning it must be paid privately or handled according to the facility’s guidelines.
• Therapy Considerations: Keep in mind that extended interruptions in therapy sessions can affect recovery progress. Coordinate with the care team to minimize disruptions to treatment schedules.

Always discuss Medicare rules with the facility administration before planning your loved one’s visit to avoid unexpected charges.

The Logistics of a Nursing Home Outing

Planning a successful nursing home outing requires careful coordination to ensure your loved one’s safety and comfort. While these trips offer emotional benefits and cherished memories, they also require extra preparation.

Key Steps to Organize a Nursing Home Visit:

1. Review Care Needs: Work with the nursing home staff to understand mobility assistance, meal planning, medication schedules, and bathroom needs during the outing.
2. Arrange Transportation: If necessary, book accessible transportation or arrange for an aide to assist with transferring the resident.
3. Consider Additional Help: For longer outings or those involving more complicated care needs, you may want to hire a nursing assistant or caregiver to accompany you.
4. Expect the Unexpected: Pack essential items like medications, mobility aids, spare clothing, and snacks—just in case.

For residents with dementia, outings may need extra planning. Keep the destination familiar and predictable, and ensure they feel safe and supported at all times.

Pro Tip: Services like senior concierge care or patient advocacy can help families arrange smooth, stress-free outings.

Final Thoughts

Taking a loved one out of a nursing home for an outing or holiday visit can strengthen emotional bonds and even improve their overall well-being. By understanding the nursing home’s policies, Medicaid and Medicare rules, and the specific logistical needs, you can turn what might seem like a daunting task into a positive, joyful experience.