Medical Leave of Absence (MLOA): Introduction

(A) MassHealth pays a nursing facility to reserve a bed for up to 20 consecutive days for a member who is on a medical leave of absence from the nursing facility, if all the conditions of 130 CMR 456.426 and 456.427 are met. (B) In accordance with federal law, nursing facilities must establish and follow a written policy regarding their bed-hold periods, which must be consistent with the MassHealth bed- hold policy. (C) Following a medical leave of absence of 20 days or fewer, the nursing facility must allow the member to return to the nursing facility and resume residence unless the member no longer requires the services provided by the nursing facility. (D) When a member’s hospitalization exceeds 20 days or does not meet the requirements of 130 CMR 456.426, the nursing facility must immediately readmit the member to the facility, to the next available bed in a semiprivate room, unless the member no longer requires the services provided by the nursing facility.