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Wait Lists: What You Need to Know

Updated: Oct 6, 2022

During the nursing facility selection process, you are likely to discover a policy unique to Tennessee:  patient wait lists. In fact, you will find wait lists at most Tennessee facilities that accept Medicaid. The practice of maintaining prospective patient wait lists originates from a 1990 court case, Linton v. Commissioner, which resulted in a federal court ruling mandating Medicaid-participating facilities admit patients on a first-come, first-served basis.

As the name implies, wait lists mean beds may not always be immediately available for patient admission. When a bed is vacant, facilities must consult the wait list to determine who is next in line to be admitted. Wait list size varies greatly among facilities and changes daily. It is important to understand that whether the list has two or 200 names, it is not an accurate reflection of when any patient will be admitted primarily because many people on the wait list are not yet in need of nursing home care or they have been placed in another facility. There may be 200 names on the waiting list, but there also may be ten empty beds that can’t be filled from the list.

In addition, the regulations include instances when a patient may be admitted according to circumstances beyond first-come, first-served. The most common example of this is admission to the nursing facility directly from the hospital due to medical need. People being admitted directly from the hospital are seen as having a higher need, and those individuals are placed before anyone on the wait list. For instance, if a nursing home has three beds available and four individuals are discharged from the hospital and in need of nursing home care, no one from the wait list will be contacted.

Also, because nursing facilities place only patients of the same gender together in each room, admission may depend on whether the patient is male or female. Admission preference also may be given in cases requiring intervention by the Department of Human Services Adult Protective Services, in limited instances of patient transfer from another facility, as well as when a nursing facility patient has been in the hospital.

Here are a few things to keep in mind if your loved one is on a nursing home’s wait list:

  1. Though the fastest way to get into a nursing home is through a hospital, there are limits. An individual must be in the hospital for three days before he or she can be discharged to a nursing home ahead of people on the wait list.

  2. If you call to inquire about your loved one’s position on the wait list, the nursing home is obligated to share that information.

  3. The wait list moves very slowly for the reasons mentioned above. Your loved one could be number three on the wait list and stay in that spot for a year or more.

  4. Some families put their loved ones on a nursing home’s wait list before care is actually needed. This is risky. If the nursing home contacts you to admit your loved one when he or she is not ready for placement, your loved one goes to the bottom of the wait list.

Although having to place your loved one’s name on a wait list may seem discouraging, Linton regulations exist to protect consumer rights and help individuals plan ahead for when long-term care services will be needed. If you are told by facility staff that your loved one’s admission may be delayed by the wait list, please remember the facility has no choice in complying with the law.

Questions? Need help? Call Takacs McGinnis Elder Care Law at 615.824.2571.

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