Let's say that your mother has been in a nursing home for the past three years which is paid for with MassHealth benefits. She may be demented, but she is familiar with the staff and has a comfortable routine which reduces her anxiety. The staff knows your mother and her idiosyncrasies, what things agitate her and how to calm her down. She gets sick and is sent to the hospital for several days.

Will she still have her bed when she gets back? Maybe not.

For many years, the Legislature had provided funding so that MassHealth would pay to keep Mom's bed free for her for up to ten days — what is called the “bed hold.” However, the State Senate decided, in a 12-25 vote, that the state could not afford to keep this policy going. There was a promise to revisit the policy when things get better.

So, what's going to happen? The nursing home will have the right to discharge Mom and tell you to pick up her things. If it does , itwill be under no obligation to readmit her, and can fill her bed with someone else. When Mom is well enough to leave the hospital, she may end up in a different facility.

Persons suffering from dementia need all the routine they can get. For many persons with advanced dementia, any move can be frightening, disorienting and distressing — they've lost their home and they can't process why. Killing the funding which makes a return home possible is simply cruel.

This change will also make it easier for nursing homes to dump a difficult resident by finding a reason to hospitalize him for a “medication adjustment,” then discharging them and letting the resident become someone else's problem.

So what can you do? If you've set up a MassHealth-approved pooled trust account to save some of Mom's assets, the trustee can pay to hold the bed open. (An elder law attorney will tell you about this option, but the person who the nursing home may recommend to prepare the MassHealth application probably won't.) Or you may need to use your own money to pay for the bed. If so, negotiate with the nursing home to pay something close to the rate that MassHealth would charge, not the private-pay rate.

You should also let your state representative and senator know that it's unfair to balance the budget on the backs of the most vulnerable and frail elders, and to make it a priority to reinstate the bed hold funding in next year's budget.