📅 The 42-Day Colorado Medicaid Bed-Hold Guide

What is the 42-Day Medicaid Bed-Hold?

Under Colorado Medicaid rules (10 CCR 2505-10, Section 8.390), Medicaid-certified skilled nursing facilities must hold a resident's bed for up to 42 days during a therapeutic leave. This means your loved one can leave the current SNF to try a new facility — while keeping their existing bed as a safety net.

Who Qualifies?

To use the 42-day therapeutic leave provision, the following must be true:

• Your loved one is a Colorado Medicaid (Health First Colorado) beneficiary
• They are residing in a Medicaid-certified skilled nursing facility (SNF)
• The current SNF is notified in writing before the leave begins
• The leave is documented as therapeutic (i.e., for medical or social benefit)

How the Window Works in Practice

1. Day 0: You notify the current SNF in writing that your loved one is taking therapeutic leave. CareSwaps prepares this notice for you.
2. Days 1–42: Your loved one resides in the new trial facility. The original bed remains held by Medicaid.
3. Decision point: By day 42, you must either formally transfer (submit a 30-day notice to vacate the original bed) or return.
4. If you return: Your loved one is readmitted to the original facility under their existing Medicaid status.

What CareSwaps Tracks For You

Managing the 42-day window manually is stressful. CareSwaps monitors the window in real time and sends you alerts at Day 14, Day 30, and Day 38 so you never miss the decision deadline. We also prepare all required written notices on your behalf.

Frequently Asked Questions

Does this apply to Assisted Living or Memory Care?

The 42-day bed-hold specifically applies to Medicaid-certified skilled nursing facilities. Assisted living and memory care communities operate under different rules and may or may not hold beds — always confirm with the specific facility.

What if the 42 days run out?

If the therapeutic leave exceeds 42 days, Medicaid will no longer pay for the held bed. The original facility may offer the bed to another resident. This is why careful tracking matters.

Do we have to pay for both beds during the 42 days?

Medicaid covers the bed-hold at the original facility. The new trial facility will bill separately. If your loved one is Medicaid-eligible, confirm coverage with the new facility before the trial begins.