I'm interested in similar experiences where a family refuses the bed offer for a particular SNF. We always ask for 3 choices from families and place referrals. Often times a bed is offered at one of the choices, but the family refuses to be discharged because they want to "wait" until a bed is ready at the SNF of their first choice. Is there a Medicare regulation that says a family must accept the first bed offer within 20 miles? Someone mentioned this reg recently, but I'm not aware of it. Also, are any CMs handing out notices to patients when they are admitted to OBS and NOT Inpatient? We have yet to do this at our facility. It seems at our facility, the patients "rule to roost". Thanks for any input.