Hospitals and Hospital Units
A. Swing-Bed Designation
A “swing-bed” hospital is one that is approved by CMS to furnish post-hospital skilled nursing facility (SNF) services. That is, hospital (or critical access hospital (CAH)) patients’ beds can “swing” from furnishing hospital services to providing SNF care without the patient necessarily being moved to another part of the building. It receives a separate survey and certification from that of the hospital. Thus, if swing-bed designation is terminated, the hospital still maintains its certification. In addition, the hospital is given an additional CMS Certification Number (CCN) to bill for swing-bed services. (The third digit of the CCN will be the letter U, W, Y or Z.)
As stated in 42 CFR §482.66, in order to obtain swing-bed status the hospital – among other things – must: (1) have a Medicare provider agreement, (2) be located in a rural area, and (3) have fewer than 100 non-newborn or intensive care beds. Swing-bed hospitals, therefore, are generally small hospitals in rural areas where there may not be enough SNFs. The hospital is thus used to furnish SNF services.
A separate provider agreement and enrollment for the swing-bed unit is not required. (The hospital’s provider agreement incorporates the swing-bed services.) The hospital can add the swing-bed unit as a practice location via the Form CMS-855A.
Additional data on “swing-bed” units can be found in Pub. 100-07, State Operations Manual, chapter 7, sections 2036 – 2040.
B. Psychiatric and Rehabilitation Units
Though these units receive a State survey, a separate provider agreement and enrollment is not required. (The hospital’s provider agreement incorporates these units.) The hospital can add the unit as a practice location to the Form CMS-855A.
C. Multi-Campus Hospitals
A multi-campus hospital (MCH) has two or more hospital campuses operating under one CCN number. The MCH would report its various units/campuses as practice locations on the Form CMS-855A. A hospital that has its own main campus but also occupies space in another hospital has a “satellite facility” in that other hospital.
For additional information on multi-campus hospitals, see Pub. 100-07, chapter 2, section 2024.
D. Physician-Owned Hospitals
A physician-owned hospital means any participating hospital (as defined in 42 CFR §489.24) in which a physician, or an immediate family member of a physician has an ownership or investment interest in the hospital. The ownership or investment interest may be through equity, debt, or other means, and includes an interest in an entity that holds an ownership or investment interest in the hospital. (This definition does not include a hospital with physician ownership or investment interests that satisfy the requirements at 42 CFR §411.356(a) or (b).
Section 2(A)(4) of the Form CMS-855A asks the applicant to identify whether it is a physician-owned hospital. If the applicant indicates in section 2(A)(2) that it is a hospital, it must complete section 2(A)(4). Applicants that are not hospitals need not complete section 2(A)(4).
• CMS-855POH must be completed if the applicant is a physician-owned hospital – even if it furnishes similar information in section 5 and/or 6 of the Form CMS-855A.
A. Swing-Bed Designation
A “swing-bed” hospital is one that is approved by CMS to furnish post-hospital skilled nursing facility (SNF) services. That is, hospital (or critical access hospital (CAH)) patients’ beds can “swing” from furnishing hospital services to providing SNF care without the patient necessarily being moved to another part of the building. It receives a separate survey and certification from that of the hospital. Thus, if swing-bed designation is terminated, the hospital still maintains its certification. In addition, the hospital is given an additional CMS Certification Number (CCN) to bill for swing-bed services. (The third digit of the CCN will be the letter U, W, Y or Z.)
As stated in 42 CFR §482.66, in order to obtain swing-bed status the hospital – among other things – must: (1) have a Medicare provider agreement, (2) be located in a rural area, and (3) have fewer than 100 non-newborn or intensive care beds. Swing-bed hospitals, therefore, are generally small hospitals in rural areas where there may not be enough SNFs. The hospital is thus used to furnish SNF services.
A separate provider agreement and enrollment for the swing-bed unit is not required. (The hospital’s provider agreement incorporates the swing-bed services.) The hospital can add the swing-bed unit as a practice location via the Form CMS-855A.
Additional data on “swing-bed” units can be found in Pub. 100-07, State Operations Manual, chapter 7, sections 2036 – 2040.
B. Psychiatric and Rehabilitation Units
Though these units receive a State survey, a separate provider agreement and enrollment is not required. (The hospital’s provider agreement incorporates these units.) The hospital can add the unit as a practice location to the Form CMS-855A.
C. Multi-Campus Hospitals
A multi-campus hospital (MCH) has two or more hospital campuses operating under one CCN number. The MCH would report its various units/campuses as practice locations on the Form CMS-855A. A hospital that has its own main campus but also occupies space in another hospital has a “satellite facility” in that other hospital.
For additional information on multi-campus hospitals, see Pub. 100-07, chapter 2, section 2024.
D. Physician-Owned Hospitals
A physician-owned hospital means any participating hospital (as defined in 42 CFR §489.24) in which a physician, or an immediate family member of a physician has an ownership or investment interest in the hospital. The ownership or investment interest may be through equity, debt, or other means, and includes an interest in an entity that holds an ownership or investment interest in the hospital. (This definition does not include a hospital with physician ownership or investment interests that satisfy the requirements at 42 CFR §411.356(a) or (b).
Section 2(A)(4) of the Form CMS-855A asks the applicant to identify whether it is a physician-owned hospital. If the applicant indicates in section 2(A)(2) that it is a hospital, it must complete section 2(A)(4). Applicants that are not hospitals need not complete section 2(A)(4).
• CMS-855POH must be completed if the applicant is a physician-owned hospital – even if it furnishes similar information in section 5 and/or 6 of the Form CMS-855A.
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