Skilled Nursing Facilities (SNFs)
A. General Background Information
As stated in CMS Pub. 100-07, State Operations Manual, chapter 7, section 7004B, a SNF is a facility that:
• Is primarily engaged in providing to residents skilled nursing care and related services for residents who require medical or nursing care; or
• Is primarily engaged in providing to residents skilled rehabilitation services for the rehabilitation of injured, disabled, or sick persons and is not primarily for the care and treatment of mental diseases;
• Has in effect a transfer agreement (meeting the requirements of §1861(1) of the Social Security Act with one or more hospitals having agreements in effect under §1866 of the Social Security Act); and
• Meets the requirements for a skilled nursing facility described in subsections (b), (c), and (d) of §1819 of the Social Security Act.
The transfer agreement mentioned above need not be submitted with the SNF’s Form CMS-855A enrollment application; the State and/or CMS regional office (RO) will verify that the agreement exists.
Like other certified providers, SNFs receive a State survey and sign a provider agreement. SNFs cannot have multiple practice locations.
B. SNF Distinct Parts
A SNF can be a separate institution or a “distinct part” of an institution. The term “distinct part” means an area or portion of an institution (e.g., a hospital) that is certified to furnish SNF services. The hospital and the SNF distinct part will each receive a separate CMS Certification Number (CCN). Also:
• A hospital may have only one SNF distinct part.
• “Distinct part” designation is not equivalent to being “provider-based.”
A SNF distinct part unit must enroll separately (i.e., it cannot be listed as a practice location on the hospital’s Form CMS-855A), be separately surveyed, and sign a separate provider agreement. (Note how this is different from “swing-bed” units, which do not enroll separately and do not sign separate provider agreements.)
C. Additional InformationFor more information on SNFs, refer to:
• Section 1819 of the Social Security Act
• Pub. 100-07, State Operations Manual, chapter 7
• Pub. 100-02, Benefit Policy Manual, chapter 8
A. General Background Information
As stated in CMS Pub. 100-07, State Operations Manual, chapter 7, section 7004B, a SNF is a facility that:
• Is primarily engaged in providing to residents skilled nursing care and related services for residents who require medical or nursing care; or
• Is primarily engaged in providing to residents skilled rehabilitation services for the rehabilitation of injured, disabled, or sick persons and is not primarily for the care and treatment of mental diseases;
• Has in effect a transfer agreement (meeting the requirements of §1861(1) of the Social Security Act with one or more hospitals having agreements in effect under §1866 of the Social Security Act); and
• Meets the requirements for a skilled nursing facility described in subsections (b), (c), and (d) of §1819 of the Social Security Act.
The transfer agreement mentioned above need not be submitted with the SNF’s Form CMS-855A enrollment application; the State and/or CMS regional office (RO) will verify that the agreement exists.
Like other certified providers, SNFs receive a State survey and sign a provider agreement. SNFs cannot have multiple practice locations.
B. SNF Distinct Parts
A SNF can be a separate institution or a “distinct part” of an institution. The term “distinct part” means an area or portion of an institution (e.g., a hospital) that is certified to furnish SNF services. The hospital and the SNF distinct part will each receive a separate CMS Certification Number (CCN). Also:
• A hospital may have only one SNF distinct part.
• “Distinct part” designation is not equivalent to being “provider-based.”
A SNF distinct part unit must enroll separately (i.e., it cannot be listed as a practice location on the hospital’s Form CMS-855A), be separately surveyed, and sign a separate provider agreement. (Note how this is different from “swing-bed” units, which do not enroll separately and do not sign separate provider agreements.)
C. Additional InformationFor more information on SNFs, refer to:
• Section 1819 of the Social Security Act
• Pub. 100-07, State Operations Manual, chapter 7
• Pub. 100-02, Benefit Policy Manual, chapter 8
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