CMS CAH Swing Bed Requirements and Changes 2023

1
Critical Access Hospital CoPs Swing BedsWhat
CAHs Need to Know
2
Speaker

• Laura A. Dixon, Esq.
• BS, JD, RN, CPHRM
• President, Healthcare Risk Education and
  Consulting, LLC
• 303-955-8104
• ldesq_at_comcast.net
• Email questions to CMS
  Critical Access Hospitals
  qsog_CAH_at_cms.hhs.gov. Acute
  hospitals qsog_hospital_at_cms.hhs.gov.

2
2
3
Introduction to CAH CoPs
4
Swing Beds General Information

• AS of July 2023, there are 1,362 CAHs in the US1.
• Almost all provide swing beds services
• Opportunity for patients to have care within
  their community closer to home
• Increase or stabilize census for CAHs
• Reimbursed at the same per-diem rate as SNF
• For most CAHs, an important revenue source
• 1. Rural Health Information Hub
  https//www.ruralhealthinfo.org/topics/critical-ac
  cess-hospitals.

5
4 Swing Bed Changes
6
Surveyor Worksheet for Swing Beds Form 288
7
CAH Resources
8
CMS CAH Website

• Includes information on topics of interest to
  hospitals with swing beds
• List of the regional office rural health
  coordinator
• This includes a hotline or help desk
• 800-905-2069
• Swing_help_at_ifmc.org

9
CMS Surveyor Training Website
10
Swing Bed Deficiency Data
11
Swing Bed Deficiencies

• Failed to inform residents of their rights orally
  and in writing
• Failed to inform non-English speaking residents
  of their rights in a language they could
  understand
• Failed to allow residents to get copies of their
  own medical records
• Failed to provide interpreters so resident would
  understand their condition
• No policy to advise on difference between
  inpatient or observation status

12
Deficiencies continued

• Restraints applied without an order or assessment
  
• Failed to follow the restraint policy regarding
  siderails
• Restraint orders written prn
• Policy for restraint not appropriate allowed
  for trial application not permitted
• No monitoring of patient in restraints
• Did not have a plan of care

13
Deficiencies continued

• Nursing staff unaware there were specific rights
  for swing bed residents
• Failed to provide medically appropriate social
  services
• Person doing social services was not licensed and
  background not appropriate to do the job
• Comprehensive assessment not done
• No information on resident re safe to smoke or
  not
• Failed to do a discharge summary

14
Swing Beds
15
Information to Provide

• Information on selecting a physician
• List of the attending physicians who are treating
  the patient
• Rights and responsibilities
• Contact information on how to contact the
  hospital and state agency and the ombudsman
• Description of swing bed

• Financial obligations
• HIPAA notice of privacy practices
• General consent form
• How to file a complaint
• How to report abuse or neglect
• Transfer policy
• Discharge policy
• Many more

16
The End Questions???

• Laura A. Dixon, Esq.
• BS, JD, RN, CPHRM
• President, Healthcare Risk Education, and
  Consulting, LLC
• 303-955-8104

Register Now
16
16