CMS Critical Access Hospital (CAH) Swing Bed Requirements and Changes

Hospitals had seen a significant increase in survey activity by CMS along with an increase number of deficiencies pre-COVID-19.  This webinar will focus on the protocol changes and the swing bed changes that were promulgated by CMS on October 12, 2018 and amended November 29, 2019. CMS completely rewrote all the swing bed regulations and rewrote the Tag numbers.  The swing bed interpretive guidelines and survey procedures are now under Appendix PP.  Many CAHs are not aware of these changes or are struggling to comply.  With the COVID-19 pandemic, waivers were issued that affect Swing Beds.  It is challenging to figure out what the interpretive guidelines and survey procedure as there is there was no crosswalk between Appendix W – for CAH – and Appendix PP – Long Term Care. This webinar was created to take the mystery out of this. 

Common deficiencies and how to avoid them will be discussed. Information on how to locate the CAH manual and other resources will be discussed.  There will also be a discussion of the 1135 Waivers available to Critical Access Hospitals with Swing Beds.

Webinar Objectives

• Discuss that CMS made some recent changes to the protocol process 
• Recall that CMS has rewritten the entire section on swing beds
• Describe what is required by CMS to be in the resident assessment which is done to do the care plan
• Recall the CMS requirements on patient activities of swing bed patients

Webinar Agenda

Changes to the CAH Manual and Introduction to CAH CoPs

• How to Locate the CAH Manual-new website
• Introduction
• CMS Surveyor training material for CAHs
• Important CMS Memos for CAHs
• Notice of survey
• Revised survey protocol
• Review of telemedicine contract
• 4 changes November 29, 2019 in Hospital Improvement Rule
• Top swing bed deficiencies
• CAH CoP surveyor classes

Special Requirements for CAH Providers of Long-Term Care Services (Swing beds)

• Interpretive guidelines and survey procedure under Appendix PP
• Eligibility
• Payment
• SNF Services
• Resident Rights
• Exercise of Rights
• Notice of Rights and Services
• Access and Visitation Rights
• Personal Property
• Married Couples
• Admission, Transfer and Discharge Rights
• Transfer and Discharge
• Content of notice
• Resident Behavior and Facility Practices
• Restraints, Abuse 
• Staff Treatment of Residents
• Hiring of employees
• Patient Activities 
• Social Services
• Dental requirements change
• Resident Assessment
• Comprehensive Care Plans
• Discharge Summary
• Nutrition
• Provision of Services
• COVID-19 reporting requirements

Who Should Attend

Anyone who is responsible for taking care of swing bed patients in a CAH or for implementing the CMS swing bed requirements. This includes the following: 

• CEOs
• COOs
• CFOs
• nurse executives
• accreditation and regulation director
• nurse managers
• pharmacists
• quality managers
• risk managers
• healthcare attorneys
• health information management personnel
• social workers
• dieticians
• health information management
• nurses
• nurse educators
• nursing supervisors
• patient safety officer
• director of Rehab (OT, PT, speech pathology, and audiology)
• dietician
• director of health information management
• infection preventionist
• dietician
• activities director of swing bed patients
• and compliance officers.