144.562 SWING BED APPROVAL; ISSUANCE OF LICENSE CONDITIONS.
Subdivision 1. Definition.
For the purposes of this section, "swing bed" means a hospital
bed licensed under sections
that has been granted a license condition under
this section and which has been certified to participate in the federal Medicare program under
United States Code, title 42, section 1395 (tt).
Subd. 2. Eligibility for license condition.
(a) A hospital is not eligible to receive a license
condition for swing beds unless (1) it either has a licensed bed capacity of less than 50 beds
defined in the federal Medicare regulations, Code of Federal Regulations, title 42, section
or it has a licensed bed capacity of 50 beds or more and has swing beds that were approved for
Medicare reimbursement before May 1, 1985, or it has a licensed bed capacity of less than 65 beds
and the available nursing homes within 50 miles have had, in the aggregate, an average occupancy
rate of 96 percent or higher in the most recent two years as documented on the statistical reports
to the Department of Health; and (2) it is located in a rural area as defined in the federal Medicare
regulations, Code of Federal Regulations, title 42, section
(b) Except for those critical access hospitals established under section
, clause (9),
and section 1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4,
that have an attached nursing home or that owned a nursing home located in the same municipality
as of May 1, 2005, eligible hospitals are allowed a total of 2,000 days of swing bed use per year.
Critical access hospitals that have an attached nursing home or that owned a nursing home located
in the same municipality as of May 1, 2005, are allowed swing bed use as provided in federal law.
(c) Except for critical access hospitals that have an attached nursing home or that owned a
nursing home located in the same municipality as of May 1, 2005, the commissioner of health
may approve swing bed use beyond 2,000 days as long as there are no Medicare certified skilled
nursing facility beds available within 25 miles of that hospital that are willing to admit the patient.
Critical access hospitals exceeding 2,000 swing bed days must maintain documentation that
they have contacted skilled nursing facilities within 25 miles to determine if any skilled nursing
facility beds are available that are willing to admit the patient.
(d) After reaching 2,000 days of swing bed use in a year, an eligible hospital to which this
limit applies may admit six additional patients to swing beds each year without seeking approval
from the commissioner or being in violation of this subdivision. These six swing bed admissions
are exempt from the limit of 2,000 annual swing bed days for hospitals subject to this limit.
(e) A health care system that is in full compliance with this subdivision may allocate its total
limit of swing bed days among the hospitals within the system, provided that no hospital in the
system without an attached nursing home may exceed 2,000 swing bed days per year.
Subd. 3. Approval of license condition.
The commissioner of health shall approve a license
condition for swing beds if the hospital meets all of the criteria of this subdivision:
(a) The hospital must meet the eligibility criteria in subdivision 2.
(b) The hospital must be in compliance with the Medicare conditions of participation for
swing beds under Code of Federal Regulations, title 42, section
(c) The hospital must agree, in writing, to limit the length of stay of a patient receiving
services in a swing bed to not more than 40 days, or the duration of Medicare eligibility, unless the
commissioner of health approves a greater length of stay in an emergency situation. To determine
whether an emergency situation exists, the commissioner shall require the hospital to provide
documentation that continued services in the swing bed are required by the patient; that no skilled
nursing facility beds are available within 25 miles from the patient's home, or in some more
remote facility of the resident's choice, that can provide the appropriate level of services required
by the patient; and that other alternative services are not available to meet the needs of the patient.
If the commissioner approves a greater length of stay, the hospital shall develop a plan providing
for the discharge of the patient upon the availability of a nursing home bed or other services that
meet the needs of the patient. Permission to extend a patient's length of stay must be requested by
the hospital at least ten days prior to the end of the maximum length of stay.
(d) The hospital must agree, in writing, to limit admission to a swing bed only to (1) patients
who have been hospitalized and not yet discharged from the facility, or (2) patients who are
transferred directly from an acute care hospital.
(e) The hospital must agree, in writing, to report to the commissioner of health by December
1, 1985, and annually thereafter, in a manner required by the commissioner (1) the number of
patients readmitted to a swing bed within 60 days of a patient's discharge from the facility, (2) the
hospital's charges for care in a swing bed during the reporting period with a description of the care
provided for the rate charged, and (3) the number of beds used by the hospital for transitional care
and similar subacute inpatient care.
(f) The hospital must agree, in writing, to report statistical data on the utilization of the swing
beds on forms supplied by the commissioner. The data must include the number of swing beds,
the number of admissions to and discharges from swing beds, Medicare reimbursed patient days,
total patient days, and other information required by the commissioner to assess the utilization
of swing beds.
Subd. 4. Issuance of license condition; renewals.
The commissioner of health shall issue a
license condition to a hospital that complies with subdivisions 2 and 3. The license condition must
be granted when the license is first issued, when it is renewed, or during the hospital's licensure
year. The condition is valid for the hospital's licensure year. The license condition can be renewed
at the time of the hospital's license renewal if the hospital complies with subdivisions 2 and 3.
Subd. 5. Inspections.
144.55, subdivision 4
, the commissioner of
health may conduct inspections of a hospital granted a condition under this section to assess
compliance with this section.
Subd. 6. Violations.
144.55, subdivision 4
, if the hospital fails
to comply with subdivision 2 or 3, the commissioner of health shall issue a correction order
and penalty assessment under section
or may suspend, revoke, or refuse to renew the
license condition under section
144.55, subdivision 6
. The penalty assessment for a violation of
subdivision 2 or 3 is $500.
History: 1Sp1985 c 3 s 3; 1986 c 420 s 1; 1989 c 282 art 2 s 9,10; 1995 c 207 art 7 s
7; 1Sp2005 c 4 art 6 s 23