Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.40 - SENIOR AND LONG TERM CARE SERVICES › Subchapter 37.40.4 - Swing-beds › Rule 37.40.402 - SWING-BED HOSPITALS, PROVIDER PARTICIPATION REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) To participate
				and be reimbursed as a swing-bed hospital service provider in the Montana
				Medicaid program, a hospital must meet all of the following requirements:
(a) The hospital is a swing-bed hospital as
				defined in ARM
				37.40.401.
(b) The hospital has fewer than 50 hospital
				beds and has provided written assurance to the health care financing
				administration that the hospital will not operate over 49 hospital beds,
				including swing-beds, except in connection with a catastrophic event.
(i) The hospital bed count is determined by
				excluding from the total licensed hospital beds:
(A) beds which because of their special
				nature would not be available for swing-bed use, such as newborn and intensive
				care beds;
(B) beds included in a
				separately certified skilled nursing facility or nursing facility;
(C) beds included in a distinct part
				psychiatric or rehabilitation unit; and
(D) beds which the department determines are
				not consistently staffed and utilized by the hospital, as demonstrated by the
				hospital's staffing schedules and census records for the 12 months immediately
				preceding application for enrollment as a medicaid swing-bed hospital services
				provider.
(c)
				The critical access hospital (CAH) with swing-bed approval has no more than 25
				acute care inpatient beds, of which no more than 15 are used for acute care at
				any one time for providing inpatient care.
(d) The hospital is located in a rural area
				of the state. A rural area is an area which is not designated as "urbanized" by
				the most recent official census. A copy of the bureau of the census listing of
				urbanized areas is available upon request from the Department of Public Health
				and Human Services, Senior and Long Term Care Division, 111 N. Sanders, P.O.
				Box 4210, Helena, MT 59604-4210.
(e) The hospital has a certificate of need
				from the state department of public health and human services to provide
				swing-bed hospital services.
(f)
				The hospital does not have in effect a 24 hour nursing waiver under the
				provisions of
				42 CFR
				488.54 (c) .
(g) The hospital's medicare or medicaid
				swing-bed certification or approval has not been terminated within two years
				prior to the application for enrollment as a medicaid swing-bed hospital
				services provider.
(h) The hospital
				meets the requirements of ARM
				37.40.416(1).
(i) The hospital has applied for
				and the department has approved enrollment in the medicaid program as a
				medicaid swing-bed hospital services provider.
(i) As a condition of granting enrollment
				approval or of allowing continuing enrollment, the department may require a
				hospital to submit documentation or information relating to participation
				requirements.
(ii) The department
				may terminate a provider's swing-bed hospital services provider enrollment if
				it determines that the hospital is not in compliance with any of the
				requirements of this rule.