Form Cms-437a - Rehab Unit Criteria Worksheet Page 6
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9THE HOSPITAL REPRESENTATIVE WHO
TAG
REGULATION
GUIDANCE
YES
NO
N/A
COMPLETES THIS ENTIRE FORM
A3513
(2) New IRF beds. Any IRF beds that are added
• If the hospital added beds to its IRF unit, the
• The representative verifies that the hospital
to an existing IRF must meet all applicable State
surveyor or CMS will verify that the hospital had
received State approval (certification of need or
Certificate of Need and State licensure laws. New
approval (certificate of need or State license )
State licensure) , if prior approval is required by
IRF beds may be added one time at any point during
before adding beds, if such approval is required.
the State, prior to any IRF unit bed increase.
a cost reporting period and will be considered
• The surveyor must verify that the hospital
• The representative verifies that the hospital
new for the rest of that cost reporting period. A
received written CMS RO approval before
received written approval from the CMS RO
full 12-month cost reporting period must elapse
adding any new beds to its IRF unit.
before any new beds were added to the IRF
between the delicensing or decertification of IRF
unit.
beds in an IRF hospital or IRF unit and the addition
• The surveyor will verify that the hospital’s IRF
of new IRF beds to that IRF hospital or IRF unit.
unit didn’t have more than one increase in beds
• The representative will verify that if the
Before an IRF can add new beds, it must receive
during a single cost reporting period.
hospital’s IRF unit decreased beds, it didn’t
written approval from the appropriate CMS RO, so
thereafter add beds unless a full 12 month cost
that the RO can verify that a full 12-month cost
• Surveyors must verify that if the hospital’s IRF
reporting period had elapsed.
reporting period has elapsed since the IRF has had
unit decreased beds, it didn’t thereafter add
beds declincensed or decertified. New IRF beds are
beds unless a full 12 month cost reporting
• The representative will verify that the hospital’s
included in the compliance review calculations
period had elapsed.
IRF unit didn’t have more than one increase in
under paragraph (b) of this section from the time
beds during a single cost reporting period.
that they are added to the IRF.
A3514
(3) Change of ownership or leasing.
• IRF status is lost if a hospital is acquired and the
The representative of the IRF unit, that has
An IRF hospital or IRF unit that
new owners reject assignment of the previous
undergone a change of ownership, must ensure
undergoes a change of ownership, or
owner’s Medicare provider assignment.
that the new owner(s) have accepted assignment
leasing as defined in § 489.18 of this
of the previous Medicare provider agreement. If the
• Only entire hospitals may be sold or leased.
chapter, retains its excluded status
new owner(s) have not accepted the assignment,
and will continue to be paid under
the representative cannot request continued
• IRF units may not be sold or leased separately
the prospective payment systems
participation as an IPPS-excluded unit.
from the hospital of which it is a part.
specified in § 412.1(a)(3) before and
after the change of ownership or
leasing if the new owner(s) of the IRF
accept assignment of the previous
owners’ Medicare provider agreement
and the IRF continues to meet all the
requirements for payment under the IRF
prospective payment system. If the new
owner(s) do not accept assignment of
the previous owners’ Medicare provider
agreement, the IRF is considered to be
voluntarily terminated and the new
owner(s) may reapply to participate
in the Medicare program. If the IRF
does not continue to meet all of
the requirements under the new IRF
prospective payment system, then the
IRF loses its excluded status and is paid
according to the prospective payment
systems described in § 412.1(a)(1).
Form CMS-437A (06/12)
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