Subdivision 1. Definition. For the purposes of this section, "swing bed" means a hospital bed licensed under sections 144.50 to 144.56 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 482.66, 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 482.66.
(b) Except for those critical access hospitals established under section 144.1483, 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 number of days of swing bed use per year as provided in paragraph (c). 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) An eligible hospital is allowed a total of 3,000 days of swing bed use in calendar year 2020. Beginning in calendar year 2021, and for each subsequent calendar year until calendar year 2027, the total number of days of swing bed use per year is increased by 200 swing bed use days. Beginning in calendar year 2028, an eligible hospital is allowed a total of 4,500 days of swing bed use per year.
(d) Days of swing bed use for medical care that an eligible hospital has determined are charity care shall not count toward the applicable limit in paragraph (b) or (c). For purposes of this paragraph, "charity care" means care that an eligible hospital provided for free or at a discount to persons who cannot afford to pay and for which the eligible hospital did not expect payment.
(e) Days of swing bed use for care of a person who has been denied admission to every Medicare-certified skilled nursing facility within 25 miles of the eligible hospital shall not count toward the applicable limit in paragraphs (b) and (c). Eligible hospitals must maintain documentation that they have contacted each skilled nursing facility within 25 miles to determine if any skilled nursing facility beds are available and if the skilled nursing facilities are willing to admit the patient. Skilled nursing facilities that are contacted must admit the patient or deny admission within 24 hours of being contacted by the eligible hospital. Failure to respond within 24 hours is deemed a denial of admission.
(f) 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 and the patient agrees to the referral being sent to the skilled nursing facility. 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 and the patient agrees to the referral being sent to the skilled nursing facility. This paragraph expires January 1, 2020.
(g) 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. This paragraph expires January 1, 2020.
(h) 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. This paragraph expires January 1, 2020.
Subd. 3. Approval of license condition. (a) The commissioner of health shall approve a license condition for swing beds if the hospital meets all of the criteria of this subdivision.
(b) The hospital must meet the eligibility criteria in subdivision 2.
(c) The hospital must be in compliance with the Medicare conditions of participation for swing beds under Code of Federal Regulations, title 42, section 482.66.
(d) 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.
(e) 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.
(f) 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.
(g) 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. Notwithstanding section 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. Notwithstanding section 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 144.653 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.
Subd. 7. [Obsolete]
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; 1Sp2017 c 6 art 3 s 3; 1Sp2019 c 9 art 11 s 33
Structure Minnesota Statutes
Chapter 144 — Department Of Health
Section 144.011 — Department Of Health.
Section 144.05 — General Duties Of Commissioner; Reports.
Section 144.0505 — Cooperation With Commissioner Of Human Services.
Section 144.051 — Data Relating To Licensed And Registered Persons.
Section 144.052 — Use Of Data.
Section 144.0525 — Epidemiologic Studies; Health Hazards; Health Surveillance.
Section 144.053 — Research Studies Confidential.
Section 144.0535 — Entry For Inspection.
Section 144.054 — Subpoena Power.
Section 144.055 — Home Safety Programs.
Section 144.056 — Plain Language In Written Materials.
Section 144.057 — Background Studies On Licensees And Other Personnel.
Section 144.058 — Interpreter Services Quality Initiative.
Section 144.059 — Palliative Care Advisory Council.
Section 144.06 — State Commissioner Of Health To Provide Instruction.
Section 144.061 — Early Dental Prevention Initiative.
Section 144.062 — Vaccine Cost Reduction Program.
Section 144.064 — The Vivian Act.
Section 144.065 — Prevention And Treatment Of Sexually Transmitted Infections.
Section 144.07 — Powers Of Commissioner.
Section 144.0721 — Assessments Of Care And Services To Nursing Home Residents.
Section 144.0724 — Resident Reimbursement Classification.
Section 144.074 — Funds Received From Other Sources.
Section 144.0742 — Contracts For Provision Of Public Health Services.
Section 144.0751 — Health Standards.
Section 144.077 — Mobile Health Care Providers.
Section 144.09 — Cooperation With Federal Authorities.
Section 144.092 — Coordinated Nutrition Data Collection.
Section 144.10 — Federal Aid For Maternal And Child Welfare Services.
Section 144.111 — Rules, Notice Published.
Section 144.12 — Regulation, Enforcement, Licenses, Fees.
Section 144.1201 — Definitions.
Section 144.1202 — United States Nuclear Regulatory Commission Agreement.
Section 144.1203 — Training; Rulemaking.
Section 144.1204 — Surety Requirements.
Section 144.1205 — Radioactive Material; Special Nuclear Material.
Section 144.121 — X-ray Machines; Other Sources Of Ionizing Radiation.
Section 144.1212 — Notice To Patient; Mammogram Results.
Section 144.1215 — Authorization To Use Handheld Dental X-ray Equipment.
Section 144.122 — License, Permit, And Survey Fees.
Section 144.1222 — Public Pools; Enclosed Sports Arenas.
Section 144.1225 — Advanced Diagnostic Imaging Services.
Section 144.123 — Fees For Diagnostic Laboratory Services; Exceptions.
Section 144.125 — Tests Of Infants For Heritable And Congenital Disorders.
Section 144.1251 — Newborn Screening For Critical Congenital Heart Disease (cchd).
Section 144.1255 — Heritable And Congenital Disorders.
Section 144.128 — Commissioner's Duties.
Section 144.14 — Quarantine Of Interstate Carriers.
Section 144.145 — Fluoridation Of Municipal Water Supplies.
Section 144.1461 — Dignity In Pregnancy And Childbirth.
Section 144.1464 — Summer Health Care Interns.
Section 144.1465 — Finding And Purpose.
Section 144.147 — Rural Hospital Planning And Transition Grant Program.
Section 144.1476 — Rural Pharmacy Planning And Transition Grant Program.
Section 144.148 — Rural Hospital Capital Improvement Grant Program.
Section 144.1481 — Rural Health Advisory Committee.
Section 144.1482 — Office Of Rural Health.
Section 144.1483 — Rural Health Initiatives.
Section 144.1485 — Database On Health Personnel.
Section 144.1492 — State Rural Health Network Reform Initiative.
Section 144.1493 — Nursing Grant Program.
Section 144.1501 — Health Professional Education Loan Forgiveness Program.
Section 144.1505 — Health Professionals Clinical Training Expansion Grant Program.
Section 144.1506 — Primary Care Residency Expansion Grant Program.
Section 144.1911 — International Medical Graduates Assistance Program.
Section 144.1912 — Greater Minnesota Family Medicine Residency Grant Program.
Section 144.193 — Inventory Of Biological And Health Data.
Section 144.212 — Definitions.
Section 144.213 — Office Of Vital Records.
Section 144.2131 — Security Of Vital Records System.
Section 144.215 — Birth Registration.
Section 144.2151 — Record Of Birth Resulting In Stillbirth.
Section 144.216 — Foundling Registration.
Section 144.217 — Delayed Records Of Birth.
Section 144.218 — Replacement Birth Records.
Section 144.2181 — Amendment And Correction Of Vital Records.
Section 144.221 — Death Registration.
Section 144.2215 — Minnesota Birth Defects Information System.
Section 144.2216 — Birth Defects Records And Reports Required.
Section 144.2217 — Classification Of Birth Defects Information.
Section 144.2218 — Transfers Of Information To Other Government Agencies.
Section 144.2219 — Transfers Of Information To Research Entities.
Section 144.222 — Reports Of Fetal Or Infant Death.
Section 144.223 — Report Of Marriage.
Section 144.225 — Disclosure Of Information From Vital Records.
Section 144.2252 — Access To Original Birth Record After Adoption.
Section 144.2255 — Certified Birth Record For Homeless Youth.
Section 144.29 — Health Records; Children Of School Age.
Section 144.291 — Minnesota Health Records Act.
Section 144.292 — Patient Rights.
Section 144.293 — Release Or Disclosure Of Health Records.
Section 144.294 — Records Relating To Mental Health.
Section 144.295 — Disclosure Of Health Records For External Research.
Section 144.296 — Copies Of Videotapes.
Section 144.297 — Independent Medical Examination.
Section 144.30 — Copies Of Records Evidence In Juvenile Court.
Section 144.32 — False Statements Cause For Discharge.
Section 144.334 — Right To Request Patient Information.
Section 144.3345 — Interconnected Electronic Health Record Grants.
Section 144.3351 — Immunization Data.
Section 144.3352 — Hepatitis B Maternal Carrier Data; Infant Immunization.
Section 144.336 — Registry Of Persons Typed For Human Leukocyte Antigens.
Section 144.34 — Investigation And Control Of Occupational Diseases.
Section 144.341 — Living Apart From Parents And Managing Financial Affairs.
Section 144.342 — Marriage Or Giving Birth, Consent For Health Service For Self Or Child.
Section 144.343 — Pregnancy, Venereal Disease, Alcohol Or Drug Abuse, Abortion.
Section 144.344 — Emergency Treatment.
Section 144.3441 — Hepatitis B Vaccination.
Section 144.345 — Representations To Persons Rendering Service.
Section 144.346 — Information To Parents.
Section 144.347 — Financial Responsibility.
Section 144.35 — Pollution Of Water.
Section 144.36 — Appeal To District Court.
Section 144.37 — Other Remedies Preserved.
Section 144.382 — Definitions.
Section 144.383 — Authority Of Commissioner.
Section 144.384 — Notice Of Violation.
Section 144.385 — Public Notice.
Section 144.3855 — Limitation.
Section 144.3872 — Female Genital Mutilation; Education And Outreach.
Section 144.391 — Public Policy.
Section 144.392 — Duties Of Commissioner.
Section 144.393 — Public Communications Program.
Section 144.394 — Health Promotion And Education.
Section 144.396 — Tobacco Use Prevention.
Section 144.397 — Statewide Tobacco Cessation Services.
Section 144.412 — Public Policy.
Section 144.413 — Definitions.
Section 144.414 — Prohibitions.
Section 144.416 — Responsibilities Of Proprietors.
Section 144.4165 — Tobacco Products Prohibited In Public Schools.
Section 144.4167 — Permitted Smoking.
Section 144.417 — Commissioner Of Health, Enforcement, Penalties.
Section 144.4172 — Definitions.
Section 144.4173 — Cause Of Action.
Section 144.4176 — Petition; Notice.
Section 144.4177 — Time Of Hearing And Duties Of Counsel.
Section 144.4178 — Criminal Immunity.
Section 144.4179 — Standard Of Proof; Evidence.
Section 144.4182 — Temporary Emergency Hold.
Section 144.4183 — Emergency Hold Hearing.
Section 144.4184 — Contact Data.
Section 144.4186 — Data Privacy.
Section 144.419 — Isolation And Quarantine Of Persons.
Section 144.4195 — Due Process For Isolation Or Quarantine Of Persons.
Section 144.4196 — Employee Protection.
Section 144.4197 — Emergency Vaccine Administration; Legend Drug.
Section 144.4198 — Mass Dispensing Under Authority Of Commissioner Of Health.
Section 144.4199 — Public Health Response Contingency Account.
Section 144.441 — Tuberculosis Screening In Schools.
Section 144.442 — Testing In School Clinics.
Section 144.445 — Tuberculosis Screening In Correctional Institutions.
Section 144.4803 — Definitions.
Section 144.4804 — Reporting Relating To Tuberculosis.
Section 144.4805 — Health Order; Rights Of Carrier And Respondent.
Section 144.4806 — Preventive Measures Under Health Order.
Section 144.4807 — Notice Of Obligation To Isolate Or Examine.
Section 144.4808 — Apprehend And Hold Order.
Section 144.4809 — Preliminary Hearing.
Section 144.4810 — Final Hearing.
Section 144.4811 — Periodic Review And Release From Detention.
Section 144.4812 — Costs Of Care.
Section 144.4813 — Data Privacy.
Section 144.49 — Violations; Penalties.
Section 144.492 — Definitions.
Section 144.494 — Designating Stroke Centers And Stroke Hospitals.
Section 144.4941 — St Segment Elevation Myocardial Infarction (stemi) Receiving Centers.
Section 144.495 — Formaldehyde Rules.
Section 144.496 — Minnesota Radon Awareness Act.
Section 144.4961 — Minnesota Radon Licensing Act.
Section 144.497 — St Elevation Myocardial Infarction.
Section 144.50 — Hospitals, Licenses; Definitions.
Section 144.51 — License Applications.
Section 144.55 — Licenses; Issuance, Suspension And Revocation.
Section 144.5509 — Radiation Therapy Facility Construction.
Section 144.551 — Hospital Construction Moratorium.
Section 144.552 — Public Interest Review.
Section 144.553 — Alternative Approval Process.
Section 144.554 — Health Facilities Construction Plan Submittal And Fees.
Section 144.561 — Description Of Certain Medical Facilities.
Section 144.562 — Swing Bed Approval; Issuance Of License Conditions.
Section 144.563 — Nursing Services Provided In A Hospital; Prohibited Practices.
Section 144.564 — Monitoring Of Subacute Or Transitional Care Services.
Section 144.565 — Diagnostic Imaging Facilities.
Section 144.566 — Violence Against Health Care Workers.
Section 144.572 — Institutions Excepted.
Section 144.573 — Pets In Certain Institutions.
Section 144.574 — Dangers Of Shaking Infants And Young Children.
Section 144.58 — Information, Confidential.
Section 144.581 — Hospital Authorities.
Section 144.585 — Methicillin-resistant Staphylococcus Aureus Control Programs.
Section 144.586 — Requirements For Certain Notices And Discharge Planning.
Section 144.591 — Disclosure Of Hospital Charges.
Section 144.602 — Definitions.
Section 144.603 — Statewide Trauma System Criteria.
Section 144.604 — Trauma Triage And Transportation.
Section 144.605 — Designating Trauma Hospitals.
Section 144.606 — Interhospital Transfers.
Section 144.6062 — Comprehensive Advanced Life Support.
Section 144.6071 — Trauma Registry.
Section 144.608 — Trauma Advisory Council.
Section 144.611 — Captioning Required.
Section 144.615 — Birth Centers.
Section 144.6501 — Nursing Home Admission Contracts.
Section 144.6502 — Electronic Monitoring In Certain Facilities.
Section 144.6503 — Facilities For Alzheimer's Disease Or Related Disorder.
Section 144.6505 — Subacute Care Waivers.
Section 144.651 — Health Care Bill Of Rights.
Section 144.6512 — Retaliation In Nursing Homes Prohibited.
Section 144.652 — Bill Of Rights Notice To Patient Or Resident; Violation.
Section 144.6521 — Disclosure Of Financial Interest.
Section 144.6522 — Designation Of A Caregiver.
Section 144.653 — Rules; Periodic Inspections; Enforcement.
Section 144.6535 — Variance Or Waiver.
Section 144.654 — Experts May Be Employed.
Section 144.655 — Program For Voluntary Medical Aid.
Section 144.656 — Employees To Be Compensated.
Section 144.657 — Volunteer Efforts Encouraged.
Section 144.658 — Epidemiologic Data Discovery.
Section 144.6581 — Determination Of Whether Data Identifies Individuals.
Section 144.6585 — Identification Of Health Care Providers.
Section 144.6586 — Notice Of Rights To Sexual Assault Victim.
Section 144.661 — Definitions.
Section 144.662 — Traumatic Brain Injury And Spinal Cord Injury Registry.
Section 144.663 — Duty To Report.
Section 144.664 — Duties Of Commissioner.
Section 144.665 — Traumatic Brain Injury And Spinal Cord Injury Data.
Section 144.671 — Cancer Surveillance System; Purpose.
Section 144.672 — Duties Of Commissioner; Rules.
Section 144.68 — Records And Reports Required.
Section 144.69 — Classification Of Data On Individuals.
Section 144.691 — Grievance Procedures.
Section 144.696 — Definitions.
Section 144.697 — General Powers And Duties Of State Commissioner Of Health.
Section 144.698 — Reporting Requirements.
Section 144.699 — Continuing Analysis.
Section 144.70 — Biennial Report.
Section 144.701 — Rate Disclosure.
Section 144.702 — Hospital And Outpatient Surgical Center Costs.
Section 144.7022 — Reporting Organizations; Penalty Orders.
Section 144.703 — Additional Powers.
Section 144.7055 — Staffing Plan Reports.
Section 144.7063 — Definitions.
Section 144.7065 — Facility Requirements To Report, Analyze, And Correct.
Section 144.7067 — Commissioner Duties And Responsibilities.
Section 144.7068 — Reports From Licensing Boards.
Section 144.7069 — Interstate Coordination; Reports.
Section 144.71 — Purpose; Definitions.
Section 144.73 — State Commissioner Of Health, Duties.
Section 144.74 — Rules, Standards.
Section 144.7401 — Definitions.
Section 144.7402 — Conditions For Applicability Of Procedures.
Section 144.7403 — Information Required To Be Given To Individuals.
Section 144.7404 — Disclosure Of Positive Blood-borne Pathogen Test Results.
Section 144.7405 — Consent Procedures Generally.
Section 144.7406 — Testing Of Available Blood.
Section 144.7407 — Blood Sample Collection For Testing.
Section 144.7408 — No Discrimination.
Section 144.7409 — Use Of Test Results.
Section 144.7411 — Test Information Confidentiality.
Section 144.7412 — Penalty For Unauthorized Release Of Information.
Section 144.7413 — Responsibility For Testing And Treatment; Costs.
Section 144.7414 — Protocols For Exposure To Blood-borne Pathogens.
Section 144.7415 — Penalties And Immunity.
Section 144.84 — Civil Service Classification.
Section 144.91 — Powers And Duties.
Section 144.92 — Grants Or Gifts.
Section 144.945 — Zika Preparedness And Response.
Section 144.95 — Mosquito Research Program.
Section 144.9501 — Definitions.
Section 144.9502 — Statewide Lead Surveillance System.
Section 144.9503 — Primary Prevention.
Section 144.9504 — Secondary Prevention.
Section 144.9505 — Credentialing Of Lead Firms And Professionals.
Section 144.9507 — Lead-related Funding.
Section 144.9509 — Enforcement.
Section 144.9512 — Lead Abatement Program.
Section 144.9513 — Healthy Housing Grants.
Section 144.966 — Early Hearing Detection And Intervention Program.
Section 144.98 — Accreditation Of Environmental Laboratories.
Section 144.989 — Title; Citation.
Section 144.991 — Administrative Penalty Order Procedure.
Section 144.992 — False Information.
Section 144.993 — Recovery Of Litigation Costs And Expenses.
Section 144.995 — Definitions; Environmental Health Tracking And Biomonitoring.
Section 144.996 — Environmental Health Tracking; Biomonitoring.
Section 144.997 — Biomonitoring Pilot Program.
Section 144.998 — Environmental Health Tracking And Biomonitoring Advisory Panel.