Create Conformity with Federal Law for Critical Access Hospitals

M.S. 144.562, M.S. 144.147. M.S. 144.148, M.S. 144.551

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Problem statement

Recent changes were made to federal law and the regulations applicable to rural Minnesota’s 61 Critical Access Hospitals. These changes resulted in two major inconsistencies with state statutes; the definitions of a rural hospital and the limit on swing beds. Hospital swing beds provide patients brief transitional care at the hospital following their acute care stay. The 2003 federal legislation also changed these bed limits upward. However, Minnesota law retains the earlier 10 bed limit, instead of the federal 25 bed limit.

In addition, several Critical Access Hospitals reduced their number of licensed beds between 1998 and 2003 to comply with the limit of 15 beds provided in the 1997 federal law creating the Critical Access Hospital option. In 2003, federal legislation raised the bed limit for Critical Access Hospitals to 25. However, Minnesota’s hospital construction moratorium prohibits these hospitals from adjusting to this federal change.

How does this legislation address the problem?

The following amendments will bring state law into conformity with new federal regulations. This will allow Critical Access Hospitals to provide all the services established under federal law for rural communities:

  • Amend M.S. 144.562 to exempt Critical Access Hospitals from the daily limit of 10 swing beds and the annual limit of 1,460 swing bed days. Critical Access Hospitals could then use any of their 25 beds for swing bed patients.
  • Amend the definition of rural hospitals in M.S. 144.147 and 144.148 to retain eligibility for current and prospective Critical Access Hospitals.
  • Amend M.S. 144.551 to allow Critical Access Hospitals a moratorium exception to increase up to the 25 beds allowed under federal law.

Move backed by stakeholders

The Minnesota Hospital Association already supports the initiative. The support of the Minnesota Rural Health Association is expected. There are no known opponents.

Consequences if this legislation does not pass:

  • If the more restrictive state limit on swing bed use is not revised, recovering patients could be unnecessarily transferred to nursing homes even though Critical Access Hospitals could provide the needed care.
  • One hospital would lose its status as a Critical Access Hospital, if the state definition of a rural hospital is not revised to include it. Yet other hospitals—in similar circumstances—would continue operating as Critical Access Hospitals.
  • Patients could be forced to travel farther for hospital services than necessary, if Critical Access Hospitals are updated.

MDH staff contact: Mark Schoenbaum (651) 282-3859.

Updated Tuesday, 16-Nov-2010 12:27:52 CST