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Description
This webinar will focus on the CMS Conditions of Participation Swing Bed and psychiatric services requirements for acute hospitals. In 2019, CMS made changes to the State Operations Manual, incorporating psychiatric hospital requirements formerly in a separate Manual, into Appendix A, plus changes to Swing Bed requirements. In 2025, CMS added multiple interpretive guidelines and survey procedures for psychiatric hospitals.
In 2018, CMS incorporated Swing Bed requirements and interpretive guidelines from Appendix T into Appendix A. This session will address both areas of specialized services.
Learning Objectives
- Discuss the requirements for qualifying for Swing Beds
- Recall the scope of patient rights for a Swing Bed patient
- Describe the special provisions that apply to psychiatric hospitals
- Discuss the five requirements for a written plan of care of psychiatric patient.
Agenda
Introduction
- How to Locate the Manual
- Survey protocol
- Top swing bed deficiencies
Swing Bed
- Eligibility overall
- Patient requirements
- Facility requirements
- Skilled Nursing services
- Competent patient
- Resident Rights
- Notice of Rights and Services
- Choice of physician
- Privacy and Confidentiality
- Send and receive mail
- Access and Visitation Rights
- Billing notices
- Personal Property
- Married Couples
- Admission, Transfer, and Discharge Rights
- Transfer and Discharge
- Required documentation
- Payment of care
- Content of notice
- Resident Behavior and Facility Practices
- Restraints, Abuse
- Hiring of employees
- Patient Activities
- Social Services
- Discharge and transfer
- Dental requirements
- Resident Assessment
Psychiatric Hospitals
- Survey process
- Psychiatric hospital and units
- Psychiatric services must be under the supervision of a physician
- Staff requirements
- Medial Record requirements
- Patient’s history
- Legal status
- Admitting diagnosis
- Reason for admission
- Reflect social services provided
- Need for neurological examination
- Requirement for a psychiatric evaluation and timing of such
- Medical history to be completed
- Mental status and onset of circumstances for admission
- Description of attitudes and behaviors
- Intellectual function and inventory of the patient’s assets
- Individualized treatment plan with goals and modalities
- Treatment plan requirements
- Progress notes requirements
- Frequenecy
- Recommendations
- Assessment of progress
- Need for adequate documentation, including treatment provided
- Who to document progress notes
- Content of progress notes
- Requirement for a discharge summary and plan
- Staff requirements
- Number of personnel
- Need for qualified personnel and responsibilities
- Qualifications and responsibilities of the director of services
- Availability of medical personnel
- Qualification of the director of nursing
- Staffing requirements
- Requirements of psychological services
- Director of social services
- Social services staff requirements
- Requirements of the therapeutic activities program
Appendix and Resources
Who Should Attend
- CEOs
- COOs
- Nurse executives
- Accreditation and Compliance/Regulation Director
- Nurse managers
- Quality managers
- Risk/Patient Safety managers
- Health information management personnel
- Social workers
- Dieticians
- Nurses
- Nurse educators
- Nursing supervisors
- Patient safety officer
- Anyone responsible for the care of psychiatric patients
- Anyone responsible for the care of swing-bed patients
- Persons responsible for implementing the CMS swing bed requirements
Speaker
Laura A. Dixon recently served as the Regional Director of Risk Management and Patient Safety for Kaiser Permanente Colorado, providing consultation and resources to clinical staff. Prior to joining Kaiser, she served as the Director of Facility Patient Safety and Risk Management and Operations for COPIC from 2014 to 2020. In her role, Ms. Dixon provided patient safety and risk management consultation and training to facilities, practitioners, and staff in multiple states. Such services included creating presentations on risk management topics, assessing healthcare facilities, developing programs, and compiling reference materials that complement physician-oriented products.
Before joining COPIC, she served as the Director, of the Western Region, Patient Safety and Risk Management for The Doctors Company, Napa, California. In this capacity, she provided patient safety and risk management consultation to the physicians and staff in the western United States. Ms. Dixon’s legal experience includes medical malpractice insurance defense and representation of nurses before the Colorado Board of Nursing.
Ms. Dixon has over twenty years of clinical experience in acute care facilities, including critical care, coronary care, peri-operative services, and pain management.
As a registered nurse and attorney, Laura holds a Bachelor of Science degree from Regis University, RECEP of Denver, a Doctor of Jurisprudence degree from Drake University College of Law, Des Moines, Iowa, and a Registered Nurse Diploma from Saint Luke’s School Professional Nursing, Cedar Rapids, Iowa. She is licensed to practice law in Colorado and California.