As part of the agreements under the conditions of participation in the CAH, a CAH must develop agreements with an acute hospital for the transfer and transfer of patients, emergency and non-emergency communication and transport. The agreement must include at least one other hospital that can provide acute care and receive transfers from patients requiring services not available in the CAH. Even if a CAH does not have another health facility, it can also benefit from cooperation and network agreements. A manual of effective cooperation between hospitals with critical access and state-qualified health centers explains how cooperation with QQHCs can lead to subsidies, shared recruitment costs and a reduction in labor costs through transfers to primary QQC providers for the uninsured. Demonstration of hospital value for critical access: A guide for potential partnerships identifies potential partners for caHs and discusses how CAHs can demonstrate their value to them. The National Resource Center for Rural Health also provides a number of examples of networks that have included caHs in their network spotlights. CAH should not exceed 25 stationary acute beds. For CAH with rocking bed agreements, each of their beds can be used for acute hospital care or for rocking bed services. Any hospital bed located in or next to any place where the hospital bed could be used for hospital care is part of the 25-bed limit. The rocking bed requirements apply to any patient licensed from a hospital or CAH and admitted to a swing bed for qualified care services.
The requirements for acute CAH also apply to patients with Swing Bed. A rocking bed is a bed that can be used either for acute care or for postoperative care corresponding to care provided by qualified care facilities (SNFs). Medicare and Medicaid Services centers allow caHs and other hospitals to set up rocking beds, giving the facility flexibility to meet unpredictable acute care and NFC requirements. The CAH may also have an agreement with its SAQ transfer hospital or choose to enter into this agreement with another organization. The requirements for public networks vary. For more information about quality assurance options, see What are the quality assurance and quality improvement options for CAHs? Please read the CMS regulations for critical access hospitals that have rocking beds? Rocking beds offer an alternative to qualified care facilities….