The California Department of Health Care Services (DHCS) has updated the Rural Swing Bed rates for Accommodation Codes 04 (Regular Services) and 05 (Leave of Absence/Bed Hold).
Due to the Coronavirus disease (COVID-19) outbreak, a public health emergency was declared for the United States on January 31, 2020, and a national emergency was declared under the Stafford Act on March 13, 2020. In response to the COVID-19 outbreak, DHCS will temporarily provide an additional 10 percent reimbursement for Long Term Care (LTC) per diem rates. DHCS received federal approval of State Plan Amendment (SPA) 20-0024, effective March 1, 2020, which authorizes temporary additional reimbursement for eligible LTC facilities during the emergency period related to the COVID-19 outbreak. For rate year (RY) 2020-2021, the COVID-19 increased amounts will remain unchanged and will be added to the per diem rates that became effective August 1, 2020.
Upon expiration of the public health emergency or national emergency, whichever occurs first, LTC reimbursements will revert to the RY 2020-2201 annual per diem rates.
Rural Swing Bed rates are exempt from the Assembly Bill (AB) 97, 10 percent payment reduction, but are subject to the AB 97 rate freeze at the reimbursement rate established in 2008-2009 including any applicable add-ons. However, retroactive to September 1, 2013, Distinct-Part Nursing Facilities – Level B (DP/NF-B) located in designated rural or frontier areas are exempt from the AB 97 rate freeze.
- Effective August 1, 2020, the Rural Swing Bed rates in hospitals located in designated rural/frontier areas with DP/NP-Bs are as follows:
Rural Swing Bed (Exempt from AB 97 Rate Freeze)
The temporary rate of $522.77 includes 2020 $1.72 unfrozen add-ons and $43.67 temporary COVID-19 increase.
The temporary rate of $514.02 is $522.77 minus 2020 Leave of Absence/Bed Hold rate of $8.75
- Effective August 1, 2020, the Rural Swing Bed rates for rural hospitals that do not have a DP/NF-B are not exempt from the AB 97 rate freeze
Rural Swing Bed (Not Exempt from AB 97 Rate Freeze)
The temporary rate of $344.27 includes 2008 rate of $305.15 plus 2020 $7.91 frozen add-ons plus $31.21 temporary COVID-19 increase.
The temporary bed hold rate is $344.27 minus 2020 Leave of Absence/Bed Hold amount of $8.75.
Providers do not need to resubmit claims to adjust their payments. The California MMIS Fiscal Intermediaries will process any retroactive rate adjustments for claims paid at the prior rate.
For billing or payment questions, providers may call the Telephone Service Center at 1-800-541-5555, Monday through Friday from 8 a.m. to 5 p.m.
Providers may find the Rural Swing Bed rates posted on the Rural Swing Bed page of the DHCS website.