CMS Pub. 100-01, ch. 5, § 20

A hospital (other than psychiatric) means an institution which is primarily engaged in

providing, by or under the supervision of physicians, to inpatients, diagnostic and

therapeutic services for medical diagnosis, treatment, and care of injured, disabled, or

sick persons; or rehabilitation services for the rehabilitation of injured, disabled, or sick

persons.

To be eligible to participate in Medicare, a hospital must also be an institution which:

• Maintains clinical records on all patients;

• Has bylaws in effect with respect to its staff of physicians;

• Has a requirement that every patient must be under the care of a physician;

• Provides 24-hour nursing service rendered or supervised by a registered

professional nurse, and has a licensed practical nurse or registered professional

nurse on duty at all times;

• Has in effect a hospital utilization review plan;

• Is licensed or is approved by the State or local licensing agency as meeting the

standards established for such licensing; and

• Meets other health and safety requirements found necessary by the Secretary of

Health, and Human Services. (These additional requirements may not be higher

than comparable ones prescribed for accreditation by the Joint Commission on

Accreditation of Hospitals with exceptions specified in the law).

Such an institution, if approved to participate as a hospital, may also be approved as a

swing bed facility pursuant to demonstration authority or if the hospital is a rural hospital

with less than 100 beds. (See §30.3 below.)