CMS SOM App. W, Tag C-0840

Time of Application

Except for recently closed facilities as described in §485.610(a)(2), or health clinics

or health centers as described in §485.610(a)(3), the facility is a hospital that has a

provider agreement to participate in the Medicare program as a hospital at the time

the hospital applies for designation as a CAH.

Interpretive Guidelines §485.612

This COP only applies to initial surveys. All facilities that apply to become a CAH are

surveyed using the CAH CoP to determine compliance, whether they are:

• A currently operating CAH; or

• A re-opened CAH; or

• A CAH that down-sized to become a clinic.

If a facility has never been a Medicare participating hospital and wishes to be a CAH, the

facility is a new provider to Medicare and must first meet the certification as a hospital

and then put in a change of status request to be a CAH. In these cases, the facility must

be surveyed twice. They must be initially surveyed using the hospital CoP and, when the

change request is received, they must be surveyed again using the CAH CoP. In

addition, these facilities are to be treated as new providers to Medicare necessitating

completion of an application package as a new Medicare provider.