CMS SOM App. W, Tag C-1040

or more providers or suppliers participating under Medicare to furnish other services

to its patients, including—]

(iii) Food and other services to meet inpatients' nutritional needs to the extent

these services are not provided directly by the CAH.

Interpretive Guidelines §485.635(c)(1)(iii)

If the CAH does not provide all food and other services required to meet the nutritional

needs of the CAH’s inpatients using CAH staff, then the CAH must provide these

services under an agreement or arrangement.

The CAH must assure that dietary services provided under an agreement or arrangement

are provided in accordance with the CAH’s policies adopted as required by

§485.635(a)(3)(vii). Unless the CAH is a grandfathered co-located CAH (see

§485.610(e)(1)) that has an arrangement with the co-located facility to provide food

services to the CAH’s inpatients, it is expected that the CAH’s vendor provides dietary

services on-site at the CAH in order to meet the needs of the CAH’s inpatients.

Surveyors assess compliance with the requirements of §485.635(a)(3)(vii) in the same

manner, regardless of whether the services are provided by CAH staff or a vendor. In the

case of a grandfathered co-located CAH that obtains food services from the co-located

facility, surveyors must assess the food service operations in the co-located facility as

part of the CAH survey.

Survey Procedures §485.635(c)(1)(iii)

• Verify that the CAH has an agreement or arrangement with a vendor to provide

dietary services to inpatients if the CAH does not use its own staff to provide these

services.