Mississippi Rural Emergency Hospital Conversion Process

The guidelines below have just been released by the Mississippi State Department of Health regarding the process of investigating and seeking approval for conversion to a Rural Emergency Hospital model.

Process:

1. Notification:  Notify the MSDH Office of Licensure of the intent to convert to a REH on facility letterhead.   
   • Please send notice of intent to:  HFLC-NLTC@msdh.ms.gov
     
2. Required Documents (The following documents must  be included with CMS Federal Enrollment application [CMS PECOS] and State Licensure application):
   • EXHIBIT Model Attestation 
   • EXHIBIT Model REH Action Plan
   • Copy of executed Transfer Agreement(s) with Level I and/or Level II Trauma Center as required by 42 CFR § 485.538 Condition of Participation: Agreements (See QSO-23-07-REH for full details).

2. Federal Application:  Prior to completing the licensure application, facilities should complete the CMS enrollment process to convert to a REH.  See the following enclosures for enrollment steps:
   • QSO-23-07-REH final.pdf
   • REH Medicare Provider Instructions
   • MLN2259384 CMS Rural Emergency Hospital Enrollment
   • Complete CMS Enrollment through the CMS PECOS Website at: https://pecos.cms.hhs.gov.  See REH Enrollment Instructions PECOS or 855A (attached).

4. REH Initial Survey:  Eligible facilities that are existing CAHs and hospitals converting to an REH may attest to meeting the REH CoPs and will not require an automatic on-site initial survey as eligible facilities are expected to be in full compliance with the existing CAH and hospital requirements (as applicable) at the time of the request for conversion (See QSO-23-07-REH for full details).
   
5. License Application:   After CMS has approved the conversion to a REH and the facility has received their new CMS REH provider number with effective date, click the following link to complete the MSDH Rural Emergency Hospital License application:   https://app.smartsheet.com/b/form/e688589dd5304695a4c78efaebfcd38e
   
6. Fees:  There are no licensure fees to convert to a REH.
   
7. License Effective Date:  Upon approval of the licensure application, the MSDH License Administrator will issue a REH License backdated to the effective CMS REH Certification date.
   
8. Certificate of Need (CON):  CON approval is NOT required to convert to a REH, however, after receiving CMS Certification as an REH, your facility must contact the MSDH Office of Health Policy and Planning (CON) at (601) 576-7874 to request placing inpatient beds in abeyance (do not include acute beds allocated for a SNF Unit). 
   
9. SNF Unit – Facilities considering adding SNF services in a Distinct Part Unit: 
   • Contact the CON office for a Determination 
   • Complete the CMS enrollment process – Contact the MSDH Long Term Care Division for additional information at 601-364-1110.

9. License Renewal:  REH License year is January 1 – December 31.  
   • Renewal notices are sent in October. 
   • Annual renewal fee of $661.25.  

Contact the MSDH License Administrator at (601) 364-2722 with any questions.