Most of the concerns I`ve heard about these elements are that small hospitals often “turn away” patients who are presented as able to return to the environment at a lower level just to let them arrive in a state that overloads smaller hospital capacities and often requires a new transfer to the higher care facility within hours or days. The Ohio regulations are representative of the first group and state that a CSA “must have a written transfer agreement with a hospital for the transfer of patients in the event of medical complications, emergencies, and other needs in the event of an occurrence.” In contrast, according to the Texas Executive Order, a CSA must “have a written transfer agreement with a hospital or all physicians performing a CSA operation must have omission privileges at a local hospital.” In addition, the Directive should include provisions on emergency care and stabilising treatments in the CFS, within the limits of the possibilities offered by CSA staff until the patient is transferred. Staff should be trained to implement this Directive in the event of a medical emergency, so that regular training sessions and mock exercises can be useful in times of crisis. “As a result, there may be continuity of supply issues,” Blackmond said in a commentary. “Perhaps the revised regulation would reduce the perceived burden on ASD, but it will increase the burden on full-service hospitals and not improve the quality of patient care.” Finally, that emergency directive should provide for a compensation clause allowing each party to claim reimbursement from the other party in order to cover all liabilities, claims, actions, losses, costs, damages or expenses resulting from any of its acts or omissions in the performance of the agreement. (b) Other diagnostic or therapeutic services. Medicare pays for diagnostic or therapeutic services other than SNSF postclinical services when they are provided – a) services provided by a trainee or resident in training. Medicare pays for medical benefits, provided by an intern or resident (as part of a hospital education program approved under section 409.15), as a postclinical SNF, when the intern or intern is in a critical access hospital that has placed a patient at a higher level of care, brings a patient back to hospital status, or does he or she have to return to a swing-bed status? We have a transfer-back agreement, but they always came back to us in a swing bed, and just recently the care hospital wanted to send patients back because they solved the heart problem and they wanted to send them back to the hospital so we could take care of the first admission for cellulite. Is this eligible? Hospital leaders are urging cmS to drop a proposal that would eliminate the need for a written transfer agreement if an outpatient intervention center attempts to transfer a patient to the hospital. . . .