Nursing Home Bed Change Information

Prior to requesting a bed change, visit NC DHSR Construction: Construction Project Information (ncdhhs.gov) to determine if a construction project is required.

Licensure Bed Changes

This is a list of documents the Nursing Home Section needs to process a bed change.

  1. A material compliance determination from the Certificate of Need Section.
  2. An approved Construction transmittal.
  3. A memo from you requesting a change. The memo must describe the change desired and state the date the changes are to be effective and include a reference to the cost reporting year of the facility. The desired changes described in the memo must agree completely with the listing of beds shown on form DHSR-4504(PDF, 21 KB).
  4. A completed current DHSR-4504(PDF, 21 KB) (Breakdown of Room Numbers and Beds). Do not overlook the bottom part on the second page. Include adult care home beds under Licensed Only column header.
  5. A completed proposed form DHSR-4504(PDF, 21 KB) Every room must be ready to receive the defined number of occupants. A license will not be issued for inactive, non-operational or to-be-constructed rooms.
  6. A current facility floor plan.
  7. A proposed facility floor plan. Every room must be ready to receive the defined number of occupants.
  8. A bed change application and fee, if applicable.

Certification Bed Changes

In addition to the licensure information above, Medicare rules must be followed.  A facility may change the size of its distinct part twice per cost reporting year. A facility may change the bed size of its skilled nursing facility (SNF) and/or nursing facility (NF) once on the first day of the beginning of its cost reporting year and again on the first day of a single cost reporting quarter that falls within the same cost reporting year. Requests for changes in distinct part must be received by this office at least 45 days in advance of the beginning of either the next cost reporting year or the cost reporting quarter that falls within the same cost reporting year, whichever applies. The change only becomes effective at the beginning of the cost reporting year or the cost reporting quarter. This request should identify the current facility configuration and the proposed configuration.

Should a facility choose to change to 100 percent fully certified (dually certified), it may do so on the first day of a single cost reporting quarter regardless if a change has been done on the first day of the beginning of its cost reporting year. However, in this case, a facility may not make any further changes to the number of certified beds until the first day of the subsequent cost reporting year. Requests for the change to 100 percent fully certified must be received by this office at least 45 days in advance of the beginning of the cost reporting quarter.

A facility may change the designated bed location of the distinct part if there is no change in the number of certified beds and provided a request for this change is received by this office 30 days in advance of the change.

To make changes in bed certification or in the number of beds, the following information is needed:

Guidance for distinct parts must apply. This information can be accessed from the Medicare State Operations Manual online . See Section 3202.

Direct nursing home bed change information and questions to [email protected].