Physician-Owned Specialty Hospitals Poorly Equipped To Handle Medical Emergencies, According To HHS OIG Report

Main Category: Public Health
Also Included In: Primary Care / General Practice
Article Date: 11 Jan 2008 - 11:00 PDT

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Physician-owned specialty hospitals are poorly equipped to handle emergency care, according to an HHS Office of Inspector General report released on Thursday, the Washington Post reports. HHS Inspector General Daniel Levinson in the report wrote that of 109 physician-owned hospitals reviewed, 55% had emergency departments and the majority of those hospitals had only one ED bed. The report also found that 7% of physician-owned hospitals do not meet Medicare requirements that a registered nurse be present at all times and that a physician be on call if none are on site.

In addition, the report found:

• 22% of the hospitals did not address in written policies how emergency situations should be evaluated and handled, which is required by CMS;
  
  
• 34% of the hospitals rely on dialing 911 to obtain emergency care for patients; and
  
  
• Fewer than one-third of hospitals had a physician on site at all times.
  

The report recommended that CMS identify and track all physician-owned hospitals to ensure they can handle emergency situations and meet requirements. Acting CMS Administrator Kerry Weems in a letter to Levinson agreed with the report's findings and said most of the recommendations are being pursued by the agency.

Molly Sandvig, executive director of Physician Hospitals of America, said that the report is flawed because it provides no comparison between emergency care at physician-owned hospitals and other kinds of hospitals. She said that CMS should take action against any hospital that does not meet the agency's requirements.

Possible Legislative Action
A Senate Finance Committee spokesperson said that this year the committee plans to pursue new patient safety rules and more regulation of physician-owned hospitals in Medicare legislation. Congress in December 2007 considered legislation that would have mandated more regulation of physician-owned hospitals, but the measure did not pass.

Committee Chair Max Baucus (D-Mont.) -- who requested the report along with committee ranking member Chuck Grassley (R-Iowa) -- said, "This report found specialty hospital shortcomings across the board," adding, "It's unbelievable that a facility that calls itself a hospital would, at times, not even have a doctor on call or a nurse on duty. It is unacceptable that these facilities are not designed or equipped to handle emergencies."

Grassley in a statement said that the report "documents the significant and potentially life-threatening shortcomings of physician-owned specialty hospitals when it comes to emergency services," adding, "Congress needs to take action to stem the trend before the situation is irreversible" (Lee, Washington Post, 1/10).

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