Specialty Hospitals Poorly Equipped To Handle Medical Emergencies

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Physician-owned specialtyhospitals 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 GeneralDaniel Levinson in the report wrote that of 109 physician-owned hospitalsreviewed, 55% had emergency departments and the majority of those hospitals hadonly one ED bed. The report also found that 7% of physician-owned hospitals donot meet Medicare requirements that a registered nurse be present at all timesand 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 reportrecommended that CMS identify and track all physician-owned hospitals to ensurethey can handle emergency situations and meet requirements. Acting CMSAdministrator Kerry Weems in a letter to Levinson agreed with the report'sfindings 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 flawedbecause it provides no comparison between emergency care at physician-ownedhospitals and other kinds of hospitals. She said that CMS should take actionagainst any hospital that does not meet the agency's requirements.

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Possible LegislativeAction

A Senate Finance Committee spokesperson said that this year the committee plans to pursue newpatient safety rules and more regulation of physician-owned hospitals inMedicare legislation. Congress in December 2007 considered legislation thatwould have mandated more regulation of physician-owned hospitals, but themeasure did not pass.

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

Grassley in a statement said that the report "documents the significantand potentially life-threatening shortcomings of physician-owned specialtyhospitals when it comes to emergency services," adding, "Congressneeds to take action to stem the trend before the situation isirreversible" (Lee, Washington Post,1/10).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation.

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