Physician-Owned Speciality Hospitals' Ability to Manage Medical Emergencies

摘要

Physician-owned specialty hospitals are hospitals that primarily perform cardiac, orthopedic, or surgical procedures and are partially or fully owned by physician investors. Two recent deaths of specialty hospital patients have raised concerns about the ability of these hospitals to manage medical emergencies. In both instances, a patient experienced complications following elective surgery. Neither hospital had a physician on duty at the time the emergency occurred, and both hospitals called 9-1-1. The patients were then transferred to community hospitals, where they were both pronounced dead. All hospitals that participate in the Medicare program must demonstrate to the Centers for Medicare & Medicaid Services (CMS) their initial and ongoing ability to meet a set of health and safety standards, referred to as the Conditions of Participation (CoP). The CoPs require that all hospitals have a physician on duty or on call at all times. Hospitals are also required to provide 24-hour nursing services, furnished or supervised by a registered nurse. In addition, the CoPs require that hospitals have written policies and procedures in place for addressing individuals emergency care needs, regardless of whether the hospital has an emergency department. Finally, according to CMS, a hospital is not in compliance with the CoPs if it relies on 9-1-1 services as a substitute for its own emergency services. However, there is no specific Medicare prohibition on a hospital calling 9-1-1 to arrange for the transfer of a patient to another hospital.