New survey guidance could affect microhospitals

Recent CMS revisions to the State Operations Manual for Hospitals are zeroing in on the agency’s definition of a “hospital.” According to one expert, this new survey guidance may be an attempt to define the parameters of a microhospital [...]

What is a microhospital?

Typically, microhospitals have fewer than 30 beds and offer a slim portfolio of lower-acuity services tailored to a specific community need. Common focuses include emergency services, psychiatry, women and children, and orthopedics.

“Microhospitals are so flexible, they really can be developed for a whole host of situations. Whether it is to provide needed psychiatric and mental health care to an underserved area, whether it is to provide a women’s and children’s hospital, it could be an orthopedic hospital, it can be in a rural setting,” says Lyndean Lenhoff Brick, JD, president and CEO of The AdvisGroup (formerly Murer Consultants), a healthcare management consulting firm in Mokena, Illinois. “Because you don’t have the massive overhead that our hospitals have historically had, this is a very important sea change. We are going to continue to see microhospitals. The hospital of the future is going to be a microhospital." [...]

Clarity needed

However, there is confusion about the guidelines. According to Brick, microhospitals and state survey agencies are struggling to understand how to interpret the survey guidance. The AdvisGroup is working closely with its microhospital clients, state survey agencies, and CMS to ensure microhospitals meet the definition of a hospital and are an appropriately recognized venue of care and are paid as such.

The revised survey guidance focuses on whether a hospital is “primarily engaged in providing inpatient services.” [...]

What microhospitals should do

Brick says the most important thing for microhospitals to do right now is to demonstrate that they are primarily engaged in hospital care. This includes:

• Being open 24 hours a day
• Providing care on weekends
• Having staffing levels that are consistent with inpatient care needs
• Scheduling surgeries on weekends as well as weekdays
• Scheduling inpatient and outpatient surgeries
• Having a management and governance structure that is consistent with inpatient and hospital care

“In short, my message is: They have to have heads in beds 24/7. They have to run it like a hospital; they have to be a hospital,” says Brick.

Source: Credentialing Resource Center