HHS: Specialty hospitals violated Medicare rule

This spring, Senate Finance Committee leaders plan to try again to limit specialty hospitals through Medicare legislation.

By David Glendinning, AMNews staff. Jan. 28, 2008.

Washington -- A new report outlining violations of health and safety standards at some physician-owned specialty hospitals has lawmakers renewing efforts to ban the facilities.

The Dept. of Health and Human Services Office of Inspector General investigated 109 of the country's orthopedic, cardiac and surgical hospitals and found that more than one-third of them may be in violation of Medicare's conditions of participation.

Eight of the facilities, surveyed on randomly selected days, did not have a registered nurse present or failed to have a physician on duty or on call at all times -- a clear violation of Medicare's rules. In addition, 37 of the facilities had written emergency response procedures that involved calling 911 to stabilize a patient experiencing an emergency. The Centers for Medicare & Medicaid Services says that hospitals are in violation of their conditions of participation if they rely on 911 for initial treatment instead of on their own emergency capabilities.

The OIG concluded that the administration should work to require all hospitals -- not just specialty facilities -- to meet Medicare's hospital staffing rules, to have the capability for evaluation and initial treatment of emergency patients, and to include necessary information in their written policies regarding how to manage medical emergencies. CMS concurred with the findings.

For some lawmakers who have opposed specialty hospitals, the report is more evidence that legislation is required to address the problems.