Surgical Hospitals Stripped of Hospital Status
Medicare targeting facilities that don't keep enough patients overnight.
W
hen is a
surgical
hospital
not a hospital? When
it doesn't keep enough
patients overnight,
according to CMS,
which terminated a
surgical hospital's
Medicare designation
as a hospital because
it failed to meet
Medicare standards
for hospital enrollment. In other words, the hospital treated too few
inpatients relative to its number of outpatients to qualify as a hospital.
While Medicare's Conditions of Participation have always required
that a hospital be "primarily engaged" in treating inpatients, it never
specified what a hospital had to do to meet this requirement. But now
we have a better sense of Medicare's daily census (at least 2 inpa-
tients) and length-of-stay (at least 2 midnights) requirements.
Inpatient-to-outpatient ratio
State health officials conducted an unannounced survey of Blue Valley
Hospital (BVH) in Overland Park, Kan., last November and found
BVH, which specializes in weight-loss surgery, did not have any inpa-
tients at the time. A subsequent state report cited hospital-provided
data showing about 309 outpatient surgeries over a yearlong period,
compared with 146 inpatient surgeries. CMS determined that Blue
2 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U N E 2 0 1 8
Legal Update
Lorin Patterson and Robert M. Holland
• INPATIENT CARE Surgical hospitals that don't treat enough inpatients could lose
their CMS hospital designation.