1.39 and 1.8, respectively) to demonstrate its ability to comply with
the CMS requirements going forward.
Despite its detailed plan of correction, CMS determined that the
plan was "aspirational only" and terminated the facility's agreement
on April 11, 2018. The next day, Blue Valley sued the Department of
Health and Human Services and CMS in the United States District
Court for the District of Kansas. The lawsuit is ongoing.
Guidance for providers
In light of the Blue Valley enforcement action, surgical hospitals should
review their operations to determine whether they are likely to meet
the updated CMS criteria when undergoing a survey. Doing so will pro-
vide facilities with the insight and time to correct any issues before
CMS surveyors arrive. How can surgical hospitals demonstrate their
commitment to meeting the CMS requirements?
• Evenly distribute inpatient cases so that a minimum of 2 inpatients
are in the facility at all times because meeting this initial threshold
may "head off" additional scrutiny at the outset of a surprise survey
by regulators.
• Actively recruit physician specialists from additional specialties
(such as spinal surgery) that require inpatient admissions.
• Consider increasing the number of licensed inpatient beds. For
those surgical hospitals that are physician owned it may be necessary
to relinquish operating rooms and procedure rooms as inpatient beds
are added because of Obamacare's restrictions on expansion by physi-
cian-owned hospitals.
• Adjust the facility's schedules to provide for weekend use by inpa-
tients and ensure that the facility's staffing patterns include consistent
coverage over the weekends, demonstrating the expectation of, and
ability to provide, night and weekend care.
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