Free-standing ER or Urgent Care Center?

Analysis of Opportunities in Establishing Either a Free-Standing Emergency Room or an Urgent Care Center

One of the newest trends in facility development is the Off-Site Emergency Room. The development of Off-Site Emergency Rooms has been regulated by some states to require an operating room. Other states allow these facilities to function as an Outpatient Department that triages patients. The question for many health systems becomes whether the new facility should be an Emergency Room or an Urgent Care Center. A number of factors must be examined to answer the question properly. These include:

  • Does the State prescribe conditions for compliance for free-standing emergency departments?
  • What are the reimbursement differences between the different models of emergency care delivery?
  • Can the department be provider-based under the regulations?
  • What are the patient and community needs in the areas to be serviced?
  • What is the host strategy to incorporate physicians into the model?

Murer Consultants is a national leader in the development of free-standing emergency rooms for a wide range of clients. Our services include regulatory, financial and community-need analysis.

Murer Consultants offers regulatory and financial analysis, as well as development of urgent care centers or free-standing Emergency Departments. Murer Consultants can provide the following:

  • Regulatory/Financial Analysis
    • Operational requirements under licensure regulations;
    • Operational requirements under Medicare regulations;
    • Operational requirements under Medicare for Type A and Type B facilities;
    • Reimbursement differentials between Type A and Type B facilities;
    • Provider-based requirements as applied to urgent care and emergency facilities;
    • Licensure and certification requirements relative to pharmacy, controlled substances registration and DEA registration;
    • Licensure and certification requirements relative to radiological imaging; gross revenue;
    • Licensure and certification requirements applicable to available services and staffing.
    • Identify national and local trends in urgent care and freestanding emergency facility utilization and reimbursement.
  • CON Consultation
    • Need assessment
    • Preparation of CON Application and Supporting Materials
    • Expert Testimony
    • Strategy Development
  • Need Analysis / Pro Forma Projections
    • Identification of Community Need and Support
  • Urgent Care/Emergency Facility Development
    • Provide a detailed master development plan with time frames to serve as a blueprint within the first thirty (30) days after initiation of a development project. This comprehensive master plan shall address:
      • Federal and State regulatory compliance;
      • Organizational structure;
      • Finance/reimbursement;
      • Facility space utilization; and
      • Operating budget and staffing requirements.
    • Conduct a Strategic Planning Session with key individuals to confirm the scope of the project and to agree upon key points, procedures and decision making process.
    • Serve as the liaison with CMS and State regulators and the fiscal intermediary throughout the development project to assure compliance with regulatory requirements.
    • Prepare each new facility for licensure and Medicare certification. Such process shall include:
      • Preparation of State Licensing Packet;
      • Preparation of Medicare Certification Packet;
      • Filing of CMS Disclosure Form CMS-855A, Medical Federal Health Care Provider/Supplier Enrollment Application;
      • Filing of all additional required CMS forms including 1513, 1514, 1561, and 2572;
      • Assistance with Section 504 Civil Rights Policies;
      • Completion of Civil Rights Packet;
      • Completion of State Pharmacy Application, where applicable;
      • Completion of State Narcotics Registration, where applicable;
      • Completion of DEA registration; and
      • Completion of CLIA Application.
    • Preparation of the hospital for compliance with CMS standards including development of a plan for satisfaction of all requirements relative to Medicare Conditions of Participation, as applicable.
    • Advisement of staff and assistance with organization of materials to be presented to the surveyors at time of licensure and certification, as applicable, as well as serving as the liaison with State and Federal regulators, including DEA and CLIA offices, to assure completeness of licensure application and certification processes.
    • Advisement as to impact of new regulations for urgent care, emergency and provider-based facilities.
    • Preparation of Vendor Agreements for purchase of services from other hospitals or health care providers, as applicable.
    • Phone consultations throughout the tenure of this agreement.

For more information contact: Murer Consultants, Inc. (708)478-7030