Questions about Micro-Hospitals?
Lyndean Brick, President and CEO, Offers Key Insights
Currently operating in at least 19 states, micro-hospitals deliver care in a highly effective, low cost setting. They focus directly on community needs and operate within a compact clinical and administration framework. These hospitals are licensed as a hospital. If Medicare reimbursement is sought, they are certified as a short term acute care hospital. The regulatory requirements for micro-hospitals are the same as a hospital. There are no short cuts when it comes to compliance.
Although there is no formal definition for a micro-hospital, they generally run from two to 25 beds, depending on state requirements to meet hospital standards. Their footprint is smaller in scale, too, and thus less costly than a 100-200 bed hospital. Size-wise the current trend is 25,000 to 75, 000 square feet, but size varies depending on state specific requirements for establishing hospitals.
Smaller project = shorter development/construction time and lower cost.
Micro-hospitals are a realistic option for health systems seeking to address community needs in metropolitan areas where patients may have limited or over-crowded options for acute or emergency care. The micro-hospital provides easier access for communities in need of options; they expand access for communities seeking more efficient or boutique services.
FREQUENTLY ASKED QUESTIONS:
When did micro-hospitals first emerge?
Where are micro-hospitals found?
What types of affiliations do micro-hospitals typically maintain?
Even though the hospital systems themselves are mostly affiliated with non-profit systems, many look to for-profit partners for developing and operating such facilities.
What are the major rule-setting agencies for micro-hospitals?
To what regulatory and accreditation requirements are micro-hospitals subject?
How, if at all, do these requirements differ from traditional hospital standards? Are there any accreditations/certifications available for micro-hospitals?
What types of practitioners typically practice at micro-hospitals?
What types of services are offered at micro-hospitals?
What’s the medical staff governance model for a micro-hospital? Is there a dedicated team of medical staff leaders at each facility, or are practitioners integrated into system-wide staffs?
How are practitioners vetted and authorized for practice at micro-hospitals?
What unique challenges, considerations, circumstances do medical staffs and credentialing professionals face when vetting and assessing competence for practitioners working in micro-hospitals?
- First, as the medical staff may be small in size due to limited specialty services offered by a micro-hospital, there can be issues with garnering adequate participation for medical staff committees, including those which would undertake the evaluation processes for physicians.
- Second, with a medical staff of limited size, often it is infeasible to maintain a director over all specialty areas unless required by regulation. For those areas required to have a directorship, the financial mandates of a physician representative can be difficult to fill in the small hospital setting. These director levels are often those individuals who are overseeing the FPPE/OPPE process within the hospital itself, which may subsequently make competency assessment and tracking a difficult task.
- Third, as a micro-hospital does not by definition have the volume of a larger hospital, competency assessment may prove challenging where areas of evaluation are small and/or far between.
Thus participation and oversight from system or larger hospital owners or partners may play an important role in providing support and specialty coverage for a small hospital with a focused service line.