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Report Raps Doctor-Owned Hospitals

NEW YORK -- Most physician-owned specialty hospitals are poorly equipped to handle medical emergencies, federal investigators reported yesterday, underscoring a longstanding safety concern about the rapid rise in the number of such hospitals.

The report found only 55 percent of 109 physician-owned hospitals reviewed had emergency departments - and the majority of those had only one bed - wrote inspector general Daniel Levinson at the Department of Health and Human Services. Fewer than a third had physicians on site at all times, and 34 percent relied on dialing 911 to get emergency medical assistance for patients in trouble, according to the report.

Moreover, 7 percent of physician-owned hospitals failed to meet Medicare requirements that a registered nurse be on duty at all times and that at least one doctor be on call if none are in the hospital, the report found.

The federal Centers for Medicare and Medicaid Services does not require participating hospitals to have emergency departments, but they must keep written policies for handling emergencies. And they cannot rely on 911 services as a substitute for their own emergency care.

About a quarter of the hospitals studied were in Texas, and the rest were in Midwestern and Western states, said Randy Fenninger, the Washington lobbyist for Physician Hospitals of America, a trade group based in Sioux Falls, S.D.

"This report found specialty hospital shortcomings across the board," said Senate Finance Committee Chairman Max Baucus (D-Mont.), who, with Sen. Charles Grassley (R-Iowa), requested the investigation. "It's unbelievable that a facility that calls itself a hospital would, at times, not even have a doctor on call or a nurse on duty."

Molly Sandvig, executive director of Physician Hospitals of America, said the study provides no comparison data on how well other kinds of hospitals provide emergency services.

Doctor-owned hospitals serve patients with heart, orthopedic, surgical or other medical needs, and their patients tend to report shorter, more pleasant stays.

The issue drew national attention early last year when a 44-year-old patient went into respiratory arrest after elective spinal fusion surgery at West Texas Hospital, a small facility in Abilene. The staff called 911. The patient, taken by ambulance to a larger regional hospital, died Jan. 23. West Texas closed at the end of March after losing its Medicare certification.

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