HospitalInspections.org

Based on observations, review of facility policies and procedures, and facility documents, and interviews with staff (EMP), it was determined the facility failed to function as a hospital as defined by the Social Security Act, in that they were not primarily engaged in providing services to inpatients. The facility census was zero during two onsite visits on March 5, 2018, and June 18, 2018.

Findings include:

Review of the "Social Security Act", section 1861(e)(1), revealed "(e) The term "hospital" means an institution which-(1) is primarily engaged in providing, by or under the supervision of physicians, to inpatients (A) diagnostic services and therapeutic services for medical diagnosis, treatment, and care of injured, disabled, or sick persons, or (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons."

Review of facility document "BARIX CLINICS OF PENNSYLVANIA OPERATING PLAN FOR PATIENT CARE 2018", revealed " FACILITY DESCRIPTION AND DEMOGRAPHICS: Barix Clinics of Pennsylvania is a 23 bed medical surgical hospital that provides a comprehensive bariatric program, pain management program, and other specialized surgical services. These programs includes medical screening, counseling, nutritional guidance, education, surgical services, post-surgical care, and support groups ... SCOPE OF SERVICE Barix Clinics of Pennsylvania serves an adult medical surgical population, principally the morbidly obese patient undergoing bariatric surgery, endoscopy, pre-admission, post-operative and medical care. Additional services are offered for the designated patient population including but not limited to reconstructive procedures following weight loss, pain management, cholecystectomies, hernia repairs, and medical/surgical care. Services are provided 24 hours per day, 7 days per week. The following departments participate in patient care within the organization – Nursing, Surgical Services, Respiratory Therapy, Radiology / Ultrasound, Laboratory, Infection Control, Nutrition Services, Social Work / Discharge Planner, and Medical Staff."

Observational tour on March 5, 2018, at 9:27 AM of the hospital's only nursing unit, revealed there were no inpatients admitted. The census was zero.

Interview with EMP1, on March 5, 2018, at 8:45 AM, confirmed there were no inpatients admitted to the hospital.

Interview with EMP2, on March 5, 2018, at 8:53 AM, confirmed there were no inpatients admitted to the hospital.

A second survey attempt was conducted on June 18, 2018.

Observational tour on June 18, 2018, at 11:44 AM, of the hospital's only nursing unit, revealed there were no inpatients admitted. The census was zero.

Review on June 18, 2018, of the facility's Average Daily Census, as provided by EMP2, revealed: March 2017 - 1.3, April 2017 - 1.2, May 2017 - 1.1, June 2017 - 1.5, July 2017 - 0.9, August 2017 - 1.5, September 2017 - 1.5, October 2017 - 1.0, November 2017 - 1.6, December 2017 - 1.8, January 2018 - 2.4, February 2018 - 3.1, March 2018 - 2.5, April 2018 - 1.9, and May 2018 - 3.3.

Review on June 18, 2018, of the facility's Average Length of Stay, as provided by EMP2, revealed: March 2017 - 1.8, April 2017 - 1.9, May 2017 - 1.8, June 2017 - 1.6, July 2017 - 1.5, August 2017 - 1.8, September 2017 - 1.6, October 2017 - 1.4, November 2017 - 1.6, December 2017 - 1.7, January 2018 - 2.1, February 2018 - 2.2, March 2018 - 2.0, April 2018 - 2.0, and May 2018 - 1.9.

Review on June 18, 2018, of the "OR Weekly Schedule", no date, as provided by EMP2, revealed surgery was performed on Monday, Tuesday, Wednesday and Thursdays. Further review of this documented revealed "Pharmacist is here Monday through Friday, 6 am to 5 pm. On call starts at 4 pm until 6 am weekdays and we have on call weekend coverage as well."

Review on June 18, 2018, of an untitled document, provided by EMP2, no date, revealed the facility had 19 inpatients for the month of May 2017 and performed 78 outpatient surgeries, 24 inpatients for the month of June 2017 and performed 81 outpatient surgeries, 19 inpatients for the month of July 2017 and performed 58 outpatient surgeries, 26 inpatients for the month of August 2017 and performed 62 outpatient surgeries, 27 inpatients for the month of September 2017 and performed 71 outpatient surgeries, 21 inpatients for the month of October 2017 and performed 81 outpatient surgeries, 27 inpatients for the month of November 2017 and performed 61 outpatient surgeries, 32 inpatients for the month of December 2017 and performed 55 outpatient surgeries, 35 inpatients for the month of January 2018 and performed 58 outpatient surgeries, 33 inpatients for the month of February 2018 and performed 73 outpatient surgeries, 32 inpatients for the month of March 2018 and performed 65 outpatient surgeries, 41 inpatients for the month of April 2018 and performed 62 outpatient surgeries, and 50 inpatients for the month of May 2018 and performed 72 outpatient surgeries. In the last 12 months there were 386 inpatients and 877 outpatient surgeries performed.

Review on June 18, 2018, of the Nursing Schedules, from May 1, 2017, through May 27, 2018, revealed the form marked the census for each calendar day. Further review revealed there were 146 days in which the facility's census was zero. Further review revealed there were 17 days in which the facility's census was one during this same time period. There were also at least 23 days in which the census was not documented.

Interview with EMP2, on June 18, 2018, between 9:00 AM and 11:55 AM, confirmed there were zero inpatients admitted. EMP2 further confirmed there are more outpatient surgeries than inpatients. EMP2 further confirmed there were no surgeries planned for June 18, 2018. EMP2 further confirmed there are no surgeries planned for Fridays, Saturdays, or Sundays. EMP2 further confirmed the census data, as listed above in the Nursing Schedules paragraph. EMP2 further confirmed there are usually zero inpatients on Saturdays and Sundays.