HospitalInspections.org

Based on review of documents and staff interviews it was determined the hospital failed to ensure all applicable Federal, State and Local Laws were followed where they pertain to the definition of a hospital, as to the lack of inpatient admissions.

Findings include:

1. Title 64, Legislative Rule, West Virginia Division of Health, Series 12, Hospital Licensure, 64-12-2. Definitions, 2.14. Hospitalization is defined in part: "The in-house accommodation and care of any person for a continuous period of time, generally longer than twenty four (24) hours, for the purpose of providing medical, surgical, nursing and other professional health care services."

2. Social Security Act 1861, Part E-Miscellaneous Provisions, Definitions of Services, Institutions, Etc., Sec.1861. [42 U.S.C. 1395x], Inpatient Hospital Services, states in part: " (b) The term 'inpatient hospital services' means the following items and services furnished to an inpatient of a hospital..." Hospital (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..." Utilization Review states in part: "for the review, on a sample or other basis, of admissions to the institution, the duration of stays therein, and the professional services (including drugs and biological's) furnished, (A) with respect to the medical necessity of the services, and (B) for the purpose of promoting the most efficient use of available health facilities and services."

3. The term "observation" is defined as to determine if the patient needs to be admitted to the hospital as an inpatient.

4. The term "inpatient" refers to a patient admitted to the hospital for longer than twenty four (24) hours to receive medical care and other professional health care services.

5. During an interview with the Chief Executive Officer and the Director of Nursing on 12/17/13 at 1030, the Utilization Plan was reviewed and between 1/1/12 through 10/31/13 the hospital has had one (1) inpatient admission and one hundred nine (109) observations patients. The shortest observation stay was two and one half (2.5) hours and the longest being seventy four (74) hours. The average length of stay for the remainder of the observation patients was approximately eight (8)-twelve (12) hours.