State Approves Regulations for Free-Standing Emergency Departments

10528958-smallA state committee unanimously adopted rules for free-standing emergency departments.

The rules will help ensure quality patient care and regulate excessive proliferation of these standalone ER’s, which are physically separated, often by many miles, from the parent hospital building, state officials say.

Free-standing emergency departments, or FED’s, don’t exist yet in Alabama although three — all in the Birmingham area — have been approved by regulators for construction.

Approved in Alabama by the Certificate of Need review board are:

– Brookwood Medical Center, issued on Sept. 7, 2010, at U.S. 280 and Alabama 119.

– Baptist Health System, issued on Nov. 8, 2012, near Interstate 459 and Alabama 150.

– UAB Medical West, issued on Nov. 8, 2012, in the Interstate 459 corridor in western Hoover.

Stephen D. Preston, Brookwood’s vice president of external affairs, said Brookwood’s proposed 19,000 square-foot facility could be completed in about a year if and when it clears litigation.

Trinity Medical Center has sued to stop Brookwood’s plan and that case is now in the Alabama Court of Civil Appeals.

“We still have to get through the court system,” said Preston, who this morning attended the vote of the State Committee of Public Health. “The FED rules are a good thing to protect the public regarding the level of care they will receive.”

Trinity issued an emailed statement Tuesday stating: “Trinity believes that the costs to the consumers, the impact on existing hospitals, and the costs to Medicaid and other payors should be taken into account before any freestanding emergency department is approved.”

Also in a statement, UAB said it “was interested in completing [its] project.”

Baptist Health System didn’t respond to requests for comment.

UAB and Baptist have opposed each other’s plans.

In at least one aspect, the rules are more stringent than rules regulating traditional emergency departments. Among the new rules are requirements that the medical director be board certified in emergency medicine. Nurses also must have a special certification for emergency health care work.

Other rules includes requirements for a helipad and that the free-standing emergency departments be thoroughly integrated into an existing hospital licensed in the state of Alabama.

“We aren’t going to just allow some company from New York coming in here and throwing up a bunch of free-standing emergency rooms,” said Dr. Tom Geary, director of the Bureau of Health Provider Standards at the Alabama Department of Public Health.

Geary said the next step is that the rules will be filed with a committee of the state Legislature. After that happens, the rules will go into effect about a month later. Geary predicted the rules will be in force by the end of August.

Hospitals with approved CON’s for FED’s must submit construction plans to theAlabama Department of Public Health for a rigorous review, Geary said.

Despite the new rules, health officials still believe that there needs to be some requirement for how close together the FED’s can be. The department of health doesn’t have the jurisdiction to regulate that, and Dr. Don Williamson, chief health officer at ADPH, said he would like to see language added to the state health plan that would allow that kind of regulation.


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