Is It a Hospital or Not? CMS Issues Guidance on How to Determine

September 20, 2017 | Strategic Insights for Health System


​The Centers for Medicare and Medicaid Services (CMS) on September 6, 2017, issued guidance to better clarify how it will determine whether a facility is considered a hospital under §1861(e) of the Social Security Act. The guidance says that an entity “must be primarily engaged in providing care, by or under the supervision of physicians, to inpatients," either “diagnostic services and therapeutic services for medical diagnosis, treatment, and care of injured, disabled, or sick persons" or “rehabilitation services for the rehabilitation of injured, disabled, or sick persons.

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