Key Takeaways: CMS’s Final Guidance on Hospital Co-Location

On November 12, 2021, the Centers for Medicare & Medicaid Services (CMS) issued final co-location guidance for hospitals and other health care facilities.[1] The guidance was immediately effective and provided clarity with respect to how such health care facilities can work collaboratively to provide care at a single location. The initial co-location guidance was issued on May 3, 2019. A link to the final guidance is located here.

Key takeaways from the final guidance include:

  • Medicare conditions of participation permit hospitals to co-locate with other hospitals and other health care providers and share certain common space within the same building or campus.
  • Co-location occurs when two Medicare-certified hospitals or a Medicare-certified hospital and another health care provider are located in the same building or campus and share space, staff and/or services.
  • All co-located hospitals must be able to demonstrate independent compliance with applicable Medicare hospital conditions of participation.
  • Hospitals choosing to co-locate must carefully consider attendant compliance risks pertaining to utilizing shared space and/or service arrangements.
  • The State Operations Manual (Appendix A) will soon be amended to include specific co-location requirements relative to the hospital survey process.
  • Attached to the final guidance is a survey module which is intended to assist surveyors of co-located hospitals with issues pertaining to space, contracted services, staffing, emergency services, and identification of deficiencies.

Please stay tuned for future blog posts in which we will provide some additional details and discussion regarding the final co-location guidance.

[1] The hospital co-location guidance does not apply to critical access hospitals or private physician practices in leased or shared space agreements in hospitals.