CMS SOM App. A, Tag A-1077

Outpatient services must be appropriately organized and integrated with inpatient

services.

Interpretive Guidelines §482.54(a)

The organization of the hospital’s outpatient services must be appropriate to the scope

and complexity of services offered.

The hospital’s outpatient services, at all locations, must be integrated with inpatient

services (e.g., medical records, radiology, laboratory, surgical services, anesthesia

(including pain management) services, other diagnostic services, etc), as appropriate to

the outpatient services offered. The hospital must have written policies in place to assure

the integration of outpatient services, including an established method of communication

between outpatient service departments to corresponding inpatient services.

The hospital must coordinate the care, treatment and services provided to a patient. In

order to provide continuity of care, it should have an established method of

communication between inpatient services and outpatient care in order to provide

continuity of care to its patients.

Survey Procedures §482.53(a)

• Verify that the outpatient services are organized in a manner appropriate to the

scope and complexity of services offered.

• Verify that the hospital has an established method of communication and

established procedures to assure integration with inpatient services to provide

continuity of care.

• Review medical records of outpatients who were later admitted to the hospital in

order to determine that pertinent information from the outpatient record has been

included in the inpatient record.

• Determine that each outpatient service location is integrated with the appropriate

hospital inpatient services in accordance with the needs of the patient care

provided at each of those locations.