Provider Spotlight: Dr. Mandel, ER Maverick & Locum Tenens Physician

Dr. Ken’s Corner: Micro-Hospitals Fill Niche in Healthcare Marketplace

Micro-hospitals, hospitals with fewer than 12 inpatient beds, are popping up nationwide in urban and suburban neighborhoods, extending the reach of larger metro hospitals.  Strategically located, these ultra small facilities are proving to be an efficient, cost-effective way to bridge the gap between the emergency room and the need for hospital care that doesn’t require the infrastructure of a full-service hospital.

Micro-hospitals are fully staffed and equipped to provide emergency care, outpatient surgery, and inpatient services with the exception of major trauma and ICU care.  The availability of inpatient beds allows the micro-hospital to admit patients for overnight or short stays of 2 to 3 days for conditions like pneumonia, dehydration, and infections requiring IV antibiotics.  Patients with more serious or life-threatening conditions are transferred to the hospital system’s larger, more comprehensive facility.

“Most health systems are using them as entry points into markets where demand would not be able to support a full-scale hospital,” according to the Advisory Board.  This allows a hospital system to expand its presence with a relatively small outlay of capital.  Sometimes referred to as neighborhood or community hospitals, micro-hospitals are usually located at some distance from their parent hospitals.  Shorter ED wait times and convenient care close to home are cited as the main benefits for patients.

“The lower patient count and smaller setting make micro-hospitals an attractive option for some doctors too, according to 52-year old James Nichols, medical director of Baylor Emergency Medical Center in Aubrey, Texas” near Dallas (  “After years in traditional large hospital settings seeing tens of thousands of patients a year, Nichols found himself suffering from a serious case of burnout.  He said finding a place at a smaller facility allowed him to slow down and saved his career.”

The majority of micro-hospitals are currently located in Texas, Colorado, Arizona, and Nevada but are being developed at a rapid rate in other states as well.  By partnering with hospital systems, Texas-based Emerus has developed 28 facilities nationwide and is on track to surpass 60 fully operational micro-hospitals by 2019 (Emerus website).

To maintain their accreditation status (as required to receive Medicare payments), it’s critically important that micro-hospitals be able to demonstrate that they are “primarily engaged” in providing services to inpatients.  The Joint Commission recently announced that it would not conduct surveys at these facilities unless they have at least two active inpatients during the survey time period (