CMS pulls Medicare coverage from Ohio hospital amid state scrutiny

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Insight Hospital and Medical Center Trumbull is facing two significant setbacks amid its push to reopen with its sister facility, Hillside Rehabilitation Hospital, both in Warren, Ohio. The two hospitals are owned by Flint, Mich.-based Insight Health System.

On Sept. 24, CMS released a Medicare notice that it will terminate its Medicare program agreement with Insight Hospital and Medical Center Trumbull on Oct. 10.

The notice pointed to several Medicare Conditions of Participation compliance issues, including: basis and scope, governing body, patient’s rights and discharge planning. CMS also found that the hospital failed to meet two of its Emergency Medical Treatment and Labor Act requirements.

“We are communicating with CMS and we’re assessing the pathways they require to allow reopening,” an Insight spokesperson said in a Sept. 25 statement shared with Becker’s

For patients admitted before the termination, Medicare may continue payment for up to 30 days of covered services delivered on or after Oct. 10, the notice said.

Insight Hospital and Medical Center Trumbull is also facing scrutiny from the Ohio Department of Health, which found “several significant issues” during a Sept. 23 inspection that “need to be addressed before the hospital can reopen,” according to a Sept. 25 health department statement shared with Becker’s

“We are happy that everything is getting up and running and now we will be obtaining third party verification for some of the regulatory matters,” an Insight spokesperson said in a separate statement shared with Becker’s. “We’re thankful for the partnership with elected officials and government agencies who have assisted with overcoming obstacles and helping us move forward rapidly. We are exercising an abundance of caution, as our team and patient safety is our priority. We anticipate opening as soon as that is completed.”

Insight Health System purchased Insight Hospital and Medical Center Trumbull and Hillside Rehabilitation Hospital in November 2024 from Dallas-based Steward Health Care, which sought Chapter 11 protection in May 2024. Insight Hospital then halted nonemergent patient admissions in early March prior to both hospitals abruptly pausing operations in late March due to financial and ongoing bankruptcy issues stemming from Steward’s ownership. 

In late August, Insight CEO Jawad Shah, MD, told Becker’s the health system was “elated” to start the reopening process and begin “working with the chains off.”

“We’ve been very open with the public and with the government to tell them that this is where we are, and then getting a lot of support. It’s not that we are a massive healthcare system,” he said. “We are a medium to small size system, and we can only tolerate so much in terms of inefficiencies. We’ve made that clear, and we’ve seen that we’ve gotten a lot of support, where people are really jumping in and helping. We’re particularly indebted to different layers of the government that helped us expedite certain things, in terms of regulatory issues and licensing. That’s all helped us get to where we want to at the end.”

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