COVID-19 Update: Eminent Domain and the Inpatient Slingshot

Why do we need Eminent Domain to take over hospitals? We knew pandemic would strike eventually, so why are we scrambling for hospital space and resources?

For years, healthcare experts across the country have noted how community hospitals are “overbedded,” and the need for 300-bed facilities in every town across the country is much less dire than it was 100 years ago.

Our future is looking more like 100 years ago with every day that passes, including the creative use and invocation of rare, wartime laws like Eminent Domain. Eminent Domain has a specific tie to medical real estate in that it allows the government to seize private property, including hospitals, for the sake of public use.

Historically, the amount of confiscated land held by the federal government reached its peak during World War II, when the US converted viable property throughout the country into airstrips and manufacturing hubs.

In these unprecedented times, COVID-19 has caused us to question everything we previously assumed. Most of us hadn’t experienced a pandemic and felt confident it was no match for modern, western medicine — just a rare phenomenon documented by black and white pictures of rows of patients and horse-drawn ambulance buggies. But, with a peak in COVID-19 cases on the horizon for April, healthcare is still bracing for continued resource shortages and a lack of available hospital beds — the pandemic everyone, yet no one, saw coming.

Eminent Domain has most recently been raised as a potential option in Philadelphia, after the owner of the defunct Hahnemann University Hospital failed to negotiate turning the facility into a COVID-hospital. Last year, a few months after Hahnemann University Hospital shut down, HealCo Founder and CEO, Kirat Kharode, moderated a panel in Philadelphia about the impact of the closure. “Most of the panelists, including local hospital executives, felt very confident that the other area hospitals had effectively relieved the emergency volume load from Hahnemann, and there was no interruption in services for patients,” noted Kharode.

Still, invocation of Eminent Domain is sparingly used and must face careful consideration before being applied by local governments to resurrect hospitals from the dead that can otherwise only survive in pandemics.

As of late 2019, when the turmoil of COVID-19’s global impact was still too distant for most to process, providers were being incentivized to keep patients out of the hospital more than ever before. The pendulum has since made a slingshot return to an inpatient care focus in response to coronavirus, and outpatient care has come to a screeching halt.

As the Surgeon General recommends all elective and non-emergent procedures should be indefinitely postponed, primary care doctors consult with patients through telemedicine, and wellness providers pivot from their preventative measures completely — the healthcare industry is forced to face a return to the inpatient movement it fought so hard to revolutionize.

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