Understanding Different Hospital & Facility Categories or Classifications
The word hospital is derived from the Latin word ‘hospes’, which means ‘guest or visitor’ and ‘someone who provides lodging or entertainment for a guest or visitor’ (also known as hospitality). The first hospital to provide treatment for medical conditions in the U.S., Pennsylvania Hospital, was founded in 1751 by Benjamin Franklin and Dr. Thomas Bond. Overtime, hospitals have grown to be places where people seek medical care provided by specialized nurses, physicians, and the entire medical team.
As you are looking for a job you may come across different terms to describe what type of facility you are applying to. The type of hospital you consider for your next job can really influence the type of experience you have while there.
General Medical-Surgical Hospital Classifications
Public Hospital- These types of hospital are fully funded by the government and survive from the money that is collected by taxpayers. Public hospitals often are like a catch-all safety net that provide care to people with otherwise limited access to healthcare. These facilities are nonprofit, accept all types of insurance (or lack of), and usually have a large number of beds to accommodate a large number of patients. Public hospitals can be a great experience for those looking for a high-acuity and challenging environment.
Private Hospital– These hospitals are owned by a person or group of people and can be for-profit or nonprofit. Private hospitals tend to be smaller than public hospitals, but can see high acuity patients within their systems. Private hospitals differ in that they have the option to lawfully turn away or transfer patients to public hospitals if they are not able to provide services or if the patient is uninsured or does not have a particular insurance. These hospitals can be great places for providers who want to be a part of shaping care within the institution, while serving patients in a more upscale environment than a public hospital.
For-Profit Hospital- Hospitals owned by investors or shareholders of a publicly traded company are called for-profit hospitals. They may be small single for-profit community hospitals, or the facility may be part of a larger corporate network that is spread across different regions of the country. Operational decisions at these facilities are frequently made with financial gains and returns in mind, as well as patient safety goals. For-profit hospitals see a variety of patients, depending on the services they offer.
Not-for-Profit Hospital- Hospitals that are driven by community based needs and not shareholder profits are referred to as not-for-profit hospitals. These facilities are treated like charities by the government, as long as they are meeting the requirements to be considered nonprofit. Boston Medical Center (aka BMC) is a great example of a nonprofit facility that drives care with community needs in mind. BMC is a 514 bed, nonprofit academic medical center, and it is New England’s busiest trauma and emergency services medical center. Nurses looking for a fast-paced workplace with a culture of respect and caring can find their perfect job at BMC alongside highly skilled nurses and other professionals.
Faith-Based Healthcare Facility- Some healthcare systems are founded on spiritual beliefs and operate with goals to serve all of God’s people in mind. Most of these facilities have deep roots in Catholicism and shape their care to reflect their core values. Most of these hospitals are not-for-profit and pride themselves on charitable contributions to their communities. SSM (Sisters of St. Mary) health is a perfect example of a faith-based system that prides themselves on providing exceptional service while revealing the presence of God through compassionate care. St. Anthony’s Hospital in Oklahoma City is a comprehensive medical center that serves OKC as a large teaching hospital with focus on cardiology, oncology, surgical services, and behavioral medicine. St. Anthony’s is an amazing place to work for nurses who are looking to be part of an all-inclusive team with extensive community involvement. SSM Health has hundreds of open job listings across their system.
Federal Hospital– There are about 200 facilities in the U.S. that are operated by the federal government. These hospitals provide routine medical and surgical care to specific patient populations, usually active military personnel and their families. They are overseen by the Department of Defense, the Department of Health and Human Services, and the Veterans Health Administration. Most healthcare workers in these facilities are associated with the military but they do occasionally hire civilians.
Long Term Care Facilities- These types of institutions are dedicated to providing longer term care, whether it be for an acute or chronic issue. Nursing homes, long term acute care, and rehab facilities fall into this grouping. Some of these institutions are public, and some are private, but they all serve people who need around the clock care and prolonged services after an acute hospital stay. Nurses love working in these facilities because they have a time to bond with their patients and provide care along a continuum.
What are the Different Types of Hospitals?
Hospitals can belong to one of the above classifications but the services they provide within their organizations can be broken down even further into specific categories. Healthcare systems often have several types of facilities under one of the umbrella terms above.
Acute Care Community Hospital- Also known as simply ‘community hospitals’, these facilities tend to be smaller than large academic institutions or trauma centers. They can be rural or urban, and provide short term care for acute health issues. Almost all hospitals can be termed a ‘community’ hospital, but usually the term refers to institutions with fewer beds (less than 500) and minimal teaching programs for new physicians. Community hospitals are excellent for healthcare professionals that don’t want to work on a large medical campus but still want to provide specialized care to people within their city or town.
Trauma Center- Trauma centers can be broken down into level I, level II, or level III trauma centers, with level I offering the most services and having the highest level of care. There are also level IV and V hospitals with limited trauma services. The American College of Surgeons (ACS) is responsible for evaluating and designating the trauma level of an institution. Level I facilities can provide any and all aspects of care from prevention to rehabilitation. Level I centers must admit at least 1200 trauma patients per year or 240 patients with an Injury Severity Score of more than 15. They must have an active trauma research program and their trauma program must be headed by an ICU physician that is board certified in surgical critical care. Level II centers can initiate definitive care and must have general surgeons on call, but cannot provide as many comprehensive services as a level I. Level III centers can provide resuscitation and life-saving emergency services but usually must transfer their patients to a higher level of care when it is safe to do so. Level I trauma centers, like Boston Medical Center, are often teaching facilities and can be a rewarding experience for healthcare professionals looking to increase their knowledge and expertise
Teaching Hospital- Academic medical centers, also called teaching hospitals, are facilities that provide medical education and training to future healthcare professionals. They are often associated with a medical and/or nursing school and employ physician residents as part of their medical team. Residents are doctors that have graduated medical school and are in their clinical training in a specialized program on their journey to becoming attending physicians. St. Louis University Hospital is a prime example of a level I trauma academic center. They are also a stroke and STEMI center. Hospitals like this are great places for new nurses who want to increase their knowledge base in a fast-paced environment and for experienced nurses that are looking to expand their skills and work their way up the clinical ladder.
Magnet Facility- Magnet hospitals are certified by the American Nurses’ Credentialing Center. These facilities are driven by nurses not only in patient care, but as part of the team that is making decisions about changes and institutional goals. To achieve Magnet status a hospital must display a high level of excellence in five categories: transformational leadership, structural empowerment, exemplary professional practice, new knowledge, innovation and improvements, and empirical outcomes. Five out of the six hospitals in the HonorHealth system in Arizona have achieved Magnet status, including Scottsdale Osborn Medical Center and Scottsdale Shea Medical Center. Nurses that want to find a job in a nurse-driven culture and provide input about changes within their hospital should seek employment at Magnet facilities.
What is a Specialty Hospital?
In addition to all of the aforementioned classifications, hospitals can be defined based on services they provide for specific conditions.
Psychiatric Hospital- These facilities focus on mental and behavioral health and can provide both in and outpatient services. They may be residential or acute care institutions but do not provide acute medical or surgical care. Providers with an interest in mental health enjoy these types of work environments without the distractions of acute medical issues.
Urgent Care- Urgent care sites are emergency centers usually located off the main campus of a major medical center and are scattered throughout a community. They cannot provide extensive services like a central Emergency Department, but can deliver care to patients with lower acuity ‘emergencies’. These centers are not set up to deal with major traumas or immediate life threatening injuries, beyond basic life-saving equipment. They will transfer those patients to the most appropriate medical center if need be. Urgent care sites employ nurses with urgent care and ED experience, and can be a nice break from the stressful environment of a traditional ED.
Chest Pain Center- A few different terms can be used for these types of hospitals. They may advertise themselves as ‘cardiac care’ or ‘STEMI time critical response’ hospitals. This means that the facility has a cath lab with 24/7 capability to provide door to intervention services in less than 90 minutes. Many have cardiovascular surgical teams and highly specialized providers that focus on cardiac care and interventions.
Stroke Center- Stroke centers have been awarded this designation through meeting standards that promote better outcomes in stroke care. They have a dedicated stroke focused program with ways to measure performance and patient outcomes. There are varying levels of becoming a ‘stroke center’ that are based on services provided. A ‘comprehensive stroke center’ is the highest level of stroke certification.
Specialty Hospital- Specialty hospitals provide focused care for a subset of medical or surgical problems. The services offered are limited to no more than two diagnosis related groups and are not comprehensive. A good example of this are the orthopedic surgery specialty hospitals that exist solely for management of ortho related problems. This can also include birthing and psychiatric centers.
Clinics- The word ‘clinic’ is most often used to describe a facility that manages care on an outpatient basis. The clinic can be specialized or general, but the patients are there for short visits to follow up or initiate care with a physician or advanced practice provider. Workflow is different from the care given within an acute care hospital, but can be a nice break for professionals that are looking to step away from the immediate bedside.