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CMS's Proposed Hospital Staffing Revisions Get Cool Reception

Margaret Dick Tocknell, for HealthLeaders Media, January 3, 2012

Here's a sampling of the comments posted on regulations.org:

A 13-page letter signed by more than 80 physicians groups, including the AMA, the American Academy of Family Physicians and the American College of Surgeons, takes issue with proposed changes to the existing governance and medical staff regulations. The letter notes that CMS is not statutorily authorized to reduce the regulatory burden for hospitals or to address healthcare workforce shortages. "The statute limits CMS' authority to promulgate the CoPs in furtherance of the health and safety of hospital patients." The letter adds that the proposed changes "would be detrimental to the health and safety of patients in the hospital setting."

To allow one governing body to oversee multiple hospitals in a single healthcare system would "disenfranchise the patients of any hospital…that is unique among its member hospitals for any reason, including geographic location, services rendered and patient demographic," says the letter.

Stephen P. Blatt MD, president-elect of the Good Samaritan Hospital medical staff in Cincinnati, agrees saying, "allowing a single governing body to oversee all hospitals within a multi-hospital system would further remove the governing body from the daily operations, governance and medical staff affairs of each individual hospital. Governing bodies are essential for maintaining quality of care within hospitals and health systems and having them further removed from these issues will only worsen safety and quality of care."

No surprise that the American Hospital Association supports the governing change. "This change recognizes the more integrated organizational model adopted by many hospitals." The AHA asked CMS to clarify that hospitals with more than one CMS certification number may have a single governing body.

In its letter the AMA group also opposes allowing hospitals to grant privileges to physicians who are not on the medical staff of the hospital. The move would "allow a hospital to …exclude some physicians from the medical staff. This proposal would undermine the medical staff's chief function: self governance."

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2 comments on "CMS's Proposed Hospital Staffing Revisions Get Cool Reception"


S Bork (1/9/2012 at 7:23 PM)
Amazing in one article it's all about value based purchasing and quality initiatives, then the next article with the real bottom line[INVALID]it's all about expecting better outcomes, but doing with less. Wanting higher quality but then maybe we can pull this off with untrained staff, or u-do-it medicine... Do you really think that eliminating an infection control log already in place is really in the patient's best interest? Or do you think maybe the hospitals "own tracking system" might just turn up different outcomes? Allowing hospitals to develop a "stand alone" nursing care plan is nice that way everyone can have the very same one. Saves money for sure as we won't really have to individualize the care. Why appoint medical staff to the the hospital when we can just throw open the doors and just let everybody operate when they get here? Same with credentialing[INVALID]toss it. You have a license right? Finally I must admit this one tops it all. One million lives lost, the previous focus on medication errors, thousands of articles, regulations, and rules and now just let the patients manage their own medications. I can just wait as they manage the pain medications. Do patients on the vent have to have a family member adjust the settings? Wow, what an amazing bunch of "proposals".

Jenise McGovern-Lowe (1/6/2012 at 10:35 AM)
I am an RN and a risk manager of an acute care hospital. I am opposed to allowing the patient or support person to administer medications. It would be a dangerous practice. A patients stay in the hospital is based off of an illness or event that requires medical intervention. A treatment plan for his illness is individually developed and based off of current illness/injury and concurrent medical history. Alot of information is collected and reported between medical disciplines licensed to make assessmnets. The assessmnet includes the pts. current condition and his reponse to the treatment provided. This requires a controlled environment that includes all of the consistent routines and any variables. Medication administration has to be a consistent routine and the patients response has a large role in the resolution of the illness, the discharge plan and hospital length of stay. There is a safety risk to the patient and the nurse if she/he were asked to make these medical assessments based off of only half of what she/he is sure of.