CMS's Proposed Hospital Staffing Revisions Get Cool Reception
A rule proposed by the Centers for Medicare & Medicaid Services to allow changes in the governance structure and medical staffing at hospitals has little support among the more than 100 public comments submitted.
The rule is part of an extensive CMS review of the entire set of conditions for participation (CoP) that hospitals must meet to participate as deemed hospitals in the Medicare and Medicaid programs. CoP requirements have been reviewed and revised on an ad hoc basis, but this is the first time in many years that CMS has undertaken a retrospective review of the CoP.
The proposed revisions fall into several broad categories, including governance, staffing, care plans, medications, infection control, and transplant organ recovery. Among the specific proposals:
- Allow one governing body to oversee multiple hospitals in a single healthcare system.
- Allow hospitals to grant privileges to physicians and non-physicians to practice within their state's scope of practice regardless of whether they are appointed to the hospital's medical staff.
- Revise nursing services requirements to allow hospitals to develop either a stand-alone nursing care plan or an overall interdisciplinary care plan.
- Allow hospitals to set up a program so patients or a support person can self-administer hospital-issued medications as well as the patient's own medications brought into the hospital.
- Eliminate the requirement that a dedicated log of infection incidents be maintained and instead allow hospitals to develop their own tracking systems.
- Eliminate the blood typing requirement performed by transplant centers before organ recovery takes place.
The comments filed were primarily from individual physicians and nurses. The usual stakeholders also weighed in, including the American Hospital Association, American Nurses Association, and the American Medical Association. Comments were also submitted by the American Telemedicine Association, Catholic Health Initiatives, and the National Kidney Foundation.