Lifting a Regulatory Burden Could Create Dangerous Consequences

Cheryl Clark, November 17, 2011

When the Centers for Medicare & Medicaid Services last month proposed a rule to relax some Medicare conditions of participation for hospitals seeking federal reimbursement, we heard that leaders of acute care facilities jumped for joy.

Instead of dishing out tons of new regulatory paperwork, the payers in chief were finally deleting some that were thought to be unnecessary. In doing so, CMS officials said, they would be saving hospitals an estimated $942 million a year and allowing providers to spend more time at the bedside. 

This announcement "is welcome news for hospitals and patients, providing much-needed regulatory relief to a health system choked with paperwork," the American Hospital Association's President and CEO, Rich Umbdenstock said in a statement.

That’s all well and good... except for one thing.

The 76-page CMS proposal seeks to eliminate one requirement that could cause more in time and harm – in headaches and adverse events, not to mention true disasters and damage to family relationships – than it prevents.

The agency proposes to allow hospitalized patients, or their caregivers, or 'support' persons, the ability to administer some medications themselves, eliminating the requirement that a hospital employee (i.e. a nurse) perform those functions.

Here's the language of the proposed rule: "We also propose additional revisions at proposed §482.23(c)(6) that would allow hospitals the flexibility to develop and implement policies and procedures for a patient and his or her caregivers/support persons to administer specific medications (non-controlled drugs and biologicals).

"This proposal would be consistent with the current practice of giving patients access at the bedside to urgently needed medications, such as nitroglycerine tablets and inhalers, and selected non-prescription medications, such as lotions and rewetting eye drops. These proposed changes would apply to the self-administration of both hospital-issued medications and the patient’s own medications brought into the hospital."


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