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CMS: 2% of hospitals earn a “five star” rating

rating-153609_1280 The agency says it will be posting those ratings on its Hospital Compare site “shortly.” Out of 4,599 hospitals previewed:
• 2.2% will receive 5 stars
• 20.3% will receive 4 stars
• 38.5% will receive 3 stars
• 15.7% will receive 2 stars
• 2.9% will receive 1 star
The remaining 20.4% didn’t meet the minimum measure/group reporting thresholds set forth in the Star Ratings Methodology Report and are unrated.
The star ratings are meant to be a simple, comprehensive look at hospital quality to help consumers make their medical choices. The ratings have come under fire by several hospital organizations who say that the ratings don’t show true quality and that the methodology it uses is flawed.

Joint Commission’s 2017 antibiotic stewardship standards

In the wake of a CMS ruling that will make antibiotic stewardship programs (ASP) mandatory, The Joint Commission recently announced that it will roll out a similar standard. Effective January 1, 2017, the new Medication Management standard requires facilities to create an effective ASP. The standard applies to:

The Joint Commission released the standard a month after attending the White House Forum on Antibiotic Stewardship, which focused on implementing changes over the next five years to slow the emergence of antibiotic-resistant bacteria, detect resistant strains, promote stewardship of existing antibiotics, and prevent the spread of resistant infections. Representatives from 150 retailers, food organizations, healthcare organizations, and animal health organizations were in attendance.

Only 40% of U.S. hospitals have an antibiotic stewardship program and an estimated 30% to 50% of prescribed antibiotics are unnecessary or inappropriate.  In the U.S., drug-resistant diseases cause 23,000 deaths and 2 million illnesses each year. That number is expected to increase exponentially in the upcoming decades. 

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CMS begins oncology bundles

On July 1, nearly 200 group practices began a five-year demonstration program of CMS’s. The model’s goal is to improve the quality and decrease the costs of cancer care nationwide. Cancer is the second leading cause of death in America, with 22.5% of all deaths in 2014 resulting from some form of it. Meanwhile, the costs of cancer care are expected to rise to $158 billion in 2020, an increase of 27% over 2010.

“The Oncology Care Model encourages greater collaboration and information sharing so that cancer patients get the care they need,” said U.S. Department of Health and Human Services Secretary Sylvia M. Burwell, in an announcement. “This patient-centered care model furthers the goal of the Vice President’s Cancer Moonshot to improve coordination, care, and outcomes while spending dollars more wisely.”CMS Logo

Participating physicians will receive performance-based payments for caring for Medicare cancer patients under a bundled payment model. They’ll also receive a monthly care management payment for each beneficiary. Participating in the Oncology Care Model is 17 health insurance companies, more than 3,200 oncologists, and approximately 155,000 Medicare beneficiaries. The group practices involved will all follow nationally recognized clinical guidelines for chemotherapy, with improved services including: [more]

U.S. House passes mental health bill

On June 6, the House of Representatives passed the “Helping Families in Mental Health Crisis Act” by a 442-2 vote. The bill would allow CMS to reimburse providers for treating Medicaid patients’ mental health and physical health on the same day, increase the number of psychiatric hospital beds, and cut CMS spending by $5 million over 10 years. The bill was created and led by Rep. Tim Murphy, a licensed child psychologist, in response to the Sandy Hook shootings.

“This historic vote closes a tragic chapter in our nation’s treatment of serious mental illness and welcomes a new dawn of help and hope,” he said in a press release. “We are ending the era of stigma. Mental illness is no longer a joke, considered a moral defect and a reason to throw people in jail.”

The Senate is expected to vote on the bill by the end of the year.

 

CMS releases list of proposed rules, makes antibiotic stewardship mandatory

Last week, CMS published a list of proposed rule changes for hospitals and laboratories.  One of the more notable proposals would make antibiotic stewardship programs [ASP] mandatory. ASPs are viewed by many as a way to prevent antibiotic misuse and the spread of drug-resistant disease.

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“We propose to change the introductory paragraph [in Infection Control Condition of Participation §482.42] to require that a hospital’s infection prevention and control and antibiotic stewardship programs be active and hospitalwide for the surveillance, prevention, and control of HAIs and other infectious diseases, and for the optimization of antibiotic use through stewardship,” according to the proposed rule.

Only 40% of U.S. hospitals have an antibiotic stewardship program and an estimated 30% to 50% of prescribed antibiotics are unnecessary or inappropriate.  In the U.S., drug-resistant diseases cause 23,000 deaths and 2 million illnesses each year.

The document also changed included changes to patient rights, restraint usage, physician assistants, medical records, diet orders, periodic evaluations, and several more. To see the full list of changes, click here.

Healthcare professionals can comment on the proposed rules until 5 p.m. on August 15, 2016. Comments can be sent by traditional mail to CMS or done online.

 

CMS proposal would make antibiotic stewardship programs mandatory

Healthcare professionals have 60 days to comment on a proposed CMS rule to make antibiotic stewardship programs (ASP) mandatory for all hospitals and critical access hospitals.

“We propose to change the introductory paragraph [in Infection Control Condition of Participation §482.42] to require that a hospital’s infection prevention and control and antibiotic stewardship programs be active and hospital-wide for the surveillance, prevention, and control of HAIs and other infectious diseases, and for the optimization of antibiotic use through stewardship,” according to the proposed rule.

Only 40% of U.S. hospitals have an antibiotic stewardship program and an estimated 30% to 50% of prescribed antibiotics are unnecessary or inappropriate.  In the U.S., drug-resistant diseases cause 23,000 deaths and 2 million illnesses each year.

Joint Commission to adopt 2012 Life Safety Code®

The Joint Commission announced this week that it would join CMS in adopting the 2012 edition of the Life Safety Code® (LSC). CMS and Joint Commission surveyors will begin using the 2012 LSC on July 5. In a press release, the accreditor said it would be updating its Life Safety standards chapter in the near future. Details on the update will be published in a future edition of Joint Commission Perspectives.

Click here for our previous coverage on CMS’ adoption of the 2012 LSC. 

AAHHS hopes to get deeming status in 2017

The Accreditation Association for Hospitals/Health Systems (AAHHS) hopes to receive deeming status from the CMS by 2017, according to AAHHS spokesperson Laura Bohacz. AAHHS acquired the Health Facilities Accreditation Program (HFAP) last year, with all HFAP-accredited hospitals expected to be fully switched over to AAHHS standards by 2020.
AAHHS had originally hoped to get its deeming status by the end of 2016, though Bohacz says the delay won’t have any other effects on the transition process.

Read the full story on the HFAP acquisition and its impact in the June issue of Briefings on Accreditation and Quality.

New bill would change Medicare readmissions reduction program

A bill is currently being considered by the House of Representatives that would change the structure of Medicare’s Hospital Readmissions Reduction Program (HRRP) to reflect socioeconomic factors. Many in the industry have claimed that facilities are unduly penalized when things like poverty or rurality aren’t considered.

As part of that argument, Steven Lipstein, CEO of BJC HealthCare System, spoke to Kaiser Health News about the costs of HRRP. One of BJC’s facilities, Christian Hospital of St. Louis, is expected to lose $600,000 in Medicare reimbursements because of HRRP, he said. He pointed out that figure doesn’t include the amount lost at BJC’s 13 other facilities. Lipstein said that if Medicare readjusted its reimbursement policy to reflect patients with socioeconomic disadvantages, Christian Hospital would only have to pay $140,000 in penalties.

Medicare penalized almost half of all hospitals for excessive readmissions in 2015 for a total of $420 million.

CMS adopts 2012 Life Safety Code®

CMS adopts 2012 LIFE SAFETY CODE®

In a highly-anticipated move expected to significantly affect the regulatory rules that hospitals and other healthcare facilities are held to, the Centers for Medicare & Medicaid Services (CMS) has officially adopted the 2012 edition of the Life Safety Code® (LSC).

CMS has confirmed that the final rule adopts updated provisions of the National Fire Protection Association’s (NFPA) 2012 edition of the LSC as well as provisions of the NFPA’s 2012 edition of the Health Care Facilities Code. The New Life Safety Code® Field Guide for Healthcare Facilities cover

 

Healthcare providers affected by this rule must comply with all regulations by July 4—60 days from the publication date of the rule in the Federal Register.

The adoption of the rule has long been anticipated, as the LSC, which governs fire safety regulations in U.S. hospitals, is updated every three years, and CMS has not formally adopted a new update since 2003, when it adopted the 2000 edition. As a result, CMS surveyors have been holding healthcare facilities to different standards to other regulatory agencies that have gradually adopted provisions of the new LSC in their survey requirements.

Some of the main changes required under the final rule include:

  • Healthcare facilities located in buildings that are taller than 75 feet are required to install automatic sprinkler systems within 12 years. after the rule’s effective date.
  • Healthcare facilities are required to have a fire watch or building evacuation if their sprinkler systems is out of service for more than 10 hours.
  • The provisions offer long-term care facilities greater flexibility in what they can place in corridors. Currently, they cannot include benches or other seating areas because of fire code requirements limiting potential barriers to firefighters. Moving forward, LTC facilities will be able to include more home-like items such as fixed seating in the corridor for resting and certain decorations in patient rooms.
  • Fireplaces will be permitted in smoke compartments without a one-hour fire wall rating, which makes a facility more home-like for residents.
  • For ASCs, alcohol-based hand rub dispensers now may be placed in corridors to allow for easier access.

To get up to speed on the 2012 Life Safety Code®  check out the following resources from HCPro Marketplace:

Visit the Federal Register document to read the final rule in full, and view the CMS press release on the LSC here.