Government Revamps Quality Rules

While adding requirements for hospitals, the new “Conditions of Participation” issued by the Centers for Medicare & Medicaid Services (CMS) will actually save more than $900 million annually in administrative efficiencies, according to senior managers at the agency. “Conditions of Participation” are the quality and safety standards that government survey teams and private accreditation agencies use to evaluate hospitals and other providers during onsite visits. Failure to comply with the conditions can result in penalties, including removal from the Medicare and Medicaid programs. The new conditions for hospitals issued in a proposed federal rule last fall would be the first update of the standards since 1986. Officials at CMS indicate that the agency considered stakeholder input gathered for a year prior to publication. Among the changes are revisions meant to strengthen care coordination between settings and to encourage patient-centered care. Efficiencies include permitting a single governing body for multiple institutions in a hospital system; eliminating a requirement for nursing care plans separate from other care plans; and permitting pharmacies to approve electronic standing orders. To read the proposed rule: “Medicare and Medicaid Programs; Reform of Hospital and Critical Access Hospital Conditions of Participation,” issued October 24, visit