Hospitals say upcoming requirements to report capacity data and the number of patients with respiratory illness to the CDC are burdensome and are calling on CMS to delay enforcement.
On Nov. 1, a new CMS rule will take effect requiring hospitals to electronically report data on the number of patients with confirmed COVID-19, flu and respiratory syncytial virus, as well as overall bed capacity data, on a weekly basis.
Six details:
1. During the COVID-19 pandemic, hospitals were required to report COVID admissions and capacity data to the CDC. The requirement ended May 1, although federal officials encouraged reporting on a voluntary basis. The CMS rule set to take effect in November will reinstate some of the pandemic-era reporting requirements, though hospitals will now need to report data weekly rather than daily, as was previously required for certain data elements.
2. Specifically, hospitals and critical access hospitals must report data on respiratory viruses, "including confirmed infections of respiratory illnesses among hospitalized patients, hospital bed consensus and capacity (both overall and by hospital setting and population group, and limited patient demographic information, including age," according to the requirement, which was published to the Federal Register in August as part of changes to CMS' Inpatient Prospective Payment System.
3. The American Hospital Association and Federation of American Hospitals expressed frustration over the new rule and have urged federal agencies to consider alternative approaches to data sharing, MedPage Today reported Oct. 14.
"Hospitals and health systems understand the potential value of selected data on acute respiratory illnesses to inform public health efforts," Akin Demehin, senior director of quality and patient safety at the AHA, told the news outlet. "However, we continue to believe a Condition of Participation to compel hospital reporting is needlessly heavy-handed and inconsistent with the core intent of CoPs."
Meanwhile, the FAH has asked CMS to delay enforcement of the rule and reconsider voluntary reporting. The group is also requesting that inpatient rehabilitation and psychiatric facilities be excluded from the requirements, a spokesperson told MedPage Today.
4. CMS and the CDC have said the data reporting is necessary to inform infection control policies and maintain visibility into respiratory virus activity. "Not maintaining this reporting would result in an absence of vital information on local, regional, and national transmission and impact of respiratory illness and overall healthcare system capacity, with significant implications for both patient care and public health mitigation," the authors of the requirement wrote.
5. Some experts are calling on CMS to fund the mandate, which the agency estimates will require 39 hours of work per year per hospital by a nurse
"A facility isn't going to be able to hire an additional nurse to do a task that requires a week of time, so the existing staff will have to do the work, and that will reduce the amount of time they may have for other activities," Harold Miller, president and CEO of the Center for Healthcare Quality and Payment Reform, told the news outlet.
The mandate is one of many unfunded requirements in the Medicare Conditions of Participation, which could be especially burdensome for smaller hospitals.
"If a mandate is important, then it should be paid for," Mr. Miller said. "Each individual mandate may have a small impact, but many mandates with small impacts can add up to a high total cost, and without accompanying revenue, that means a high total loss. ... At a small hospital that is already losing money, it increases the overall losses and makes it more likely that the hospital will be forced to close."
6. Earlier in October, the CDC released a new "community snapshot" feature designed to provide a simple way for users to get a sense of whether respiratory illnesses are increasing or decreasing based on emergency department visits. The tool will be updated based on feedback and will reflect hospitalization trends later this fall when hospitals resume reporting that data.