On Sept. 28, CMS finalized new requirements to improve the care and safety for more than 1 million residents at long-term care facilities participating in Medicare and Medicaid programs. Among the new requirements is the implementation of an antibiotic stewardship program.
Changes to the rule include, among others, bolstering the rights of residents by prohibiting the use of pre-dispute binding arbitration agreements, ensuring that care facilities consider the health of their residents when addressing staffing needs and requiring facilities to bring on an infection prevention and control officer and implement an antibiotic stewardship program to monitor use and establish use protocols.
According to the CDC, approximately 70 percent of nursing home residents receive one or more courses of antibiotics during a year.
David Hyun, MD, senior officer with the Pew Charitable Trusts' antibiotic resistance project, told CIDRAP News studies suggest anywhere from 40 percent to 70 percent of those antibiotic prescriptions are unwarranted and contribute to antibiotic resistance.
The American Health Care Association, which represents long-term care facilities in the U.S., has expressed concern about the costs of these new programs.
"Even CMS admits this new wave of regulations will bring with it hundreds of millions in additional costs without any new funding streams," said Mark Parkinson, president and CEO of the AHCA. "We will spend the coming days and weeks determining what overall impact those mandates will have on our members."
Dr. Hyun told CIDRAP the transition will be challenging, but added there are effective antibiotic stewardship strategies long-term care facilities can implement successfully with limited resources, including tracking prescribing patterns of its physicians and providing tailored feedback.
"There are ways this can be adapted," said Dr. Hyun
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