Critical-access hospitals get break on staffing

The CMS has proposed reducing hospital staffing requirements at critical-access hospitals, rural health clinics and federally qualified health centers, which could save those facilities as much as $676 million a year.

The proposed rule, issued Monday (PDF), would eliminate the requirement that a physician be present at those facilities at least once every two weeks. The CMS called the ruled burdensome and outdated.

“Many rural populations suffer from limited access to care due to a shortage of healthcare professionals, especially physicians,” the proposed rule read. “Recent improvements in, and expansion of, telemedicine services allow for physicians to provide certain types of care to remote facilities at much less cost."

The proposal, which revises a final rule issued in May, (PDF) is part of President Barack Obama's 2011 executive order to reduce burdensome regulations. Other changes in the rule include allowing dietitians to order patient diets without needing the approval or supervision of a doctor or other clinician and allowing nuclear medicine techs in hospitals to prepare radiopharmaceuticals without constant supervision of physicians or pharmacists.

“By eliminating outdated or overly burdensome requirements, hospitals and healthcare professionals can focus on treating patients,” said HHS Secretary Kathleen Sebelius in a release.

Both the American Hospital Association, which represents not-for-profit hospitals, and the Federation of American Hospitals (PDF), which represents for-profit hospitals, lauded the proposed rule saying it frees up hospital resources.

Another regulation eliminated by the proposed rule involved requirements that hospital governing boards retain a physician on their governing boards. The CMS instead mandates boards to consult with physicians over matters including scope of hospital services.

“CMS recognized that the requirement was not feasible for all hospitals,” AHA President and CEO Rich Umbdenstock said in the release. “CMS revamped the requirements to focus on the need for good communication between governing boards and medical staff members about patient care.”

The AHA singled out a requirement that multihospital systems with a single governing body consult with each of the system's hospitals. “Hospitals are delivering more coordinated, patient-centered care and CMS should not let antiquated organizational structures stand in the way,” Umbdenstock also said.