A Republican senator is pressing federal agencies to get together on a regulatory plan for how hospital employees can deal with violent outbursts and confrontations inside hospitals.
Sen. Roy Blunt (R-Mo.), who chairs the Senate health appropriations subcommittee, told an audience at the American Hospital Association's annual meeting on Monday that he discussed a now-overdue interagency report on the issue with HHS Secretary Alex Azar.
"This is a critically important issue," Blunt said. "We have enough challenges finding healthcare providers that will come and stay as it is."
He told hospital leaders he asked Azar about the status of the report before last Thursday's HHS appropriations hearing.
"We will get that report from OSHA and CMS," the senator said. "We will do what we can to help you protect your people that are out there trying to help other people solve their biggest problem."
The report is supposed to be issued jointly by the CMS and the Occupational Safety and Health Administration, in order to lay clear groundwork for the agencies to work together on regulatory guidance for hospital employees to follow. Blunt and his fellow appropriators required the report through a provision in last fiscal year's health appropriations bill.
But the report was due within 180 days of that bill, and that deadline passed two weeks ago.
"It's a first start for the feds to walk into this area," said Missouri Health Association President Herb Kuhn, who has taken a lead on pushing for federal action. "It's the epidemic nobody's talking about in healthcare. You go into a modern day labor and delivery room and it's almost like the Jerry Springer show on a daily basis. It's a rough world out there."
Hospitals have been warning over the past several years that violence is becoming more and more prevalent inside their walls and poses a significant threat to their employees. Dr. Tom Mihaljevic, president and CEO of Cleveland Clinic, recently called the issue a "national epidemic," a phrase echoed by Kuhn.
About 20% of nurses and nursing students nationwide have been physically assaulted on the job, according to one report.
Kuhn traced the trend back about five years ago, when his member hospitals started to report a growing number of community and family violence incidents moving into their emergency departments, labor and delivery rooms, critical-care units and ICUs. He said the situations have mounted along with opioid use and other mental health issues.
"All across the board, you see more and more of our societal issues coming through the doors, and it's becoming harder and harder as we work to try to protect our employees and to protect our patients," he told Modern Healthcare shortly after Blunt's speech.
Kuhn said the disconnect between the CMS' and OSHA's responsibilities make it more complicated for hospital employees to try to de-escalate situations or to manage them without getting penalized. The CMS conditions of participation and certification rules make sure hospitals are taking care of patients and keeping them safe, but they don't have jurisdiction over hospital employees. That falls to OSHA, under the Labor Department.
"The point is to at least ask HHS and the Department of Labor to get together and see if they can do anything together on regulations, so that if employees are accosted there are better ways they can protect themselves," Kuhn said.
Last year, a California law went into effect that requires hospitals and other clinics to have a plan to manage violence. The provision, backed by nurses, passed in 2014.