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CMS announces proposed rule updating CoPs

Patient Safety Monitor Alert, March 31, 2005

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The Centers for Medicare & Medicaid Services (CMS) announced on March 24 a proposed rule updating the hospital conditions of participation (CoPs). The proposed rule would revise requirements for completion of history and physical (H&P) examinations, authentication of verbal orders, security of medications, and completion of post anesthesia evaluations. The CMS is accepting comments on the proposed rule until May 24.

"Based on extensive input from health professionals and the healthcare community, we are proposing to revise some specific aspects of our regulations to provide better support of the delivery of high-quality, up-to-date care at a lower cost," said Mark McClellan, MD, PhD, administrator for CMS.

The revised requirements include:

• H&P-Expanding the number of practitioners who are allowed to perform the H&P and the time frame for completion
• Authentication of verbal orders-All orders, including verbal orders, must be dated, timed, and authenticated by the practitioner responsible for the patient's care. During a five-year transition from publication of the final rule, it would allow the prescribing practitioner or a practitioner responsible for the patient's' care to date, time, and authenticate all orders, including verbal orders. This would reduce burden and provide flexiblity for hospitals in meeting the requirements for authenticating verbal orders. In addition, if a state law does not specifiy the time frame for authenticating verbal orders, hospitals have 48 hours to do so.
• Medication security-All drugs and biologicals must be kept in secure areas to prevent unauthorized people from accessing them.
• Post anesthesia evaluation-Any individual qualified to administer anesthesia is allowed to complete and document the post anesthesia evaluation for inpatients

For more information, visit the CMS Web site at www.cms.hhs.gov.

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