Advisories and Alerts
Advocacy Alert: House Reform Bill Cuts Billions From Payments For Hospital Services
Urge your representative to reject proposed cuts
The hospital field supports true health care reform, but we must band together to fight cuts that are contained in the draft reform bill released by House leaders Friday. The cuts come in two major areas:
Permanent update cut: The draft bill proposes a permanent cut to Medicare's annual hospital Market Basket updates that we estimate could cut payments for hospital-based services by an estimated $150 billion or more over 10 years. The bill also includes an aggressive readmissions policy that would cut billions more.
Public plan paying Medicare rates: The draft proposes a public insurance plan that would pay Medicare rates for hospitals for the first two years. After that, the rates would be set by the HHS secretary … and we have no reason to believe those rates would surpass Medicare rates. With a fairly rapid phase-in, the public plan would eventually be available to all, potentially attracting millions more patients to a plan that continues the underpayment for hospital services. If rates continued at Medicare levels, an estimate by the private consulting firm Lewin shows, the plan could result in as much as $36 billion in annual lost revenues to hospitals.
Please see the below fact sheets for more information on these two issues and please contact your representative today. Also, take advantage of the upcoming June 29 - July 3 congressional recess to help your representative understand that hospitals are for true reform ... but arbitrarily cutting hospital payments does not help patients or communities.
Proposed Rule for National Emission Standards for Hazardous Air Pollutants for Reciprocating Internal Combustion Engines (May 6, 2009)
The EPA is soliciting comments for the above proposal. The proposal will potentially impact each hospital emergency generator but will not require any additional effort beyond what is typically already being done by hospital engineers and facility managers.
Interim Guidance document on swine flu from the Centers for Disease Control (April 30, 2009)
The appended Interim Guidance document on swine flu from the Centers for Disease Control (CDC) gives some very good direction on how to prepare for an influx of patients with "flu-like" symptoms. As you will notice in the guidance document, this is not a small-particle airborne virus; therefore, there is no need to modify standard ventilation practices, convert additional rooms to provide airborne infection isolation protection, or place HEPA filtration devices in waiting rooms or lobbies.
There are some facility-related recommendations, however, including these:
- Set up screening areas at entrance points into the facility.
- As the need increases, designate additional waiting spaces for patients who need to be isolated. (This does not require turning that space into a negative environment.)
- Continue to review your pandemic plan for an increase in patient volume and potential staffing limitations. Remember, this is not an airborne virus
- Perform procedures that are likely to generate aerosols (e.g., bronchoscopy, elective intubation, suctioning, administration of nebulized medications) in a location with negative pressure air handling whenever feasible. Patients with swine flu do not need to be placed in an airborne infection isolation (AII) room or environment.
- Monitor rooms used for procedures generating aerosols and document the negative airflow and air exchanges.
- Schedule and control visits to allow for appropriate screening for acute respiratory illness before visitors enter the hospital, and provide visitors with appropriate instruction on use of personal protective equipment and other precautions (e.g., hand hygiene, limiting surfaces touched) while in the patient's room. Visitors should also be instructed to limit their movement within the facility.
- Post signage at entry points instructing patients and visitors about hospital policies, including the need to notify staff immediately if they have signs and symptoms of febrile respiratory illness. Facilities in communities where swine influenza transmission is occurring should limit points of entry to the facility.
- If facility staff is working in and around patients with swine flu, the staff should be medically cleared, fit-tested, and trained for respirator use, including: proper fit-testing and use of respirators, safe removal and disposal, and medical contraindications to respirator use.
Click here to contact Douglas Erickson by e-mail for further information.
Regulatory Advisory: CDC Guidance on Swine Flu (April 27, 2009)
As of Monday afternoon April 27, 2009 there have been 40 cases of swine flu confirmed in 5 states. In response to this rapidly evolving issue ASHE has prepared this advisory. The following information has been extracted from the Center for Disease Control and Prevention (CDC) website postings (see specific references below).
Regulatory Advisory: Revised 2009 Joint Commission Hospital Accreditation Standards (March 26, 2009)
On March 26, 2009, the Joint Commission issued revised requirements for the Hospital Accreditation Program. These revisions replace the draft revised requirements issued by the Joint Commission on January 5. The original revisions included changes or additions to 165 Elements of Performance (EPs). In the new revisions, the number of new or modified EPs has been reduced from 165 to 87.
Statement from ASHE: American Recovery and Reinvestment Act Update (March 19, 2009)
In the recently passed American Recovery and Reinvestment Act of 2009, Congress has made funds available that affect the health care sector of the economy.
Regulatory Advisory: Joint Commission Publication of Standards Errata (February 12, 2009)
The Joint Commission published errata to the 2009 Joint Commission Standards in the February 2009 issue of Joint Commission Perspectives®, (Volume 29, Issue 2). [More ...] 
Regulatory Alert: The Joint Commission New and Revised 2009 Accreditation Requirements (January 8, 2009)
On January 5, 2009, the Joint Commission posted a 46-page document titled "New and Revised 2009 Accreditation Requirements, Hospital Accreditation Program" on its Web site. It appears that these new and revised requirements, which are in addition to the revisions included in the 2009 Comprehensive Hospital Accreditation Manual, have not been released or published through any Joint Commission sources other than the Web site posting. This has led to confusion regarding compliance requirements among accredited hospitals and health care organizations.
Advocacy Alert: Signatures needed on House letter urging President-elect to include hospital issues in economic recovery package (January 7, 2009)
The first priority of the Obama administration when it takes office in two weeks is to enact an economic recovery package. Reps. Robert Brady (D-PA) and Joe Wilson (R-SC) are asking their House colleagues to sign a letter urging the President-elect to include relief for hospitals in the plan. Has your representative signed? The letter cites the "necessity of maintaining the economic health of our nation's hospitals" and notes that hospitals are among the nation's largest employers—five million jobs nationwide.