CMS Proposes Mandatory Antibiotic Stewardship Program For Long Term Facilities
Jackie Oberst
7/17/2015
The Centers for Medicare & Medicaid Services (CMS)
this week proposed a rule requiring all long term care facilities to establish
an antibiotic stewardship program, including antibiotic use protocols and
antibiotic monitoring, all further proof of the federal government’s escalated
response in the battle against superbugs, malicious microbes that are resistant
to these drugs.
Antibiotic stewardship programs, such as the one outlined in
CMS’ rule, have proven to decrease the development of antibiotic resistance,
reduce the occurrence of C.
difficile infections, improve patient outcomes, and reduce pharmacy
costs.
The rule would become a condition of participation in
Medicare. Specifically, the agency would require pharmacists to “review a
resident’s medical chart at least every six months and when the resident is new
to the facility, a prior resident returns or is transferred from a hospital or
other facility, and during each monthly drug regimen review when the resident
has been prescribed or is taking … an antibiotic.”
Facilities will also be required to designate an infection
prevention and control officer that will periodically review and update the
program, educate and train staff, and serve as a member of the facility’s quality
Assessment and Assurance Committee.
Numerous organizations support the cause, such as the
Infectious Diseases Society of America. The American Health Care Association
(AHCA) and the National Center for Assisted Living included infection controls
into their quality
initiatives.
“It is really affecting the population we serve in the long
term community and post-acute community. The elderly, who are often suffering from
comorbidities, are now developing resistance to the drugs they might need
because they have received them in a gratuitous, almost excessive way over the
years,” AHCA Board Chair Leonard Russ recently told
ProviderTV after he and over 150
health and animal stakeholders attended the White House Forum on Antibiotic Stewardship
in June.
The President’s Council of Advisors on Science and
Technology released a report in September 2014 recommending that a regulatory
requirement for antibiotic stewardship be in place by the end of 2017. This
report coincides with an executive order that same year from President Obama
calling for similar regulations to preserve drug efficacy in the face of rising
multidrug-resistant pathogens. In March 2015, the administration released the
National Action Plan for Combating Antibiotic-Resistant Bacteria, an
overarching plan that identifies key steps for federal departments and agencies
to take to improve diagnosis and treatment yet contain the spread of
antibiotic-resistant bacteria.
The rule is posted on the Federal
Register and is available for public comment until Sept. 10, 2015.
Jackie Oberst is Provider’s Managing Editor. Email her at
joberst@providermagazine.com. Follow the magazine on Twitter @ProviderMag.