The Centers for Medicare and Medicaid Services has published a final rule revising requirements in the hospital conditions of participation for completing history and physical examinations, authenticating verbal orders, securing medications, and completing post-anesthesia evaluations. The new rule gives hospitals and practitioners greater flexibility in meeting needs of patients and addresses concerns of the healthcare community that the old regulations were outdated and unduly burdensome.
The new H& P requirement expands the timeframe for completion of the H&P and the number of individuals who may perform the H&P. The regulation for authentication of verbal orders requires that all orders, including verbal orders, must be dated, timed, and authenticated by the prescribing practitioner within 48 hours--with a temporary exception. For a five-year period beginning with the date of publication of the final rule, verbal orders no longer need to be signed by the prescribing practitioner but can be authenticated by another practitioner responsible for the care of the patient. CMS believes this temporary revision to the authentication requirement will provide flexibility for hospitals until health IT is sufficiently advanced to allow the prescribing practitioner to authenticate his or her own orders promptly.
The regulation on security of medications requires that all drugs and biologicals be kept in secure areas and locked when appropriate. This regulation maintains flexibility for hospitals in determining control of nonscheduled drugs and biologicals and is more patient-focused and outcome-oriented. Finally, the requirement for post-anesthesia evaluation permits the evaluation of inpatients to be completed and documented by any individual qualified to administer anesthesia rather than restricted to the individual who administered the anesthesia. The final rule becomes effective Jan. 26. Read the press release.
