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 CMS Proposes Mandatory Antibiotic Stewardship Program For Long Term Facilities

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.
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