APIC Supports Ending CMS Vaccine Mandate
Urges CMS to add central lines, catheters to quality metrics
Under the CMS hospital-acquired conditions (HAC), APIC proposed a recommendation to further promote patient safety in the HAC Reduction program. “We recommend adding standardized utilization ratios (SUR) for indwelling urinary catheters and central lines as part of the eCQM (electronic clinical quality measures) metric,” APIC stated. “This metric currently exists within [the] Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN), calculated using data already entered, so it poses no additional reporting burden. This metric would provide important context to the standardized infection ratio (SIR) metric already part of HAC [and] may provide better insight into the factors driving the SIR.”
Making this metric part of the eCQM program would emphasize the value of decreasing overall device use, while rewarding appropriate use, APIC emphasized.
“When [COVID-19] vaccines were first made available and there was value in closely tracking the uptake of vaccinations, monthly reporting added value,” APIC stated. “The value at that time outweighed the burden it imposed on those responsible for entering the data. At this time, however, monthly reporting should not be required. Entering a single COVID-19 vaccination summary report into NHSN at the end of the reporting period for the respiratory season should meet the minimum data requirements for CMS reporting.”
Regarding SARS-CoV-2 vaccination of healthcare workers, APIC further stated:
• Despite CMS’s withdrawal of the Omnibus COVID-19 Health Care Staff Vaccination Requirements, APIC continues to support COVID-19 vaccination among healthcare personnel in all healthcare settings as the most effective infection prevention tool to protect staff, patients, and visitors against severe illness, hospitalization, and death.
• APIC supports the modification of the COVID-19 Vaccination Coverage Among Healthcare Personnel (HCP) Measure beginning with the fiscal year 2025 Hospital Inpatient Quality Reporting Program, the prospective payment system-exempt cancer hospitals, and the long-term care hospital quality reporting program to update the definition by replacing “complete vaccination course” with “up to date” to enable continuity of reporting among all healthcare facilities.
• APIC supports updating the numerator to specify the time frames within which HCP are considered up to date with their vaccinations as the first day of the quarter being reported.
• APIC urges CMS to modify the COVID-19 Vaccination Coverage Among HCP measure to require an annual summary report, similar to the current HCP influenza vaccination reporting requirement.
REFERENCE
- Association for Professionals in Infection Control and Epidemiology. Re: Docket #CMS-1785-P: Medicare Program; Proposed hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and policy changes and fiscal year 2024 rates. Published June 9, 2023. https://apic.org/wp-content/uploads/2023/06/FY-2024-IPPS-comments_final_6-9-23.pdf
In a letter to the Centers for Medicare & Medicaid Services, the Association for Professionals in Infection Control and Epidemiology supported the end of mandated COVID-19 vaccines for healthcare workers and suggested adding two key hospital infection risks as quality indicators.
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