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April 18, 2007

Hospital Report Card Act - Final Rules Published

On March 28, the final rules covering the Hospital Report Card Act became effective and were published in the April 13, 2007 Illinois Register. These rules cover the nurse staff information and infection process and outcome measurements to be reported to the Illinois Department of Public Health and the public.

The new rules can be found at either the State of Illinois Illinois Register site or by clicking here. These rules are included in the Administrative Code of Illinois under Title 77 – Public Health, Part 255. As you will recall, under the Hospital Report Card Act under Public Act 93-563, hospitals are already required to follow the Whistleblower Protections (Section 35) and Staffing Levels upon request (Section 15). This Public Act is available by clicking here.

Nurse Staffing Reporting Requirements
In addition to existing requirements for providing nurse staffing information to consumers upon request, the new rules do have some additional requirements:

  • Effective March 28, 2007 – Hospitals should notify the public of the right to access nurse staffing information, including posting on their web site and disseminating patient education materials on how to obtain nurse staffing information.
  • In order to ensure you are compliant with existing and recently released rules and turnaround timelines on patient or consumer requests, hospitals are encouraged to review Section 255.150 of the Administrative Code for Public Health.
    - July 1-September 30, 2007 -- Hospitals will be educated by Illinois Department of Public Health on reporting requirements for nurse staffing.
    - October 1-December 31, 2007 -- Hospitals will participate in a pilot submission of data using a standardized submission approach.
    - January 1-March 31, 2008 -- First set of nurse staffing information to be gathered by hospitals and submitted by April 20 with any updates by July 1 2008.
    - July 2- September 30, 2008 -- First set of comparative nurse staffing information to be released to public.
  • Please note that all hospitals are required to submit nurse staffing information. When the actual results are released to the public, there are requirements to adjust and offer comparisons by types of hospitals and service areas and units.

    Infection Reporting Requirements.
    Infection reporting requirements have various phase in dates beginning with July 1, 2007 and extending to July 1, 2008.

  • Starting with July 1, 2007 for PPS inpatient hospital discharges and October 1, 2007 for non-PPS inpatient hospital discharges according to CMS Hospital Quality Alliance reporting guidelines:
  • SCIP-Inf 1 – Prophylactic antibiotic received within one hour prior to surgical incision
  • SCIP- Inf 2 – Prophylactic antibiotic selection for surgical patients
  • SCIP- Inf 3 – Prophylactic antibiotics discontinued within 24 hours after surgery end time
  • Surgical outcome measures by reporting postoperative wound infection diagnosed during index hospitalization
     
  • October 1, 2007 for both PPS and non-PPS hospitals according to CMS Hospital Quality Alliance reporting guidelines:
  • SCIP Inf – 3b, 3c - Cardiac surgery patients with prophylactic antibiotics discontinued within 48 hours after surgery
  • SCIP-Inf-4 - Cardiac surgery patients with controlled 6 a.m. postoperative serum glucose
     
  • July 1, 2008 for both PPS and non-PPS hospitals:
  • Central vascular catheter-related bloodstream infection rates in designated critical care units
  • Patients diagnosed with postoperative ventilator-associated pneumonia (VAP) during index hospitalization as set forth in SCIP
     
  • PPS hospitals will be required to report the first quarter of data covering third quarter 2007 patient discharges by October 31, 2007 and to make all corrections by January 1, 2008. It is anticipated that this first set of quarterly information could be reported publicly during 1st quarter 2008 pending there is sufficient number of cases that make the reported information meaningful to consumers.
  • Please be aware of the following when you are reviewing the infection reporting SCIP requirements:

  • Sampling can be used in reporting as long as hospital follows CMS Hospital Quality Alliance rules on sampling and the volume meets the criteria established by CMS for sampling
  • Hospitals may find that they do not provide the surgical services under SCIP and therefore are not required to report the SCIP measurements. Surgical services currently covered under SCIP include: CABG, Hip Arthroplasty, Knee Arthroplasty, Colon Surgery, Hysterectomy, Vascular Surgery, and other Cardiac Surgery procedures
  • Patients included in reporting are those 18 years and older and for patients in specialty pediatric hospitals, age requirements are extended to include those patients who, due to condition, care and treatment requirements, continue to be considered pediatric.
  • To the extent possible, the rules include nationally adopted measurements currently reported by hospitals to CMS to reduce the reporting burden on hospitals.

    Training and Support
    IHA is working closely with the Illinois Department of Public Health and will be helping to coordinate education, training, and support on both the infection and nurse staffing information reporting requirements. Within a couple of weeks, IHA will have more details on the Webinars, conference calls, educational meetings and material, and a combined effort and process to quickly address and respond to questions or issues by hospitals on reporting requirements.

    Helpful Hints To Get Started

  • Review rules to ensure hospital is compliant with existing provisions such as whistleblower, nurse staffing, orientation and training
  • Review rules to understand how your hospital may best comply with the nurse staffing information reporting requirements. While there will be standardized methods that hospitals will need to utilize in defining and reporting information, it is helpful to understand what your current practice is for definitional and collection purposes.
  • Review rules on infection reporting to understand the reporting requirements and time frames for reporting this information.
  • As the rules are now in place, initiate discussions with hospital and executive management on reporting requirements and any information already gathered or provided. Update your hospital board on new rules and your hospital plans for reporting this information.
  • For hospital infections, continue or initiate multi-disciplinary discussions on methods and approaches for reducing hospital infections as the Hospital Report Card Act includes public reporting of process and outcome measurements. As many efforts in reducing infections involve expenditure of resources, incorporate the infection control and prevention specialists, quality improvement staff, chief financial officer or their staff, nursing executives, chief medical officer, health information technology staff, and other clinical and executive staff in your discussions. Many hospitals are undertaking organizational assessments on return on investment approaches in reducing hospital infections and have found these investments to result in improved outcomes of care for patients and a financial return on this type of quality improvement investment.
  • Assess if there are any gaps in consistency of information within administrative billing, internal infection control data and results, and current SCIP reporting. CMS has already started to link some of the billing and Hospital Quality Alliance information together and is identifying variations in reported information. Hospitals should strive to reach consistency within their organization on internal and externally reported information.
  • IHA will continue to keep you updated on developments and to provide hospitals with resources and support for not only reporting of information under the Hospital Report Card Act rules, but also on strategies and opportunities for quality improvement.

    Staff Contact: Pat Merryweather: (630) 276-5590