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| What's Causing the TASS Outbreak?
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The American Hospital Association is proposing that CMS lay down a new set of rules when it comes to physician ownership of specialty hospitals, including capping physicians' investments at 3 percent. The suggestions are included in a six-page letter critiquing CMS's May 9 interim report to Congress on physician-owned specialty hospitals.
AHA says the CMS analysis does not fully detail how it intends to monitor and regulate physician investment in specialty hospitals. They add that if CMS expects to resume allowing self-referrals to specialty hospitals in August — as a federally imposed moratorium on Medicare payments for such situations expires — it should set stricter limitations to avoid conflicts of interest and should elucidate the services that specialty hospitals are mandated to provide.
"When physicians own, even in part, the facilities to which they refer patients, their decisions are subject to competing interests," says an AHA spokesman. "We are strongly urging Congress to act quickly to close the loophole in federal law by permanently banning physicians from referring patients to new limited-service hospitals they own."
AHA also argues that physician-owners at specialty hospitals should be required to annually disclose their investments to the Department of Health and Human Services for public posting and reveal these investments to their patients when scheduling admissions to the hospitals.
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| Illinois RNs Can Administer Conscious Sedation
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Recently signed legislation lets Illinois's RNs administer conscious sedation such as Versed and other state-specified, rapidly reversible medications during procedures when ordered to do so by a physician.
Nurses in the state had been allowed to administer Versed pre- and post-op for pain control but not during a case. Versed is considered an anesthetic intraoperatively, and only a physician or a CRNA under a physician's direct orders could administer it, says Mark Mayo, executive director of the Illinois Freestanding Surgery Center Association.
According to the legislation, RNs must maintain current Advanced Cardiac Life Support certification or Pediatric Advanced Life Support certification, as appropriate to the age of the patient, in order to be allowed to administer the drugs.
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| Class Action Lawsuit Alleges Wage Conspiracy
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Hospitals allegedly conspired to suppress nurses' wages, according to class action lawsuits filed in Albany, N.Y., Chicago, Memphis and San Antonio. The separate but similar lawsuits argue that hospitals in each city exchanged non-public salary information through meetings, telephone conversations and written surveys, which resulted in suppressed wage competition among hospitals, according to the Albany lawsuit.
Pointing out that the hospitals complain of nursing shortages, the lawsuit notes that they have not offered competitive wages to alleviate the vacancies. Instead, the plaintiffs say compensation for nurse employees has been at artificially low levels.
"Hospitals in all four cities have decided to increase their profits on the backs of their nurses," says Daniel Small, the plaintiffs' attorney, in a statement. "Nurse pay should be set by the market, not by a secret agreement among hospitals."
According to the plaintiffs' estimates, nurses have been underpaid an annual average of $14,000 in Memphis, $6,000 in Albany, $5,000 in Chicago and $1,300 in San Antonio.
Officials at Memphis's Baptist Memorial Health Care say they're still reviewing court documents but deny the allegations. "It's important for our employees and community to know that these charges are without merit," says Echelle Lane Rutschman, spokeswoman for Baptist, who says the health system determines its compensation packages fairly and legally.
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| News and Notes
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Hospitals allegedly conspired to suppress nurses' wages, according to class action lawsuits filed in Albany, N.Y., Chicago, Memphis and San Antonio. The separate but similar lawsuits argue that hospitals in each city exchanged non-public salary information through meetings, telephone conversations and written surveys, which resulted in suppressed wage competition among hospitals, according to the Albany lawsuit.
Pointing out that the hospitals complain of nursing shortages, the lawsuit notes that they have not offered competitive wages to alleviate the vacancies. Instead, the plaintiffs say compensation for nurse employees has been at artificially low levels.
"Hospitals in all four cities have decided to increase their profits on the backs of their nurses," says Daniel Small, the plaintiffs' attorney, in a statement. "Nurse pay should be set by the market, not by a secret agreement among hospitals."
According to the plaintiffs' estimates, nurses have been underpaid an annual average of $14,000 in Memphis, $6,000 in Albany, $5,000 in Chicago and $1,300 in San Antonio.
Officials at Memphis's Baptist Memorial Health Care say they're still reviewing court documents but deny the allegations. "It's important for our employees and community to know that these charges are without merit," says Echelle Lane Rutschman, spokeswoman for Baptist, who says the health system determines its compensation packages fairly and legally.
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