On Sep. 30, 2019, the Centers for Medicare & Medicaid Services (CMS) published the final rule Medicare and Medicaid Programs; Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction Final Rule, which revised the regulatory requirements for hospitals related to infection prevention and control, and antibiotic stewardship programs. On July 6, CMS made conforming revisions to the interpretive guidelines and issued S&C Letter QSO-22-20-Hospitals. Specifically, the letter emphasizes the role of the environment as being increasingly recognized. In A-tag A-0750 of the guidance, CMS requires that hospitals: 

  • Provide and maintain a clean and sanitary environment to avoid sources and transmission of infections and communicable diseases. All areas of the hospital must be clean and sanitary. 
  • Have water management policies and procedures to reduce the risk of growth and spread of Legionella and other opportunistic pathogens in building water systems and should consider implementing a water management program. 
  • Conduct surveillance on a hospital-wide basis in order to identify infectious risks or communicable disease problems at any particular location. 
  • Know how to recognize and contain infectious disease outbreaks. 

For additional information, access the S&C Letter at the CMS webpage on Infection Prevention and Control and Antibiotic Stewardship Program Interpretive Guidance Update.