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Joint Commission rolls out XR-29-esque rules today New standards require protocol, dose and benchmark changes

CMS updates maintenance directive

by Loren Bonner , DOTmed News Online Editor
After almost two years, the Centers for Medicare and Medicaid Services has spoken out about the hotly contested maintenance directive for hospital equipment.

On Dec. 23, CMS cleared up its equipment maintenance guideline and announced that it will require all medical imaging and radiation therapy equipment in hospitals to be maintained according to the manufacturer's recommended standards, while also giving health care facilities the opportunity to develop their own inspection and preventive maintenance procedures and schedules for other medical equipment.

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The Medical Imaging and Technology Alliance said the updated directive will help promote the safety of patients and equipment operators, while also preserving equipment performance and image quality.

Since 1994, the Joint Commission has consistently signed off on a risk-based process to evaluate an organization's equipment inventories, preventive maintenance strategies, and assignment of preventive maintenance frequencies.

In a story posted last year, George Mills, the Commission's director of engineering, told DOTmed News that the process is safe and reliable for both life support and non-life support equipment and that there has not been one adverse event associated with their protocol over the past 17 years.

But not everyone agrees. The American Society of Radiologic Technologists (ASRT), the Intersocietal Accreditation Commission (IAC), and the American Association of Physicists in Medicine (AAPM) and others believe that deviating from the manufacturers' recommended maintenance standards could threaten patient safety as well as put operators in harm's way.

In November, Rep. Tim Murphy (R-Pa.) and Rep. Allyson Schwartz (D-NY) sent a letter to CMS voicing their shared concerns with these provider and accreditation groups that weakening the requirement to follow manufacturers' recommended maintenance standards is unsafe.

CMS has always backed following the manufacturer's guidelines, and the agency clarified the guidelines in a December 2011 directive. This caught the attention of clinical engineering groups, such as the Association for the Advancement of Medical Instrumentation, among others. They worried that having to strictly adhere to these guidelines would require more manpower and present a financial burden on hospitals' already strained budgets.

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