CMS Updates Guidance on Preventive Maintenance Rules
The U.S. Centers for Medicare and Medicaid Services (CMS) has announced that hospitals can stray from the manufacturer’s recommendations on preventive maintenance (PM) frequency for some medical equipment.
Such latitude, however, is not granted for critical equipment—such as life-support, key resuscitation devices, and radiological imaging equipment—which must be serviced according to the manufacturer’s PM schedule, as stated in the Dec. 2 memorandum from the agency. In addition, CMS said the manufacturer's recommended PM frequency must be followed for “any new equipment until a sufficient amount of maintenance history has been acquired.”
The memo, distributed to state survey agency directors, is described as a “clarification of hospital equipment maintenance requirements” and comes more than a year after The Joint Commission (TJC), the largest healthcare accrediting organization in the country, had announced that a change was coming. At that time, TJC said that it had persuaded CMS to grant healthcare facilities more latitude in setting PM strategies. The new guidance from CMS appears to be more nuanced and restrictive than what TJC initially described.
According to CMS, biomeds and clinical engineers can adjust the PM schedule for noncritical equipment by using strategies such as reliability-centered or metered maintenance. But the hospital must create an evidence-based assessment that shows “the frequency adjustment will not adversely affect patient or staff health and safety.”
The updated guidance, which is now in effect, comes some 18 months after TJC began telling professionals in the healthcare technology community that CMS would allow alternate equipment maintenance schedules—beyond those set by the manufacturer. TJC officials said they had encouraged CMS to let departments determine the PM frequency for devices through a combination of strategies.
Some in the healthcare technology management community said they were disappointed the position requires abiding by solely the manufacturer’s recommendations for some devices.
“Repeatedly, data presented at professional meetings has demonstrated the relationships between scheduled maintenance and other maintenance strategies, and the opportunity to positively impact both the cost and safety for our patients,” Chris Nowak, corporate director of clinical engineering services and healthcare technology management integration from Universal Health Services in King of Prussia, PA, wrote on AAMI’s LinkedIn group. “Hopefully, our professional community with try to work with CMS and manufacturers, and provide them with a clearer understanding of valid maintenance strategies other than manufacturer recommended procedures.”
Others were more optimistic about the updated guidance. Mark Newell, regional director of clinical engineering at Trinity Health in Chicago, said in an interview that the ruling is a “step in the right direction.”
He said he was pleased that CMS said departments must use the manufacturer’s testing methods and techniques to perform the PM for all devices.
“If I can change intervals on something that never fails, great,” he said. “If I did have to do the PM though, I check performance as per the manufacturer’s instructions.”
To read the memorandum, click here (PDF).