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Additional Clarification Written on Medication Delivery Issue

April 3, 2009

Last fall, the AARC issued a position statement on the delivery of respiratory medications to address a problem some departments in North Carolina were having with state hospital regulators. While that position statement did help ease the situation, the NC Society for Respiratory Care has issued further clarification in a document now posted on their website.

The original issue had to do with concerns about medication delivery and the need for a longer window of administration for inhaled respiratory medications. Some state surveyors questioned the practice of allowing for this longer time period despite written hospital policies that permitted it. AARC and NCSRC officials began researching, working with CMS, and drafting a clarification for hospital regulators there.

CMS said that an established position by a national association such as the AARC could be used as a benchmark in this case, and subsequently the position statement was approved by the AARC and its Board of Medical Advisors last year.

Now continued questions over the policy have prompted more reaction from the NCSRC. Terry Smith, president of the North Carolina Society for Respiratory Care, has posted the clarification document on the NCSRC web site, providing additional background and the issue paper that went to CMS.  Also attached are the AARC position statement and a list of the organizations that comprise BOMA. 

In that paper he states, “Some hospitals may continue to have problems.  Remember though, first and foremost, the conditions require a hospital to have a sufficient number of respiratory therapists to carry out their responsibilities and medications must always be administered in compliance with the physician’s order.  Using the extended delivery time of up to 60 minutes cannot be viewed as a way to accommodate inefficiencies in the hospital.”

He suggests that if your hospital still has questions about how surveyors are interpreting the position statement, you can find the survey and certification staff in the regional office that deals with your state on the Centers for Medicare & Medicaid Services web site.

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