CMS Recognizes RNs’ Role Beyond the Bedside


On September 30, 2019, the Centers for Medicare & Medicaid Services (CMS) published the Omnibus Burden Reduction Final Rule. This rule aims to reduce unnecessary burdens for America’s health care providers by allowing them to focus on their patients. It does so by removing Medicare regulations identified as unnecessary, obsolete, or excessively burdensome on hospitals and other health care providers.

In the Final Rule, CMS finalizes a proposal to revise the Medicare Conditions of Participation (CoPs) for nursing services. It will remove the term “bedside” from the requirement that states, “there must be supervisory and staff personnel for each department or nursing unit to ensure, when needed, the immediate availability of a registered nurse for bedside care of any patient.” ANA applauds CMS’ recognition that RNs’ scope of practice extends far beyond bedside care in the inpatient setting and that RNs perform a wide range of duties within their scope of practice. ANA also applauds CMS’ recognition that RNs care for patients in many settings, including inpatient, outpatient, and ambulatory care settings.

One such area in which RNs play a crucial role is care coordination and transitions of care. ANA has long advocated for policymakers and other health care stakeholders to recognize and expand the role of RNs in this role. ANA’s official position statement on care coordination states that, “Patient-centered care coordination is a core professional standard and competency for all registered nursing practice. Based on a partnership guided by the health care consumer’s and family’s needs and preferences, the registered nurse is integral to patient care quality, satisfaction, and the effective and efficient use of health care resources. Registered nurses are qualified and educated for the role of care coordination, especially with high risk and vulnerable populations.”

While CMS’ recognizes that RNs practice in a far wider array of settings than just direct care nursing, CMS and Congress still have a long way to go to integrate RNs within their full scope of practice. Some of the ways ANA will continue to advocate for these changes include:

  • Inserting provider neutral language and correct valuation of RN care through the Current Procedural Terminology (CPT) and Relative-Value Scale Update Committee (RUC) processes;
  • Advocating for APRNs to certify Home Health and Hospice services; and
  • Securing adequate nursing education funding to ensure a robust future nursing workforce.

ANA will continue to vigorously promote RNs’ essential role in all health care settings – not just direct care – and to advocate for RNs at all levels to be able to practice to the full scope of their education and clinical training.

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