John BethuneOne of the best bits of news for hardworking and frustrated healthcare technology management professionals this fall was the CMS about-face on power strips. As you can read in our news summary, the agency announced on October 5 that requiring healthcare providers to comply with its originally planned restrictions on power strip use would impose unreasonable hardships on facilities. Now, CMS says, facilities can instead simply document that they are electing to use a new CMS waiver from the requirements.

In a way, it would be unfair to say that CMS has changed its mind, since so far as I know, the agency never actually made a previous public statement of its intent regarding power strips. Our insight into what CMS had planned came from a statement made by George Mills, director of engineering for The Joint Commission, at a talk he gave at the AAMI annual meeting on June 1. Mills told his listeners that CMS had informed him that power strips—or, to use the more specific terminology, relocatable power taps—would no longer be sanctioned for use with medical equipment in patient care areas.

I was in the audience for that announcement, and can attest that the room went very quiet on hearing the news. The response to our online story covering the news later that day also underscores just how dramatic this turn of events was: It received the most page views in the history of our website.

Because of the level of interest in this topic, it’s appropriate to provide the CMS summary of its new waiver policy here (and if you haven’t read it yet, here’s your opportunity!):

Categorical Waiver: CMS has determined that the 2000 edition of the National Fire Protection Association (NFPA) 101® Life Safety Code (LSC) contains provisions on the use of power strips in health care facilities that may result in unreasonable hardship for providers or suppliers. Further, an adequate alternative level of protection may be achieved by compliance with the 2012 edition of the LSC, which has extended allowances on the use of power strips in patient care areas.

CMS is permitting a categorical waiver to allow for the use of power strips in existing and new health care facility patient care areas, if the provider/supplier is in compliance with all applicable 2012 LSC power strip requirements and with all other 2000 LSC electrical system and equipment provisions.

Resident rooms in long-term care or other residential care facilities that do not use line-operated electrical appliances for diagnostic, therapeutic, or monitoring purposes are not subject to the more restrictive NFPA 99 requirements regarding the use of power strips in patient care areas/rooms. Resident rooms using line-operated patient care-related electrical equipment in the patient care vicinity must comply with the NFPA 99 power strip requirement and may elect to utilize this categorical waiver.

Individual waiver applications are not required: Providers and suppliers are expected to have written documentation that they have elected to use the waiver. A provider or supplier must notify the LSC survey team at the entrance conference that it has elected the use the waiver permitted under this guidance and that it meets the applicable waiver requirements. The survey team will review the information and confirm the facility meets the conditions for the waiver.

One of the curious aspects of this waiver policy to me, as a lay observer, is that facilities should need a waiver to use a much more up-to-date set of standards. I have no doubt that there is a legitimate reason for this strange situation. But as a patient, which standards would you rather have your healthcare facility follow—the Life Safety Code from 2000, or the one from 2012?

At least there is a positive aspect to this tortuous process of rule-setting that CMS and The Joint Commission go through: power strips are now top-of-mind for biomeds, and we can expect more attention will be paid to where and how these useful but potentially dangerous devices are deployed.

These are just a couple of the issues we’ll be looking at next month when we publish a feature story on power strip safety and the events that led to this CMS announcement. Stay tuned!