2013 CMS Jul 11 Enduring
Self Study Course Description
CMS Grievances and TJC Complaints
Sue Dill Calloway, RN, MSN, JD, CPHRM, CCMSCP
President, Patient Safety Education and Consulting
Type of Activity: Enduring Event/Web-Based Training
Release Date: July 12, 2013
Expiration Date: May 30, 2014
Estimated Time to Complete Course: 1.5 hours
There is no fee associated with this educational activity.
Target Audience: Physicians, Nurses, Administrators, QM Staff, Risk Managers, and other interested Health Care Providers
Most every hospital in the US accepts Medicare and Medicaid reimbursement and as such hospitals must be in compliance with the CMS Conditions of Participation (CoPs). This program will cover in detail the CMS requirements for hospitals if they receive a grievance.
The CMS grievance requirements are a frequent source of investigation. Many hospitals are surprised at the number of regulations and the detailed requirements to comply with this problematic standard.
This program will also discuss the Joint Commission 2013 standard on complaints and how this correlates to the CMS grievance interpretive guidelines. This is a must attend for any hospital. Staff should be aware and follow the hospital grievance and complaint policy. The policy should be approved by the board. Staff should be educated on the policy. This program will cover what is now required to be documented in the medical record.
This program will also discuss the AHRQ proposed consumer reporting system for patient safety events. AHRQ asked the Office of Budget Management to approve a proposal to test the prototype consumer reporting system for patient safety events. This included a proposal to collect information voluntarily from patients, consumers, family members and others via the internet or telephone. How this could impact the area of grievances and complaints and the role of the consumer advocate will be discussed.
After completing this activity, the participants will be able to:
1. Discuss how any hospital that receives reimbursement for Medicare patients must follow the CMS Conditions of Participation on grievances. (This is true whether the hospital is accredited by Joint Commission, AOA, DNV Healthcare or not).
2. Identify that the CMS regulations under grievances includes the requirement to have a grievance committee.
3. Discuss that the Joint Commission has complaint standards in the patient’s right (RI) chapter.
4. Recall that in most cases the patient must be provided with a written notice that includes steps taken to investigate the grievance, the results, and the date of completion.
5. Recall that AHRQ is proposing a consumer reporting system for patient safety events.
Criteria for Successful Completion
• Registration is required for verification of attendance.
• Attend the webinar in its entirety.
• Complete the web-based Course Evaluation.
• Complete the online Post-Test with a passing score of 75%.
• CSC will send you a CE Certificate upon successful completion. Note: you will be notified to retake the post-test if your score is below 75%.
Accreditation: The Indian Health Service (IHS) Clinical Support Center is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians. The IHS Clinical Support Center designates this enduring educational activity for 1 hour of AMA PRA Category 1 Credit™ for each hour of participation. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The Indian Health Service Clinical Support Center is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
This activity is designated 1.5 contact hours for nurses.
Accreditation applies solely to this educational activity and does not imply approval or endorsement of any commercial product, services or processes by the CSC, IHS, the federal government, or the accrediting bodies
Faculty Disclosure Statement: As a provider accredited by ACCME, ANCC, and ACPE, the IHS Clinical Support Center must ensure balance, independence, objectivity, and scientific rigor in its educational activities. Course directors/coordinators, planning committee members, faculty, and all others who are in a position to control the content of this educational activity are required to disclose all relevant financial relationships with any commercial interest related to the subject matter of the educational activity. Safeguards against commercial bias have been put in place. Faculty will also disclose any off-label and/or investigational use of pharmaceuticals or instruments discussed in their presentation. The course directors/coordinators, planning committee members, and faculty for this activity have completed the disclosure process and have indicated that they do not have any significant financial relationships or affiliations with any manufacturers or commercial products to disclose. There is no commercial or non-commercial company financial support for this educational activity.
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