Decode CMS CoPs Rules and Compliance Requirements for Physicians and Hospitals - Part 1

Course Description:

This webinar is designed for healthcare professionals seeking an intermediate-level understanding of the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoPs) for hospitals. The presentation aims to provide a comprehensive overview of the CMS survey process, focusing on recent updates and essential requirements to ensure hospital compliance and quality care delivery.

The session begins with an introduction to the CMS survey process, outlining the general information and the importance of the CoP manual. Participants will learn how to locate the current CMS CoP manual and understand its critical components. The webinar will delve into hospital deficiency reports and recent CMS Survey Memos of interest, highlighting key areas where hospitals often fall short and the corrective actions required.

A significant part of the presentation will cover the integration of emergency services into hospital operations. This section will emphasize the need for appropriate policies and procedures, the role of a qualified registered nurse (RN) in patient assessment, and the basic patient care requirements that must be met. The discussion will also include the necessity of having a qualified medical director, the standards of practice to be followed, and the training required for staff to comply with emergency services standards.

Outpatient services are another crucial aspect of CMS CoPs. The webinar will address the essential policies and procedures, the importance of meeting patient needs, and the documentation of care provided in outpatient departments. It will also cover the role and responsibilities of department directors in ensuring compliance with CMS requirements.

Compliance with laws, including the Office for Civil Rights (OCR) 1557, will be discussed, emphasizing non-discrimination and the provision of interpreters. The session will also highlight CMS required education, survey protocols, and the significance of discharge planning in the broader context of hospital operations.

Learning Objectives:

Understand the CMS survey process and how to navigate the CoP manual
Identify key components and requirements of recent CMS Survey Memos
Integrate emergency services effectively into hospital operations
Develop and implement policies and procedures for outpatient services
Ensure compliance with laws, including OCR 1557, regarding non-discrimination
Understand the role of interpreters in compliance with OCR 1557
Highlight the importance of CMS required education for hospital staff
Discuss the significance of discharge planning in patient care
Utilize hospital deficiency reports to improve compliance and quality
Apply QAPI Interpretive Guidelines to enhance hospital performance

Areas Covered in the Session:

Overview of the CMS Survey Process and Introduction
General information and location of the manual
Hospital deficiency reports
Memos of interest to hospitals
QAPI Interpretive Guidelines
Texting of orders
Discharge Planning
Compliance with laws
Non-Discrimination, Interpreters and Section 1557 ACA
CMS required education
Survey protocols
Survey team Emergency Services
Need for P&P
Qualified RN to assess patients
Basic patient care requirements
Services must meet patient needs
Following standards of practice
Integrated into hospital PI
Qualified medical director
Policies required
Training required
Urgent care clinics Outpatient Services
Policies and procedures
Meeting needs of patients
Outpatient orders
Documentation of care given in the OP department
Orders required
Department director job description and responsibilities
Live Q&A Session

Suggested Attendees:

Healthcare CEO
Healthcare COO
Chief Nursing Officer
Chief Medical Officer
Quality Managers
Consumer Advocate
Nurse Educators
Department Directors
All Nurses
Risk Managers
Compliance Officers
Director of Health Information
Case Managers
Pharmacists
Social Workers
Discharge Planners

About the Presenter:

Laura A. Dixon recently served as the Regional Director of Risk Management and Patient Safety for Kaiser Permanente Colorado where she provided consultation and resources to clinical staff. Prior to joining Kaiser, she served as the Director, Facility Patient Safety and Risk Management and Operations for COPIC from 2014 to 2020. In her role, Ms. Dixon provided patient safety and risk management consultation and training to facilities, practitioners, and staff in multiple states. Such services included creation of and presentations on risk management topics, assessment of healthcare facilities; and development of programs and compilation of reference materials that complement physician-oriented products. Prior to joining COPIC, she served as the Director, Western Region, Patient Safety and Risk Management for The Doctors Company, Napa, California. In this capacity, she provided patient safety and risk management consultation to the physicians and staff for the western United States. Ms. Dixon’s legal experience includes medical malpractice insurance defense and representation of nurses before the Colorado Board of Nursing. Ms. Dixon has more than twenty years of clinical experience in acute care facilities, including critical care, coronary care, peri-operative services, and pain management. As a registered nurse and attorney, Laura holds a Bachelor of Science degree from Regis University, RECEP of Denver, a Doctor of Jurisprudence degree from Drake University College of Law, Des Moines, Iowa, and a Registered Nurse Diploma from Saint Luke’s School Professional Nursing, Cedar Rapids, Iowa. She is licensed to practice law in Colorado and California.

Additional Information:

After Registration: You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.

System Requirement:

Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to talk and hear clearly

Can’t Listen Live?

No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience. For more information, you can reach out to the below contact:
Toll-Free No: 1-302-444-0162
Email: care@skillacquire.com

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