Compliance is now a regular part of Joint Commission and CMS audits, and it matters for patients too. This case management compliance webinar reviews the rules that most affect daily utilization management and discharge planning.
You'll cover the Conditions of Participation, compliance at access points, the 2-Midnight Rule and observation, the NOTICE Act, the Important Message from Medicare, HINNs and changes in patient choice. The Joint Commission monitors these issues for deemed-status hospitals, so they affect your survey results.
The session also covers balancing quality and cost, documenting for compliance, running a compliant UR committee and performing a gap analysis to find and fix compliance gaps.
WHY SHOULD YOU ATTEND?
The Joint Commission, other regulators and CMS are auditing hospitals and case management departments against the Conditions of Participation and other requirements. Every case management professional needs to know how these rules affect their practice.
The session suits directors of case management, quality and social work, compliance officers, RN case managers, social workers, hospitalists and physician advisors.
AREA COVERED
- Compliance overview for case managers
- Balancing quality and cost
- The Conditions of Participation
- Compliance at access points
- The 2-Midnight Rule and observation
- The NOTICE Act
- The Important Message from Medicare
- The HINN
- Changes in patient choice
- Utilization management and compliance
- Documenting for compliance
- How to perform a compliance gap analysis
- A compliant UR committee
LEARNING OBJECTIVES
- Explain Conditions of Participation requirements for utilization management and discharge planning
- Describe your responsibilities for observation and the 2-Midnight Rule
- Meet the requirements for the Important Message from Medicare
- Explain how patient choice lists are used
- Identify the types of HINNs and when to issue each
- Document for compliance
WHO WILL BENEFIT?
- Director of Case Management
- Compliance Officer
- RN Case Managers
- Director of Quality Management
- Director of Social Work
- Social Workers
- Hospitalists
- Physician Advisor
The Joint Commission, other regulators and CMS are auditing hospitals and case management departments against the Conditions of Participation and other requirements. Every case management professional needs to know how these rules affect their practice.
The session suits directors of case management, quality and social work, compliance officers, RN case managers, social workers, hospitalists and physician advisors.
- Compliance overview for case managers
- Balancing quality and cost
- The Conditions of Participation
- Compliance at access points
- The 2-Midnight Rule and observation
- The NOTICE Act
- The Important Message from Medicare
- The HINN
- Changes in patient choice
- Utilization management and compliance
- Documenting for compliance
- How to perform a compliance gap analysis
- A compliant UR committee
- Explain Conditions of Participation requirements for utilization management and discharge planning
- Describe your responsibilities for observation and the 2-Midnight Rule
- Meet the requirements for the Important Message from Medicare
- Explain how patient choice lists are used
- Identify the types of HINNs and when to issue each
- Document for compliance
- Director of Case Management
- Compliance Officer
- RN Case Managers
- Director of Quality Management
- Director of Social Work
- Social Workers
- Hospitalists
- Physician Advisor