Healthcare managers must deal with three components of healthcare delivery: access to care, quality of care and the cost of care. With the move to a value based care model from fee for service, there is a stronger connection between quality of care and payment. Organizations that accredit healthcare facilities such as The Joint Commission focus on quality standards. These organizations may also hold what is called “deemed status”. This means that the Centers for Medicare and Medicaid (CMS) will accept accreditation of a healthcare facility by an accrediting organization such as The Joint Commission as meeting the Conditions of Participation (CoPs). Healthcare organizations that meet the CoPs are eligible for reimbursement for the care of Medicare and Medicaid beneficiaries. Thus, the standards for accreditation include those that align with the CoPs. Managers must ensure that their organization meets these standards.
Prepare a PowerPoint Presentation of 12-15 slides, not including title page and reference page, with 150-300 words of speaker notes. Review the CMS Conditions of Participation for the type of health care organization that you chose in Week 1 and that you have used throughout this course.
- Identify at least two sections of the CoPs (e.g., patient rights, medical record services).
- Explain how these sections are implemented in your selected health care facility.
- Compare and discuss how these sections might be implemented differently in another type of health care facility.
- Make recommendations for how your healthcare facility could make improvements to ensure meeting the CoPs.
- In addition to the two CoPs that you have chosen, describe the Emergency Preparedness CoP, and how your health care facility will implement this standard.
You can research the CoPs for your chosen health care organization in the Code of Federal Regulations at 24CFR utilizing the links below:
- Hospitals (Part 482):
- Ambulatory Surgical Centers (ASC) (Part 416):
- Hospice (Part 418):
- Home Health Agencies (Part 484):
- Other Specialized Providers (Part 485):
Note: Use APA style to cite at least 2 scholarly sources.
Expert Solution Preview
Introduction:
The healthcare industry has undergone significant changes with the transition from fee-for-service to value-based care. Healthcare managers are now responsible for ensuring access to care, quality of care, and the cost of care in their facilities. Accrediting organizations like The Joint Commission focus on quality standards to ensure that healthcare organizations meet the Conditions of Participation (CoPs) set by the Centers for Medicare and Medicaid (CMS). In this assignment, we will prepare a PowerPoint presentation reviewing the CMS CoPs for a selected healthcare organization and identify at least two sections of the CoPs, explain how they are implemented, compare them with another healthcare facility, and make recommendations for improvement.
Answer:
The CMS CoPs are vital to healthcare organizations, and healthcare managers must ensure their facility meets them to be eligible for reimbursement for the care of Medicare and Medicaid beneficiaries. For our presentation, we selected a hospital healthcare organization and reviewed the CMS CoPs for Part 482.
Two sections of the CoPs that we identified are:
1. Patient Rights
2. Medical Record Services
Patient Rights:
Patient rights are a crucial aspect of healthcare delivery, and it’s essential to ensure that they are upheld. The hospital healthcare facility implements patient rights by displaying them in all patient rooms. They also educate patients and their families on these rights through various mediums like handouts and video presentations.
Comparison:
A hospice organization has unique patient rights since patients are at the end of their life. The hospice organization must provide patients with care that is respectful and understanding of their cultural, psychosocial, and religious preferences. Hospice organizations also have specific family rights, including the right to participate in care planning and make decisions concerning patient care.
Recommendations:
To improve patient rights, the hospital healthcare organization should ensure that access to the patient rights information is available in different languages, particularly in areas where patients from non-English speaking backgrounds frequent. The organization should involve the patients in care planning and decision-making processes to ensure that their preferences are met.
Medical Record Services:
Medical record services require that healthcare organizations maintain accurate and complete patient records. The hospital healthcare organization ensures this by using electronic health records (EHRs) that are easy to access and navigate. They also have a designated team responsible for updating patient information systems regularly.
Comparison:
Home health agencies are different, and patient records must include notes on the patient’s surroundings, including home conditions and other factors that may affect their care. Hospice organizations also have specific medical record services to keep track of the patient’s end-of-life care.
Recommendations:
The hospital healthcare organization could adopt the use of telehealth to improve the completeness of medical records while making the service more convenient for patients. The organization could also implement an alert system that reminds providers to update medical records regularly.
Emergency Preparedness CoP:
The hospital healthcare organization will implement the Emergency Preparedness CoP through regular emergency response training for all staff. The training will involve evacuating patients safely and promptly, preparing emergency kits, and having protocols that address emergencies. Regular emergency drills will be conducted to ensure that staff knows what to do in an emergency.
Conclusion:
Ensuring that a healthcare organization meets CMS CoPs is vital for its success in delivering quality care. Healthcare managers must identify, implement, and recommend measures to improve areas of their facility that may not align with the CoPs. Our presentation highlighted patient rights, medical record services, and emergency preparedness CoPs, providing insights into how healthcare organizations can comply with these regulations and improve healthcare services delivery.
