As case managers we must be aware of the myriad of compliance issues that we must adhere to in our daily practice. Never has this been more important to our work as case managers then it is now. Our ability to remain compliant has become an element of audits from accrediting bodies such as the Joint Commission as well as the Centers for Medicare and Medicaid Services (CMS). It is the right thing to do for patients as well.
This program will review the compliance issues that most greatly impact your practice such as the 2-midnight Rule, the NOTICE Act, HINNs, The Important Message and others. The Joint Commission is now monitoring these issues when they have deemed status from Medicare, so your compliance is critical to a good Joint Commission survey outcome. This program will help you to identify where you may have compliance practice gaps as well as how to fix them!
WHY SHOULD YOU ATTEND?
Case managers and social workers need to maintain compliance in a number of areas directly related to utilization management and discharge planning. Both the Joint Commission (and other regulatory bodies) as well as the Centers for Medicare and Medicaid Services (CMS) are auditing hospitals and case management departments for compliance with the Conditions of Participation as well as other regulatory requirements. Every case management professional needs to know how these requirements impact their professional practice.
AREA COVERED
- Compliance overview for case managers
- Balancing quality and cost
- The Conditions of Participation
- Compliance at the 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
- Compliant UR Committee
LEARNING OBJECTIVES
- Understand the compliance issues required under the Conditions of Participation for Utilization Management and Discharge Planning.
- Describe your responsibilities as they relate to Observation and the 2-Midnight Rule.
- Your requirements to be compliant with the Important Message from Medicare.
- Explain how the patient choice lists are used.
- Understand the different types of HINNs and when they should be given.
- 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
Case managers and social workers need to maintain compliance in a number of areas directly related to utilization management and discharge planning. Both the Joint Commission (and other regulatory bodies) as well as the Centers for Medicare and Medicaid Services (CMS) are auditing hospitals and case management departments for compliance with the Conditions of Participation as well as other regulatory requirements. Every case management professional needs to know how these requirements impact their professional practice.
- Compliance overview for case managers
- Balancing quality and cost
- The Conditions of Participation
- Compliance at the 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
- Compliant UR Committee
- Understand the compliance issues required under the Conditions of Participation for Utilization Management and Discharge Planning.
- Describe your responsibilities as they relate to Observation and the 2-Midnight Rule.
- Your requirements to be compliant with the Important Message from Medicare.
- Explain how the patient choice lists are used.
- Understand the different types of HINNs and when they should be given.
- 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
Speaker Profile
Toni G. Cesta, Ph.D., RN, FAAN is Partner and Health Care Consultant in Case Management Concepts, LLC, a consulting company which assists institutions in designing, implementing and evaluating acute care and community case management models, educating case management professionals and assisting in implementation of case management departmental changes. The author of nine books, and a frequently sought after speaker, lecturer and consultant, Dr. Cesta is considered one of the primary thought leaders in the field of case management. Dr. Cesta writes a monthly column called “Case Management Insider” in the Hospital Case Management journal in which she shares insights and …
Upcoming Webinars
Understanding the Artificial Intelligence Landscape
Holiday Stress and Loss: The Art of Stress Resilience in E…
Establishing Appropriate Quality Metrics and Key Performanc…
Is Your Culture Working For or Against Your Success? If You…
Ultimate Persuasion Strategies! - Secret Influence Tools & …
Using High-Performance Coaching for Managers to Address Per…
Excel - 10 Key Worksheet Functions to Skyrocket Your Produc…
OSHA Requirements for Supervisors, Project Leaders & HR - W…
Utilizing HR Metrics to Illustrate & Improve Human Resource…
Red flags that can render your OSHA Safety Program Complete…
The Human Element of Leadership in the Hybrid Work Experien…
Transform Data into Insights: A Beginners Guide to Excel Pi…
What If Analysis Tools in Excel: Goal Seek, Solver, and Dat…
Project Management for administrative professionals
How to Navigate Political Speech in the Workplace
How to Prepare For and Host a FDA Inspection and Respond to…
Mastering Year-End Payroll and Tax Compliance for 2024
Eliminate Harmful And Unproductive Drama In The Workplace
3-Hour Virtual Seminar on Chat GPT for Project Management i…
The Anti-Kickback Statute: Enforcement and Recent Updates
Excel - Pivot Tables - The Key To Modern Data Analysis and …
FDA Technology Modernization Action Plan (TMAP) and Impact …
5 Key Components of Good Manufacturing Practices to obtain …
Team Synergy: How to Harness Collective Intelligence to Max…
Successful Strategies for FDA Expedited Pathways for Your D…
The Power Of Trust In The Workplace- Improving Your Career …
Managing Toxic & Other Employees Who Have Attitude Issues
Protect Your Company With The End of the Year HR Checklist
Do's and Don'ts of Giving Effective Feedback for Performanc…
So, You’re Now the “Boss”: Essential Skills to Succeed as a…
Onboarding is NOT Orientation - How to Improve the New Empl…
Construction Lending And Real Credit Administration: Evalua…
2-Hour Virtual Seminar on the 6 Most Common Problems in FDA…
Improving Employee Engagement & Retention Through Stay Inte…
Building GMP Excellence: A Guide to Implementing Compliant …
4-Hour Virtual Seminar on Transformational Leadership - The…
Use the power of AI to turbocharge your MS Excel
Understanding cognitive load in medical device design
Human Error Reduction Techniques for Floor Supervisors
Excel Power Skills: Master Functions, Formulas, and Macros …