T141205 - 12-05-14 - CMS Requirements on Order Sets ...
CMS Requirements on Order Sets, Protocols, Preprinted and Standing Orders
Friday, December 5th, 2014
Speaker
Sue Dill Calloway RN, Esq. CPHRM, CCMSCP
AD, BA, BSN, MSN, JD
President of Patient Safety and Education Consulting
Board Member Emergency Medicine Patient Safety Foundation
614 791-1468 sdill1@columbus.
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Learning Objectives
1. Recall hospital compliance requirements with the CMS CoP.
2. Explain the CMS requirements for standing orders and protocols.
3. Explain new and revised standards, regulations, and laws put forth by CMS, TJC and the federal government.
4. Evaluate compliance requirements and penalties.
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You Don't Want One of These
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The Conditions of Participation (CoPs)
Many revisions since 1986
Hospital CoP Manual updated June 6, 2014
First regulations are published in the Federal Register then CMS publishes the Interpretive Guidelines and some have survey procedures 2
Hospitals should check this website once a month for changes
1 2cms.SurveyCertificationGenInfo/PMSR/list.asp
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CMS Issues Final Regulation
CMS publishes 165 page final regulations changing the CMS CoP and has section on standing orders
Moved standing orders to 457 in Medical Records which is the primary section
So now in sections 405, 406, 450, and 457
Changes effective June 7, 2013
CMS publishes to reduce the regulatory burden on hospitals-more than two dozen changes
Available at inspection.aspx
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Final IGs on Standing Orders
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Location of CMS Hospital CoP Manual
New website
cms.manuals/downloads/som107_Appendixtoc.pdf
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