Offered Through Partnership with Georgia Hospital Association

OVERVIEW
This program will cover the CMS grievance requirements, which has been identified as the third most common problematic standard for hospitals and a frequent cause of investigation.

The webinar will review the nondiscriminatory provision of the Affordable Care Act (Section 1557) that is enforced by the Office of Civil Rights (OCR). Section 1557 requires a hospital to have a grievance procedure; a compliance coordinator to investigate any alleged noncompliance, including discrimination; and a process to promptly resolve grievances. This program will also discuss the Joint Commission standards on complaints and DNV Healthcare on grievances and how they interface with the CMS interpretive guidelines.

LEARNING OBJECTIVES
By the end of this presentation, learners should be able to:

• Discuss that any hospital that receives reimbursement for Medicare patients must follow the CMS Conditions of Participation on grievances. (This is true whether or not the hospital is accredited by Joint Commission, HCFA, CIHQ, DNV Health care).
• Identify that the CMS regulations under grievances includes the requirement to have a grievance committee.
• Discuss that the Joint Commission has complaint standards in the patient rights (RI) chapter and DNV grievance standard in the patient rights chapter.
• Recall that in most cases the patient must be provided with a written notice that includes steps taken to investigate the grievance, the results, and the date of completion.
• Describe that the Office of Civil Rights requires hospitals to have a process to handle grievances related to discrimination under Section 1557.

SPEAKER: Sue Dill Calloway
Sue Dill Calloway is president of Patient Safety and Healthcare Consulting and Education Company, where she focuses on medical legal education, especially Joint Commission and the CMS hospital CoPs regulatory compliance. She also lectures on legal, risk management and patient safety issues. Previously, Sue was a director for risk management and patient safety for the Doctors Company. She was the VP of legal services at a community hospital and served as the privacy officer and the compliance officer. She was also a medical malpractice defense attorney for 10 years and has three nursing degrees in addition to a law degree. She is a well-known lecturer and the first in the country to be a certified professional in CMS. She has written 102 books and thousands of articles.