History and Physicals: Meeting Hospital CoPs in 2026 (W6030)-History and Physicals Meeting Hospital CoPs in 2026 Recording

Video Transcription

Video Summary

The speaker, Laura Dixon, explained CMS requirements for history and physicals (H&Ps) in hospitals and critical access hospitals, focusing on compliance, patient safety, and survey risk. She outlined when an H&P is required, including before surgery or procedures requiring anesthesia, and emphasized timing rules: within 24 hours of admission and no older than 30 days, with a day-of-surgery update required. She discussed who may perform H&Ps, noting that state law and hospital bylaws govern delegation to physicians, PAs, NPs, and other qualified practitioners.<br /><br />Laura also covered CMS’s outpatient “assessment instead of full H&P” option for certain healthy outpatients, stressing that hospitals must create a governing-board-approved policy defining eligible patients and procedures. She warned that if a patient’s condition changes, or if they are admitted after an outpatient procedure, a full H&P may then be required. She shared CMS survey trends, common deficiencies, and examples showing how missing or outdated H&Ps can lead to citations, immediate jeopardy, or even termination from Medicare/Medicaid agreements.<br /><br />Finally, she urged staff to treat missing H&Ps as a hard stop, build strong QAPI monitoring, and ensure policies, bylaws, and documentation align with federal and state requirements.

Keywords

CMS H&P requirements

history and physical

hospital compliance

patient safety

critical access hospitals

outpatient assessment

survey deficiencies

QAPI monitoring

Medicare Medicaid citations