The Centers for Medicare & Medicaid Services (CMS) made a change in 2019 which states that healthy outpatients may not be required to have a full history and physical. This session will explain how to implement this new rule and will discuss what is required to be in the policy, medical staff and board approval, revised medical staff bylaws, and more.
This program will also cover what is required to be in the history and physical and how to meet compliance with the CMS hospital Conditions of Participation (CoPs) as well as the Joint Commission (TJC) and DNV standards, which will briefly be discussed. CMS has five separate sections that address history and physicals for acute and Critical Access Hospitals.
Hospitals need to ensure that hospital policies and procedures meet the history and physical requirements. Medical staff bylaws must also comply with the regulations and interpretive guidelines and standards.
Finally, this session will cover history and physical deficiencies cited by CMS, and common deficiencies will show what CMS identifies during a medical record review.
Laura A. Dixon, BS, JD, RN, CPHRM
Laura A. Dixon served as the director of risk management and patient safety for the Colorado Region of Kaiser Permanente. Prior to joining Kaiser, she served as the director, facility patient safety and risk management and operations for COPIC from 2014 to 2020. In her role, she provided patient safety and risk management consultation and training to facilities, practitioners, and staff in multiple states.
Dixon has more than 20 years of clinical experience in acute care facilities, including critical care, coronary care, peri-operative services, and pain management. Prior to joining COPIC, she served as the director, Western region, patient safety and risk management for The Doctors Company in Napa, California. In this capacity, she provided patient safety and risk management consultation to the physicians and staff for the western United States
As a registered nurse and attorney, Dixon holds a Bachelor of Science degree from Regis University, RECEP of Denver, a Doctor of Jurisprudence degree from Drake University College of Law, Des Moines, Iowa, and a Registered Nurse Diploma from Saint Luke’s School Professional Nursing, Cedar Rapids, Iowa. She is licensed to practice law in Colorado and California.
At the conclusion of this session, participants should be able to:
Recall that CMS has history and physical requirements in the hospital CoPs that all hospitals that accept Medicare must follow.
Identify TJC and DNV standards of history and physicals.
Describe that the hospital must have medical staff bylaws and policies that include the requirements for history and physicals.
Discuss what hospitals must do to implement the new rule that history and physicals do not need to be done on healthy outpatients.
The Georgia Hospital Association Research & Education Foundation is an approved provider of nursing home administrator credits as a professional trade association in long term care under Ga. Comp. R. & Regs. 393-13-.02, (1) (a). Approved for 2 contact hours.
By attending History and Physicals: Meeting Hospital CoPs in 2024 Webinar offered by Georgia Hospital Association, participants may earn up to 2 ACHE Qualifying Education Hours toward initial certification or recertification of the Fellow of the American College of Healthcare Executives (FACHE) designation. Attendees who wish to have the hours applied toward ACHE Qualifying Education credit must self-report their participation by logging into their MyACHE account and selecting ACHE Qualifying Education Credit.