HACP-CMS Study Guide
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| What are the options when it comes to Medicare certification? | 1. A hospital can be directly certified by Medicare
2. A hospital can be accredited by a deemed-status provider
3. A hospital can forgo Medicare certification entirely
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| What are 2 roles of the State Enforcement Agency (SA)? | 1. Investigating complaints about hospitals and alleged violations of patient rights or other CoP
2. Conducting full validation surveys of hospital's compliance to the CoP
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| Who is the SA? | Usually the Department of Health or similar body
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| What are 2 other roles of SA? | 1. Issuing reports of findings and monitoring corrective action plans
2. Recommending to CMS potential termination of a hospital's ability to participate in Medicare payment programs
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| What is a CCN? | Unique hospital certification number assigned to each hospital that is used by the hospital for any service under which Medicare is billed.
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| CMS responsibility when Medicare is billed for services using the assigned CCN? | CMS will assess a hospital's compliance with the CoP for all services, areas, and locations in which the hospital receives reimbursement for patient care services billed under its CCN
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| Survey Team | Consists of 1 RN with hospital survey experience and other surveyors who have the expertise needed to determine whether the facility is in compliance.
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| Survey team size and composition factors? |
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Created by:
mannahne