NIAHO Hospital Accreditation Standards Available from DNV

As those who work to ensure hospital accreditation status know, a new player has recently entered the marketplace. DNV’s NIAHO accreditation program is the only US CMS approved program that accredits annually and integrates ISO 9001 with Medicare Conditions of Participation.

If you’d like to know more about this program, DNV is currently making their hospital standards and interpretive guidlines available for free through their web site.  Registration is required.

Hospital Acquired Conditions List – Reduced CMS Reimbursement 10/1/08

Full list of Hospital Acquired Conditions that qualify for reduced CMS reimbursement as of October 1, 2008:

CMS Hospital Acquired Condition List
Administration of Incompatible Blood
Air Embolism
Catheter Associated Urinary Tract Infection
Deep Vein Thrombosis Following Hip Replacement
Deep Vein Thrombosis Following Knee Replacement
Falls & Trauma – Burns
Falls & Trauma – Crushing injuries
Falls & Trauma – Dislocations
Falls & Trauma – Electrical Shock
Falls & Trauma – Fractures
Falls & Trauma – Intracranial Injuries
Manifestation of Poor Glycemic Control – Diabetic Ketoacidosis
Manifestation of Poor Glycemic Control – Hypoglycemic Coma
Manifestation of Poor Glycemic Control – Nonketotic Hyperosmolar Coma
Manifestation of Poor Glycemic Control – Secondary Diabetes with Hyperosmolarity
Manifestation of Poor Glycemic Control – Secondary Diabetes with Ketoacidosis
Pressure Ulcer – Stage III or IV
Pulmonary Embolism Following Hip Replacement
Pulmonary Embolism Following Knee Replacement
Surgical Site Infection – Mediastinitis after CABG
Surgical Site Infection Bariatric Surgery – Gastroenterostomy
Surgical Site infection Bariatric Surgery – Laparoscopic Gastric Bypass
Surgical Site Infection Bariatric Surgery – Laparoscopic Gastric Restrictive Surgery
Surgical Site Infection Orthopaedic Surgery – Elbow
Surgical Site Infection Orthopaedic Surgery – Neck
Surgical Site Infection Orthopaedic Surgery – Shoulder
Surgical Site infection Orthopaedic Surgery – Spine
Unanticipated Retained Foreign Body After Surgery
Vascular Catheter Associated Infection

Source:  http://www.cms.hhs.gov/HospitalAcqCond/06_Hospital-Acquired_Conditions.asp

Deaf Patient Receives $400,000 Jury Award for Denial of Interpreter

A New Jersey jury’s $400,000 verdict for a deaf patient whose doctor refused her an interpreter may be a wake-up call for all professionals — including lawyers — that they risk liability for disability discrimination. Worse, malpractice liability insurance does not usually cover such liability.

Irma Gerena claimed she repeatedly asked Jersey City rheumatologist Robert Fogari to hire an American Sign Language interpreter. Fogari said that as a solo practitioner, he couldn’t afford the estimated $150 to $200 per visit an interpreter would cost.

Read the rest from Law.com

Gearing Up for the CMS Reimbursement Changes

Guest Post by Dr. McIntosh, Vice President and Chief Medical Science & Technology Officer at

Cook Group

With the Oct. 1 CMS reimbursement rule upon us, the healthcare industry is increasing its efforts to highlight best practices and medical device innovations to reduce, if not eliminate, the conditions outlined as non-reimbursable. Some of these conditions include hospital-acquired infections (HAIs), which account for an estimated 1.7 million infections in the U.S and approximately 100,000 associated deaths each year, according to the Centers for Disease Control and Prevention (CDC).

In response to the staggering rates of HAI occurrences and the CMS updates, a variety of organizations, including the CDC and National Quality Forum (NQF), have put forth guidelines and campaigns designed to assist hospitals and medical centers in reducing infection rates. To date, these initiatives have significantly reduced the national infection rates. These recommendations include:

- Increasing hand washing before and after contact with each patient;

- Changing gloves when moving from a contaminated site to a clean site on the same patient;

- Using full barrier sterile precautions when inserting devices such as chest tubes and central venous catheters (CVC), including wearing a cap, mask, sterile gown, sterile gloves and using a large area drape that extends well beyond the working field;

- Utilizing chlorhexidine for skin preparation; and,

- Employing a five-item checklist for patients who receive fluids and medications to assure that proper procedures were taken to reduce bacteria colonization.

The CDC guidelines also make very specific recommendations for patient care, especially in regards to medical device insertion practices and procedures. CVCs are one of the most common indwelling medical devices. Infections caused by bacteria that enter a patient’s bloodstream through improper CVC maintenance and insertion are called catheter-related bloodstream infections (CRBSIs) and are the second-leading cause of death associated with HAIs, behind pneumonia. In fact, according to research conducted by John Hopkins Medical Institution, CRBSIs are responsible for as many as 28,000 patient deaths in the U.S. each year.

Innovations in the medical device industry, such as advanced catheters impregnated with the antibiotics minocycline and rifampin, have proven to be very effective tools to combat these infections. By bundling the most effective process control measures, like the ones mentioned above, with leading edge technology, the healthcare industry can reduce unnecessary treatment costs, lower infection occurrences and save lives.

Hospital workers at every level should work to embrace these bundled processes and the most advanced technologies to achieve high compliance and, consequently, reduce HAIs and CRBSIs dramatically.

Visit the CRC Blog for Credentialing Commentary

I recently added a new blog to my sidebar – the CRC (Credentialing Resource Center) Blog, sponsored by HcPro.  You’ll find it listed under The Business of Heathcare

Carole LaPine, MSA, CPMSM, CPCS, past president of NAMSS and Director of Physician Services for Trinity Health in Novi, Michigan, is the primary author, and her posts are always well thought out and informative. 

Stop by for a visit and add the CRC Blog to your favorites for up-to-date commentary on important credentialing and healthcare leadership issues.

October 1st – Medicare Payment Revisions Begin

In 2007 Medicare paid for follow-up care required for 750 cases of foreign objects retained after surgery.  

As of today, the cost of that additional care cannot be billed to Medicare.  There are nine additional “preventable” conditions on Medicare’s no-pay as of October 1, 2008 list.  The New York Times offers the full list and the number of instances paid for by Medicare in 2007.

The NYT article Medicare Won’t Pay for Medical Errors (free registration required) states, “The Congressionally mandated Medicare measure is not projected to yield large savings — $21 million a year, compared with $110 billion spent on inpatient care in 2007. But it carries great symbolism…”

“The real money, many health economists believe, may come from reorienting the payment system to encourage prevention and chronic disease management and to discourage unnecessary procedures.”