News & Analysis

August 2, 2016
News & Insights

When it comes to providing high-quality patient care, most American hospitals simply don’t. That’s if the recent round of five-star rankings from CMS are to be believed. About 1,700 hospitals (39%) earned just three out of five stars, an “average” rating, FierceHealthcare reported.

August 1, 2016
Case Management Monthly

One of the more challenging aspects of a case manager's job is helping to ensure a patient successfully transfers from the hospital to the next level of care. Under a set of proposed revisions to Medicare's Conditions of Participation (CoP) announced in November 2015. 

August 1, 2016
Briefings on HIPAA

Q: If my medical waste includes PHI, do I need a BAA with our waste management vendor?

A: Yes. For example, clinics and hospitals contracting with bio-waste disposal vendors that dispose of IV bags execute a BAA with the bio-waste disposal vendors. It's no different than the requirement to execute a BAA with a document shredding vendor. If the vendor will come in contact with PHI, a BAA is in order.

Editor's note: Apgar is president of Apgar & Associates, LLC, in Portland, Oregon. He is also a BOH editorial advisory board member. This information does not constitute legal advice. Consult legal counsel for answers to specific privacy and security questions. Opinions expressed are that of the author and do not represent HCPro or ACDIS. Email your HIPAA questions to Associate Editor Nicole Votta at nvotta@hcpro.com.

August 1, 2016
HIM Briefings

Reconciliation is a noun meaning "the process of finding a way to make two different ideas, facts, etc. exist or be true at the same time." In the world of clinical documentation improvement (CDI), "reconciliation" typically refers to diagnosis-related group (DRG) reconciliation, which is the process of adjusting DRGs when those assigned by the CDI specialist do not match those assigned by the coder.

August 1, 2016
Case Management Monthly

Assigning the correct patient status is important not only to ensure that the hospital gets accurate payment for a patient stay, but also to ensure that the patient receives access to the postacute benefits to which he or she is entitled. 

August 1, 2016
Case Management Monthly

There's good news and bad news on the 2-midnight rule front. The good news: CMS has put short-stay inpatient audits related to the 2-midnight rule on hold as of May 4. The bad news: This isn't a free pass, and it isn't going to last.

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