CPMSM Flashcards
The medical staff is actively involved in measuring, assessing, and improving what?
Patient safety data
An independent review committee consisting of physicians external to NCQA is called what?
ROC
If a hospital loses accreditation for providing falsified information to TJC, it may not participate in the accreditation process again for a period of how long?
1 year
What does the NCQA use for public reporting of survey results?
Health Plan Report Card
Areas of an organization’s system, structure and process that are most relevant to the organization’s patient safety & quality of care, AND most at risk for negative outcomes are referred to as what according to the Joint Commission?
Critical focus areas
According to NCQA what must be included in the organizations rights to appeal policies?
Written notification of the action including the reasons for the action
If a CVO wishes to request reconsideration of denial is certification it must do so within how many days?
30 days
An MCO may appeal the accreditation decision by NCQA within how many days?
30 days
T/F
Negligence is considered a standard of care violation
True
According to TJC what is the number or quantifiable measure usually related to an audit that determines if an action was effective and sustained?
MOS
If a hospital changes ownership/control/change in capacity, it must notify TJC in writing not less than how many days after the change?
30 days
According to TJC what report details the actions an organization took to bring itself into compliance with a standard or that clarifies why an organization believes it was in compliance with the standard for which it received a recommendation?
ESC
Cancer Registry programs may be accredited for up to ____ Years?
3 years
TJC - A mid-cycle self assessment against applicable standards is
PPR/FSA
In order for an organization to apply for NCQA survey, they must have been in operation for how long?
18 months
In order to apply for NCQA certification the CVO must have been under contract to provide verification services for at least____
Six months
What does NCQA call a core survey administered separately to commercially insured Medicare and Medicaid populations?
CAHPS
NCQA
A set of standardized measures used to compare health plans
is ?
HEDIS
NCQA grants a CVO certification for a period of______?
2 years
What are the categories of possible NCQA accreditation?
3 years, 1 year, denial
TJC
Organizations notified of a conditional accreditation decision have how many
business days to request re-examination of the survey findings?
10 days
