Medicare

Question 1

According to CMS, members are appointed to the medical staff after receiving recommendations from which of the following?

Answer 1

A) Medical Staff B) Chief Medical Officer C) Chief Executive Officer
Answer: A

Question 2

Does CMS require board certification?

Answer 2

CMS standards do not specifically mention board certification.

Question 3

Complaints - Medicare Hospital COPs and Interp. Guidelines - Rev. 141, 07-10-15 482.12 (a) (2)

Answer 3

The hospital must establish a process for prompt resolution of patient grievances and must inform each patient whom to contact to file a grievance.

Question 4

Compliance with Law - Medicare Hospital COPs and Interp. Guidelines - Rev. 141, 07-10-15; Interpretive Guidelines 482.12 (a) (3)

Answer 4

The governing body must assure that the medical staff has bylaws, and that those bylaws comply with state and federal law and the requirements of COPs 482.11 condition of participation: Compliance with Federal, State, and Local Laws Interpretive Guidelines 482.11 The Hospital must ensure that all applicable federal, state and local law requirements are met.

Question 5

Continuing Medical Education: Medicare Hospital COPs and Interp. Guidelines - Rev. 141, 07-10-15

Answer 5

Not Specifically addressed.

Question 6

CVOs/Delegation: Medicare Hospital COPs and Interp. Guidelines - Rev. 141, 07-10-15

Answer 6

Not Specifically addressed.

Question 7

Criminal Background Checks: Medicare Hospital COPs and Interp. Guidelines Rev 141, 07-10-15

Answer 7

required if state law requires.

Question 8

Current Competence: Medicare Hospital COPs and Interp. Guidelines - Rev. 141, 07-10-15 482.12 (a) (6) and 482.22 (c) (4)

Answer 8

The governing body must ensure that the criteria for selection of medical staff are individual character, competence, trainings, experience and judgement.

Question 9

Designated Equivalent Sources: Medicare Hospital COPs and Interp. Guidelines - Rev. 141, 07-10-15

Answer 9

Not specifically addressed.

Question 10

Disaster or Emergency Management Plan Privileges: Medicare Hospital COPs and Interp. Guidelines - Rev. 141, 07-10-15 Interpretive Guidelines 482.41 (a)

Answer 10

The hospital must coordinate with Federal, State and local emergency preparedness and health authorities to identify likely risks for their area (e.g. natural disasters, bioterrorism threats, disruption of utilities such as water, sewer, electrical, communications, fuel, nuclear accidents, industrial accidents, and other likely mass casualties, etc. and to develop appropriate responses that will assure the safety and well-being of patients [this includes] qualifications and training needed by personnel, including healthcare staff, security staff, and maintenance staff, to implement and carry out emergency procedures.

Question 11

Drug Enforcement Agency Certificate (DEA) or State Controlled Dangerous Substances Certificate Medicare Hospital COPs and Interp. Guidelines Rev. 141 07-10-15

Answer 11

not specifically addressed.

Question 12

Education: Medicare Hospital COPs and Interp. Guidelines - Rev. 141, 07-10-15 482.12 (a) (6) and 482.22 (c) (4)

Answer 12

The governing body must ensure that the criteria for selection of medical staff are individual character, competence, training, experience and judgement.

Question 13

Felony Convictions: Medicare Hospital COPs and Interp. Guidelines - Rev. 141, 07-10-15

Answer 13

Not specifically addressed.

Question 14

The governing body determines, in accordance with state law, which categories of practitioners are eligible for appointment to the medical staff. At a minimum, the medical staff must be composed of MD’s and DO’s

Answer 14

initial appointment, clinical privileges - practitioners covered according to CMS