Description:
CMS Hospital Conditions of Participation
CMS Hospital Conditions of Participation are set out in 42 CFR Part 482, which lists out conditions of participation for hospitals. Health care organizations must meet Conditions of Participation (CoPs) and Conditions for Coverage (CfCs) which CMS develops from time to time. This has to be done if they have to begin and continue to participate in the Medicare and Medicaid programs.
These CMS Hospital Conditions of Participation conditions, which are health and safety standards, serve as the basis for improvement in the quality and protection of beneficiaries’ health and safety. Another of the functions the CMS performs is that of ensuring that accrediting organizations recognized by CMS meet or exceed the Medicare standards set forth in the CoPs/CfCs.
The basis and scope of this Act are set out in Sec. 482.1, which provides the following criteria for CMS Hospital Conditions of Participation:
o certain specified requirements must be met by all hospitals participating in Medicare;
o if the Secretary finds it necessary in the interest of the health and safety of the individuals who are furnished services in hospitals, she may impose additional requirements;
o an institution participating in Medicare as a psychiatric hospital must meet certain specified requirements imposed on hospitals under section 1861(e);
o hospitals that participate in Medicare and Medicaid should have a utilization review plan that meets specified requirements;
o it also sets out the requirements for hospitals that provide long term care under an agreement with the Secretary.
To whom do CMS Hospital Conditions of Participation apply?
CMS Hospital Conditions of Participation apply to the following health care organizations:
o Ambulatory Surgical Centers (ASCs)
o Community Mental Health Centers (CMHCs)
o Comprehensive Outpatient Rehabilitation Facilities (CORFs)
o Critical Access Hospitals (CAHs)
o End-Stage Renal Disease Facilities
o Federally Qualified Health Centers
o Home Health Agencies
o Hospices
o Hospitals
o Hospital Swing Beds
o Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)
o Organ Procurement Organizations (OPOs)
o Portable X-Ray Suppliers
o Programs for All-Inclusive Care for the Elderly Organizations (PACE)
o Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services
o Psychiatric Hospitals
o Religious Nonmedical Health Care Institutions
o Rural Health Clinics
o Long Term Care Facilities
o Transplant Centers
References:
http://www.law.cornell.edu/cfr/text/42/482.1
http://www.cms.gov/Regulations-and-Guidance/Legislation/CFCsAndCoPs/index.html?
redirect=/cfcsandcops/16_asc.asp
http://bit.ly/1edM2jm
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