Ballard’s “contingency planning” article featured in Credentialing Resource Center Journal

Health care partner and QMCG Executive Director Catherine Ballard’s article, “Contingency planning: Comply with privileging requirements for provider-base locations,” was recently featured in the Credentialing Resource Center Journal. According to Ballard, today’s hospitals must promote compliance CMS’ regulations with provider-based designations. However, this process can be challenging for a number of reasons. “Promoting ongoing regulatory […]

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Understanding the Hearing Officer/Presiding Officer Role

As Medical Staff Service Professionals, the peer review process is well understood. The majority of the time, upon completion of a peer review, performance improvement measures/actions are determined and acted upon with no additional steps needed. There are times, however, when the peer review process is extended and additional procedural due process is provided in […]

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Do Not Text and Order

The Joint Commission (TJC) has again clarified its position on the use of secure text messaging for patient care orders. Specifically, in contrast to its position in May 2016, TJC, in collaboration with the Centers for Medicare & Medicaid Services (CMS), is now stating that the use of secure text orders is not permitted. Although […]

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The Challenge of Incident Reports

Incident reports, unusual occurrence reports, risk management reports — whatever you call them — are a challenge, and whether or not they will be “peer review protected” depends upon your individual state law. There are, however, some basic steps you can take to be sure that if there is any protection available, you will have […]

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Final Rules for Adult Cardiac Catheterization Services in Ohio

On April 30, 2016, new quality rules for adult cardiac catheterization services became effective. The final rules, under section 3701-84-30 to 3701-84-34.2, OAC, can be reviewed at http://www.odh.ohio.gov/en/rules/final/3701-80-to–89/f3701-84.aspx. The new rules establish three service level classifications for adult cardiac catheterization services: Level I service – Diagnostic only services without on-site open heart surgery services Level […]

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Understanding the Federal Health Care Quality Improvement Act (HCQIA) and State Peer Review Privileges in Day-to-Day Activities

When most people think of the Health Care Quality Improvement Act of 1986 (HCQIA), they think of reporting obligations to the National Practitioner Data Bank. But HCQIA, just as your state peer review privilege, has practical application to your day-to-day quality improvement activities as well. Did you know that HCQIA originated as a part of […]

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Colliding Worlds, Peer Review and Medical Necessity

QMCG Executive Director Catherine Ballard and Bricker & Eckler attorney Steve Kleinman presented the “Colliding Worlds, Peer Review and Medical Necessity” webinar on April 27, 2016. The live webinar, hosted by NAMSS, provided insightful information related to physician peer review, explanation of medical necessity review, and the similarities and benefits of both. The webinar also […]

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Sharing Quality Information Within a System

It used to be that we all knew that a medical staff credentials file, or quality file, contained peer review-protected information, and that it would only be used as part of the medical staff process. But that was yesterday. Today, more and more demands are being made on medical staff services to share their information […]

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New Quality Measures for Cardiac Catheterization Services in Ohio: Our Recommendations

On September 21, 2015, the Ohio Department of Health (ODH) posted draft rules for public comment regarding adult cardiac catheterization services. The draft rules propose new quality performance measures and reporting requirements for all cardiac catheterization services. Public comment is due by October 21, 2015. At this time, we recommend a review of your cardiac […]

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New Rules for Ohio Nursing Homes

New provisions in the nursing home licensure rules went into effect on September 1, 2015: one expedites the nursing home licensure process for new facilities, while the others impose additional requirements on all nursing homes. OAC Rule 3701-17-03.1: Effective September 1, 2015, a provider may request for a new nursing home an expedited initial licensure […]

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