Deemed status
Deemed status is a hospital accreditation for hospitals in the United States.
Getting deemed status[edit]
Meeting Conditions for Coverage and Conditions of Participation[edit]
For any organization to receive funding from Centers for Medicare and Medicaid Services (CMS), that organization must meet either the "Conditions for Coverage" or the "Conditions of Participation". These are a set of minimal standards which must be met before CMS will ever issue any reimbursement for Medicare and Medicaid Services. Two kinds of organizations can review a health care provider to check for compliance with these conditions - either a state level agency acting on behalf of CMS, or a national accreditation agency like the Joint Commission.[1]
Examples of some of the areas of focus for these minimal guidelines are the End Stage Renal Disease Program,[2] ambulatory surgical centers,[3] and organ procurement organizations.[4]
The standards for care for nursing homes were distributed as a result of the Nursing Home Reform Act.[5]
Outpatient clinics cannot receive deemed status.[6] A consequence of this is that the CMS payment systems can be more complicated at small clinics than at large hospitals for the same procedures.[6]
Conditions for Coverage and Conditions of Participation apply to these kinds of organizations:
- Ambulatory Surgical Centers (ASCs)[7]
- Community Mental Health Centers (CMHCs)[7]
- Comprehensive Outpatient Rehabilitation Facilities (CORFs)[7]
- Critical Access Hospitals (CAHs)[7]
- End-Stage Renal Disease Facilities[7]
- Federally Qualified Health Centers[7]
- Home Health Agencies[7]
- Hospices[7]
- Hospitals[7]
- Hospital Swing Beds[7]
- Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)[7]
- Organ Procurement Organizations (OPOs)[7]
- Portable X-Ray Suppliers[7]
- Programs for All-Inclusive Care for the Elderly Organizations (PACE)[7]
- Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services[7]
- Psychiatric Hospitals[7]
- Religious Nonmedical Health Care Institutions[7]
- Rural Health Clinics[7]
- Long Term Care Facilities[7]
- Transplant Centers[7]
When any of these organizations are reviewed, the survey checks quality assurance and not "continuous quality improvement".[8] In other words, the process checks for minimal expectations, and not to see whether the facility is actually improving.[8]
History[edit]
In 1994 about 5000 hospitals were eligible to receive CMS funding as a result of being reviewed by the Joint Commission.[9]
The Medicare Improvements for Patients and Providers Act of 2008 removed the deemed status of the Joint Commission and directed it to re-apply to CMS to seek continued authority to review hospitals for CfC and CoP.[10]
References[edit]
- ^ Joint Commission (August 1, 2014). "Facts about federal deemed status and state recognition". jointcommission.org. Retrieved 18 June 2015.
- ^ Centers For Medicare & Medicaid Services (Cms), HHS (Apr 2008). "Medicare and Medicaid programs; conditions for coverage for end-stage renal disease facilities. Final rule". Fed Regist. 73 (73): 20369–484. PMID 18464351.
- ^ Centers For Medicare & Medicaid Services (Cms), HHS (Oct 2011). "Medicare program; changes to the ambulatory surgical centers patient rights conditions for coverage. Final rule". Fed Regist. 76 (205): 65886–90. PMID 22022736.
- ^ Centers For Medicare & Medicaid Services (Cms), HHS (May 2006). "Medicare and Medicaid programs; conditions for coverage for organ procurement organizations (OPOs). Final rule". Fed Regist. 71 (104): 30981–1054. PMID 16749219.
- ^ The National Consumer Voice for Quality Long-Term Care (n.d.). "Deemed Status for Medicare and Medicaid Providers - Federal Requirements for Skilled Nursing Facilities". theconsumervoice.org. Retrieved 18 June 2015.
- ^ a b Settles, JA (October 1995). "Deemed status accreditation of nonhospital-based ambulatory surgery centers". Seminars in Perioperative Nursing. 4 (4): 199–204. PMID 7581344.
- ^ a b c d e f g h i j k l m n o p q r s t Centers for Medicare & Medicaid Services (6 November 2013). "Conditions for Coverage (CfCs) & Conditions of Participations (CoPs)". cms.gov. Retrieved 18 June 2015.
- ^ a b Wish, JB (1998). "Role of external oversight in quality activities: Accreditation, credentialing, licensure, and deemed status". American Journal of Kidney Diseases. 32 (6): S177–S181. doi:10.1016/S0272-6386(98)70184-2. ISSN 0272-6386. PMID 9892388.
- ^ Jost, Timothy Stoltzfus (1994). "Medicare and the Joint Commission on Accreditation of Healthcare Organizations: A Healthy Relationship?". Law and Contemporary Problems. 57 (4): 15–45. doi:10.2307/1192055. ISSN 0023-9186. JSTOR 1192055. PMID 10140656.
- ^ Battard Menendez, Juliet (2010). "The Impetus for Legislation Revoking the Joint Commission's Deemed Status as a Medicare Accrediting Agency". JONA's Healthcare Law, Ethics, and Regulation. 12 (3): 69–76. doi:10.1097/NHL.0b013e3181ee276f. ISSN 1520-9229. PMID 20733410.