CMS Interpretive Guidelines for Complaint/Grievances

Question 1

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

Accepted Answer

true

Question 2

Change in bedding, housekeeping of a room, and serving preferred food and beverages requires a written response.

Accepted Answer

false

Answer

true

Question 3

CoP stands for Conditions of Patients

Accepted Answer

false

Answer

true

Question 4

If a verbal patient care complaint cannot be resolved at the time of the complaint by staff present, is postponed for later resolution, is referred to other staff for later resolution, requires investigation, and/or requires further actions for resolution, then the complaint is a grievance.

Accepted Answer

true

Question 5

The hospital’s governing body must review and resolve grievances, unless it delegates this responsibility in writing to a grievance committee.

Accepted Answer

true

Question 6

Quality Improvement Organizations (QIO) are hospital employees charged with reviewing the appropriateness and quality of care rendered to Medicare beneficiaries in the hospital setting.

Accepted Answer

false

Answer

true

Question 7

Grievances about situations that endanger the patient, such as neglect or abuse, should be reviewed immediately, given the seriousness of the allegations and the potential for harm to the patient(s).

Accepted Answer

true

Question 8

Select ALL of the CMS interpretive guidelines for complaint/grievances:

Accepted Answer

The hospital must establish a clearly explained procedure for the
submission of a patient's written or verbal grievance to the hospital.

Accepted Answer

The grievance process must include a mechanism for timely referral of patient concerns
regarding quality of care or premature discharge to the appropriate Utilization and
Quality Control, Quality Improvement Organization.

Accepted Answer

The hospital's governing body must approve and be responsible for the effective operation
of the grievance process, and must review and resolve grievances, unless it delegates the
responsibility in writing to a grievance committee.

Accepted Answer

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

Answer

The grievance process does not require specification of time frames for review of the
grievance and the provision of a response.

Answer

The hospital can choose to establish a process for prompt resolution of patient grievances.

Question 9

A grievance is considered resolved when the hospital is satisfied with the actions taken on the patient's behalf.

Accepted Answer

false

Answer

true

Question 10

Medicare patients have the right to appeal a premature discharge

Accepted Answer

true

CMS Interpretive Guidelines for Complaint/Grievances

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