CMS Interpretive Guidelines for Complaint/Grievances

Lydia Elliott, Ed.D
Quiz by Lydia Elliott, Ed.D , updated more than 1 year ago
Lydia Elliott, Ed.D
Created by Lydia Elliott, Ed.D over 3 years ago
260
16

Description

Test your knowledge based on workbook recommended reading https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_a_hospitals.pdf

Resource summary

Question 1

Question
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
  • True
  • False

Question 2

Question
Change in bedding, housekeeping of a room, and serving preferred food and beverages requires a written response.
Answer
  • True
  • False

Question 3

Question
CoP stands for Conditions of Patients
Answer
  • True
  • False

Question 4

Question
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.
Answer
  • True
  • False

Question 5

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

Question 6

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

Question 7

Question
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).
Answer
  • True
  • False

Question 8

Question
Select ALL of the CMS interpretive guidelines for complaint/grievances:
Answer
  • The grievance process does not require specification of time frames for review of the grievance and the provision of a response.
  • The hospital must establish a clearly explained procedure for the submission of a patient's written or verbal grievance to the hospital.
  • 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.
  • 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.
  • The hospital must establish a process for prompt resolution of patient grievances and must inform each patient whom to contact to file a grievance.
  • The hospital can choose to establish a process for prompt resolution of patient grievances.

Question 9

Question
A grievance is considered resolved when the hospital is satisfied with the actions taken on the patient's behalf.
Answer
  • True
  • False

Question 10

Question
Medicare patients have the right to appeal a premature discharge
Answer
  • True
  • False
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