1. © 2009 Cengage Learning. All Rights Reserved. Regulating Hospitals

2. © 2009 Cengage Learning. All Rights Reserved. Agenda  State regulations Patient safety and rights Construction and Certificates of Need  Federal regulations HIPAA EMTALA Conditions of Participation Compliance  Accreditation

3. © 2009 Cengage Learning. All Rights Reserved. State Regulations  States may regulate: patient safety issues such as restraints and infection rates relationships between hospitals and medical staff, and construction of new facilities, expansions, and hospital closures under Certificate of Need laws.

4. © 2009 Cengage Learning. All Rights Reserved. Federal Regulation  Federal laws require: Administrative Simplification (transactions and code sets, patient privacy, security standards) under HIPAA EMTALA (treatment during medical emergencies) Conditions of Participation (all hospitals must follow CMS regulations) compliance programs that address Federal Sentencing Guidelines.

5. © 2009 Cengage Learning. All Rights Reserved. Accreditation  Hospitals must be inspected by: CMS or accrediting organization  Joint Commission (formerly JCAHO), or  American Osteopathic Association.