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CMS and JCAHO Healthcare Security Requirements Summary

Every healthcare organization/hospitalgoverned by §482.13(f)(l-3). The
accepting payment for Medicare and Medicaidindividual may be the law enforcement
patients is required to meet certain Federalofficer's prisoner but he/she is also the
standards called "Conditions ofhospital's patient. The hospital is still
Participation"  (CoPs).responsible for providing safe and
appropriate care to their patient. The
These Federal requirements are promulgated bycondition of the patient must be continually
the Centers for Medicare and Medicaid toassessed,  monitored  and  reevaluate.
improve quality and protect the health and
safety of patients. Compliance is based onJCAHO  -  2006
surveys conducted by state agencies on behalf
of the CMS. Conditions of Participation are(Healthcare  Security)
regulatory standards hospitals agree to
follow as a condition for receiving federal____________________________________________
funding  through  the  Medicare  program.
The Joint Commission on Accreditation of
Under an agreement with CMS, State healthcareHealthcare Organizations evaluates and
licensure agencies conduct surveys ofaccredits more than 18,000 healthcare
hospitals and enforce compliance with CoPsorganizations and programs throughout the
and ensure that Conditions of ParticipationUnited States. Hospitals aggressively seek
are being practiced. Hospitals and otherJoint Commission accreditation to meet
healthcare facilities are subject to randomMedicare certification and licensure
onsite reviews. Unannounced surveys canrequirements. Accreditation is also a
result from patient or public complaints orcondition of reimbursement for many insurers
inquiries. Healthcare Security is anand other payers. In addition, JCAHO
important element for the new 2006 ConditionsAccreditation reduces the hospital's
of  Participation.liability insurance premiums. Beginning in
2006 JCAHO will conduct all surveys without
CONDITIONS  of  PARTICIPATIONprior  notice.
Department  of  Health  &  Human  ServicesThe Joint Commission has accredited hospitals
for more than 50 years and today accredits
Centers  for  Medicare  &  Medicaid  Servicesover 80 percent of the nation's hospitals.
The Centers for Medicaid & Medicare Services
(Healthcare  Security)(CMS) have required JCAHO accreditation by US
hospitals since 1965 as a 'Condition of
____________________________________________Participation' requirement in order for them
to receive Medicaid and Medicare
A-0038reimbursements.
Title 42CFR, Volume 3 - §482.13 ConditionThe  Joint Commission and Healthcare Security
of  Participation:  Patients'  Rights
The Joint Commission's Standards address the
A hospital must protect and promote eachhospital's performance in specific areas, and
patient's  rightsspecify requirements to insure that patients
are provided a safe and secure environment.
Interpretive  Guidelines  Â§482.132006 Environment of Care© requirements
include, but are not limited to the
These requirements apply to all Medicare orfollowing:
Medicaid participating hospitals including
short-term, acute care, surgical, specialty,- Development and maintenance of a written
psychiatric, rehabilitation, long-term,Security Management Plan to include an
childrens' and cancer, whether or not theyEmergency  Management  Plan.
are accredited. This rule does not apply to
critical access hospitals. (See Social- Conduct an annual Risk Assessment that
Security  Act  (the  Act)  Â§1861(e)).evaluates the potential adverse impact of the
external environment on the security of
These requirements, as well as the otherpatients, staff, and others coming to the
Conditions of Participation in 42 CFRfacility.
§482, apply to all parts and locations
(outpatient services, provider-based- Use the risks identified to select and
entities, inpatient services) of the Medicareimplement procedures and controls to achieve
participating  hospital.the lowest potential for adverse impact on
security.
____________________________________________
- Identify, as appropriate, patients, staff
A-0057and  other  people  entering  the  facility.
Title 42, Volume 3 CFR - §482.13(c)(2) The- Access Control / Physical Protection -
patient has the right to receive care in acontrol access to and egress from security
safe  setting.sensitive areas, as determined by the
organization.
Interpretive  Guidelines for §482.13(c)(2)
- Mitigate Violence in the Emergency
The intention of this requirement is toDepartment  and  other  locations.
specify that each patient receives care in an
environment that a reasonable person would- Education and Training - staff, licensed
consider to be safe. For example, hospitalpractitioners, and volunteers have the
staff should follow current standards ofknowledge and skills necessary to perform
practice for patient environmental safety,their responsibilities within the
infection control and security. The hospitalenvironment.
must protect vulnerable patients, including
newborns and children. Additionally, this- Develop and implement a proactive infant
standard is intended to provide protectionabduction  prevention  plan.
for the patient's emotional health and safety
as well as his/her physical safety. Respect,- Include information on visitor/provider
dignity and comfort would be components of anidentification as well as identification of
emotionally  safe  environment.potential abductors/abduction situations
(during staff orientation and in-service
Survey  Procedures  Â§482.13(c)(2)curriculum  programs).
- Review and analyze patient and staff- Enhance parent education concerning
incident and accident reports to identify anyabduction risks and parent responsibility for
incidents or patterns of incidents concerningreducing risk and then assess the parents'
a safe environment. Expand your review if youlevel  of  understanding.
suspect a problem with safe environment in
the  hospitals.- Attach secure identically numbered bands to
the baby (wrist and ankle bands), mother, and
- Review QAPI, safety, infection control andfather or significant other immediately after
security (or the committee that deals withbirth.
security issues) committee minutes and
reports to determine if the hospital is- Footprint the baby, take a color photograph
identifying problems, evaluating thoseof the baby and record the baby's physical
problems and taking steps to ensure a safeexamination  within  two  hours  of  birth.
patient  environment.
- Require staff to wear up-to-date,
- Observe the environment where care andconspicuous, color photograph identification
treatment  are  provided.badges.
- Observe and interview staff at units where- Discontinue publication of birth notices in
infants and children are inpatients. Arelocal  newspapers.
appropriate security protections (such as
alarms, arm banding systems, etc.) in place?- Consider options for controlling access to
Are  they  functioning?nursery/postpartum unit such as swipe-card
locks, keypad locks, entry point alarms or
- Review policy and procedures on what thevideo surveillance (any locking systems must
facility does to curtail unwanted visitors orcomply  with  fire  codes).
contaminated  materials.
- Consider implementing an infant security
- Access the hospital's security efforts totag  or  abduction  alarm  system.
protect vulnerable patients including
newborns and children. Is the hospitalMaterial in this brochure provided to
providing appropriate security to protectAccutech-ICS ( by Security Assessments
patients? Are appropriate security mechanismsInternational,  Inc.,
in place and being followed to protect
patients?Disclaimer
Exceptions:The information provided by and SAI is in
accordance with our understanding of current
The use of handcuffs or other restrictiveJCAHO and CMS Regulations. It is intended for
devices applied by law enforcement officialseducational purposes only and should not be
who are not employed by or contracted by theconsidered 'legal' advice. Please consult
hospital is for custody, detention, andwith your legal counsel or Compliance Officer
public safety reasons, and is not involved infor clarification of laws and rules related
the provision of health care. Therefore, theto  your  State  when  applicable.
use of restrictive devices applied by and
monitored by law enforcement officers who areand SAI are not affiliated with the Joint
not employed or contracted by the hospital,Commission on Accreditation of Healthcare
and who maintain custody and directOrganizations.
supervision of their prisoner are not



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