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State & Psychiatric Hospital Compliance Collaborative’s Reading Tips Newsletter (RTN) January 2013, Volume 7, Issue 1
SPHCC Reading Tips Newsletter Banner

••WHAT’S NEW for January

  • Fresh SPHCC
    • Guests & Visitors – We welcome you to this Highlights section of our newsletter. As you will see below, it contains a listing of our best reading recommendations and some downloadable material for those who want to keep up with compliance issues in the field of Behavioral Health and Psychiatry.
    • Current Members:
      • ALL: Your updated Custom Resource Page (CRP) contains a link to your Hospital Profile in the abbreviation letters of your organization’s name. Please review your profile to make sure its descriptions and listed respresentative contact information is current.
      • ILLINOIS: JCCAP video training modules 1-3 will be available on your CRP for those hospitals in the Southern Region participating in this month’s Joint Commission Refresher Workshop.
    • Associates: The online Associate Open House to introduce new features and more access to compliance materials will continue just through the end of this month. Just use the sign on codes provided last month via e-mail or contact us.
  • AnchorReading Tips Newsletter (RTN):
    • Tip#1: Pareto’s Principle or the 20/80 Rule says a few critical factors (20%) generally account for most (80%) of an outcome. By reading the reviews of the recommended articles (see list below) in this publication you and key members of your staff can keep up with the most important compliance issues in Behavioral Health and Psychiatry in only 15 minutes per month. If you have more time read the full article.



••Additional Updates in:

      • Perspectives (PR): 0 more articles
      • The Source (TS): 0 more articles
      • EC News (EC): 2 more Articles
      • Jt Commission Online (JO): 6 more Pearls


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Recommended Readings, Tips & Pearls

PR: Anchor Approved: Revisions to the Review and Appeal Procedures [REF:BHC, JCCAP, JCSC, LDR, PI] Perspectives January 2013, Pg 1, Vol 33, # 1 [®]

Effective 7/1/13 for all programs (e.g., BHC, HAP), the ‘First Level Review & Appeal Committee’ will simply be called the ‘Review Hearing Panel’. In addition, timeframes and allowable processes are being firmed up. 5 is an important number in appeals of Preliminary Denial of Accreditation (PDA). For example, If compliance information is not submitted to the Accreditation Committee at least 5 business days in advance it may not be considered. Actions taken after that deadline are not “an acceptable basis for an appeal…”. In addition the request for a review hearing must also be submitted (in writing) within 5 business days of TJC’s notification of a PDA decision.
[Pearl] The article provides 4 useful summary points of what is allowed and not allowed in presentations to the Review Hearing Panel along with full text of the revisions. #JCp1301_Appeals


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TS: CMS: Complying with Rules for Standing Orders[REF: MDx, P&T, Phrm, RNx] The Source, January 2013, Vol 11, # 1, Pg 12 [®]

Recent changes to CMS Conditions of Participation permit the use of standing orders. Subsequently, TJC created MM.04.01.01, EP 15 (full text included in the article) to implement this ability in their standards. Standing orders should be consistent with nationally recognized/evidence-based guidelines, reviewed and approved by the Medical Staff, nursing staff and pharmacy leadership. And, of course, as soon as possible, all standing orders must be authenticated (with signature, date and timing as required by your state laws and hospital policies).
Tip: Make sure any standing orders are periodically reviewed and evaluated from a quality/performance perspective as per the PI expectations for medical staff under MS.0501.01 EPs 4 and 7.
Question: Is your facility currently using or considering the use of standing orders? If so share which ones by leaving a comment on this article. Thank you. #JCs1301_MM0401StndOrdrs

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EC: Clarifications and Expectations: Emergency Generator Reliability Superstorm Sandy raises questions and concerns [REF: EOC, EM, LDR, PI, SFT] EC News January 2012, Vol 16, # 1, Pg 7 [®]

EPs 5 and 6 of EC.02.03.05 requires hospitals to have sufficient emergency power to run any equipment, the loss of which, would cause patient harm. To that end, generators (and their automatic transfer switches) are to be tested for 30 minutes 12 times per year and for four hours at least once every 4 years. Although not a specific requirement of standard, there is encouragement for Ldr and PI consideration of generator failure as an issue for hazard vulnerability analysis HVA. An HVA could pick up risks like low-lying generators that might become flooded as was the case with Superstorm Sandy. #JCe1301_EmergGenerators


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[Index] [Blog] Perspectives [PR] – (August, Vol 32, # 8)



[Index] [Blog] The Source [TS] (August Vol 9 # 8)



[Index] [Blog] Environment of Care News [EC] (August Vol 15 #8)


TJC just wants you to know they are available “before, during and after a disaster”. They believe they have information and contacts that can help an organization maintain quality/safety and recover better/faster. Certainly, if your survey was expected during or might occur shortly after a disaster, you should contact your account representative to alert them to your situation. The article provides specific contact information for facilities regarding disasters as follows:
• Facilities or power-related questions: 630-792-5759
• Clinical or standards-related questions: 630-792-5900, option 6
• Other questions: phone an account executive at 630-792-3700



The concept of ‘Green Cleaning’ is presented as involving the two key areas of green products and green practices. In addition to their environmental contribution, Green Products offer the advantage of generally being less toxic for people as well. The article contains a sidebar of advice for choosing such products and gives illustration in two case examples of Green Practices.


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Quarterly Provider Updates

Mid-Quarter Instructions

Spotlight/What’s New

  • CMS-3278-NC: “Medicare Program; Request for Information on Hospital and Vendor Readiness for Electronic Health Records Hospital Inpatient Quality Data Reporting,”(1/3/13) SUMMARY: This document is a request for information from hospitals, electronic health record (EHR) vendors, and other interested parties regarding hospital readiness beginning calendar year 2014 discharges to electronically report certain patient-level data under the Hospital Inpatient Quality Reporting (IQR) Program using the Quality Reporting Document Architecture (QRDA) Category I. DATES: The information solicited in this document must be received at the address provided below, no later than 5 p.m. eastern standard time (e.s.t.) on January 22, 2013.
  • R2553CP New Waived Tests – Effective 01/07/2013 (CLIA #100-04)
    There are 36 newly added waived tests. Most of them related to BTNX Inc Rapid Response X-Press Drug Tests for various substances of abuse.


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Joint Commission Website (JCW)

  • Joint Commission Online (JCO)
    • January 9, 2013 (PDF) [®]

      • Revised restraint requirement for hospitals and critical access hospitals [Pearl: JCCAP/JCSC, MDx, LDR]

        Effective immediately, PC.03.05.19, EP 1, related to the use of restraints has been revised to more specifically address the requirement for reporting to CMS deaths that occur up to 1 week after the use of restraint or seclusion. Read More
        TIP: Make sure your death review procedures include consideration of this CMS reporting requirement. #JCo130109_RestraintRevision

      • Customize your on-site survey and help improve accreditation via the CVA survey [Pearl: JCSC, LDR]

        The CVA is a two-part survey: the first part is completed after the E-App (electronic application) is submitted; the second part is completed after the on-site survey takes place. The first part of the CVA helps the survey team know what is important to an organization and provide a more customized on-site survey. The second part tells TJC how well they met your organization’s expectations for their on-site survey. Read More
        TIP: Complete CVA part 1 with a mind toward constructively influencing surveyors/survey process. Complete part 2 with the idea of improving TJC survey process in general and advantageously positioning your organization should appeal or reviews be required.

    • January 2, 2013 (PDF) [®]
      • New accountability performance measures for 2012 [Pearl: JCSC, PI]
        There are 4 new accountability measures for 2012 including HBIPS-4a/HBIPS-5a (Patients discharged on multiple antipsychotic medications without appropriate justification). “Beginning in 2013, only HBIPS-4a/HBIPS-5a (patients discharged on multiple antipsychotic medications without appropriate justification) will be reported.
        Pearl: HBIPS-4a/HBIPS-5a is derived by subtracting HBIPS-5a (multiple antipsychotic medications at discharge with appropriate justification – overall rate) numerator cases (those cases with justification) from both the numerator and denominator of HBIPS-4a (multiple antipsychotic medications at discharge – overall rate)”. #JCo130102_NewAcctMeasures

    • December 27, 2012 (PDF)
      • Update: Targeted Solutions Tool™ hand hygiene and wrong site surgery projects [FYI: BHC, IC, RNX]

        Organizations (both hospital and BHC) using the TST for Hand Hygiene “have significantly improved (41% over baseline) their hand hygiene by mirroring the work of the Center’s participating health care organizations…”. Read More

    • December 19, 2012 (PDF) [®]
      • New R3 Report explains revised patient flow requirements [Pearl: LDR, MDx, PI, RNx]TJC recently released an R3 Report (requirements, rationale, and references) entitled ‘Patient flow through the emergency department‘, that explicates revisions to LD.04.03.11 and PC.01.01.01 that focus on the importance of patient flow in hospitals.. Revisions to LD.04.03.11, EPs 6 and 9 will not go into effect until 1/1/14, but the rest have been in effect since 1/1/13. These changes apply beyond the emergency room to hospitals (even psychiatric hospitals) in a more general sense. J
        Tip: Click here to download the full R3 Report on Patient Flow [®]
      • Standards changes to meet hospital… deeming requirements [Pearl: MDs, RNx, Phrm] [Ftxt]
        Effective immediately, there have been revisions to the following as reflected in Pre-Publication Standards: [®]

        • MS.01.01.01, EP 13 – note confirming that the medical staff may include “other categories of nonphysician practitioners”.

        • MM.07.01.03, EP 6 – Change in the timing requirement to “immediate” for reporting medication errors, adverse drug events, and medication incompatibilities #JCo121927_ms010101mm070103

  • Joint Commission Topic Library (JTL)



SPHCC Library Additions & Full Text Articles

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ALL: Everybody, CHP: Chaplain, C&P: Credentialing & Privileging, E&M: Engineering & Maint, EOC: Environment of Care, FB: Finance/Business, FdDt: Food services/Dietary, GB: Gov Body, HR: Human Resources/Personnel, HST: Human Service Tech/Aid, IC: Infection Control, IM: Info Mgt/Med Records, IT: Info Technology, JCCAP: Jt Com Certified Accreditation Professional, JCSC: Jt Com Survey Coordinator, LDR: Leadership/Mgt, MEC: Med Exec Committee, MD: Medical Staff, ofco: Officer and/or Committee, PI:Performance/Quality Improvement com/dept, PPR: PPR team mbrs/ldrs, P&T: Phrm & Therapeutics Com, Phrm: Pharmacy,PSY: Psychology, PtAd: Patient Advocate, PtEd: Patient Education, RHB: Rehab/Activity Therapy, RN: Nursing, SFT: Safety,StEd: staff ed & training dept, SW: Social Work, TxTm: Treatment Team, UrUm: Utilization Review/Management,X: Exec, Dir or Chief (e.g., MDx = Medical Director)
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