Recommended Regulations and Standards for Specific Healthcare Settings (Updated)
Editor’s note: This update supplants the December 2002 practice brief “Recommended Regulations and Standards for Specific Healthcare Settings (Updated).”
HIM skills are applied to a multitude of healthcare settings. This practice brief lists recommended resources for each setting.
Whether honing existing skills or making the transition to a new healthcare setting, acquisition of and thorough familiarization with the regulations and standards listed below is recommended.
Practice Setting: Acute Care/Hospitals |
|
| Recommended Resource |
Source |
| Certified inpatient EHRs |
Certification Commission for Healthcare Information Technology, www.cchit.org/choose/index.asp |
| CMS Conditions of Participation for Hospitals (42 CFR 482) |
CMS, www.access.gpo.gov/nara/cfr/waisidx_04/42cfr482_04.html |
| Comprehensive Accreditation Manual for Hospitals |
The Joint Commission, www.jointcommission.org/AccreditationPrograms/Hospitals |
| Comprehensive Accreditation Manual for Critical Access Hospitals |
The Joint Commission, www.jointcommission.org/AccreditationPrograms/CriticalAccessHospitals |
| Conditions of Participation for Patient Rights |
CMS, www.cms.hhs.gov/CFCsAndCoPs/downloads/finalpatientrightsrule.pdf
|
| Critical Access Hospitals Center |
CMS, www.cms.hhs.gov/center/cah.asp |
| Healthcare Facilities Accreditation Program |
American Osteopathic Association, www.aoa-net.org/Accreditation/HFAP/HFAP.htm |
| Hospital Outpatient Prospective Payment System |
CMS, www.cms.hhs.gov/HospitalOutpatientPPS/HORD/list.asp
|
| Interpretive guidelines for hospitals |
CMS, www.cms.hhs.gov/manuals/Downloads/som107ap_a_hospitals.pdf |
| Interpretive guidelines for swing bed hospitals |
CMS, www.cms.hhs.gov/manuals/downloads/som107ap_t_swing_beds.pdf |
| Long-Term Care Hospitals Prospective Payment System |
CMS, www.cms.hhs.gov/LongTermCareHospitalPPS/01_overview.asp |
| Medicare Benefit Policy Manual |
CMS, www.cms.hhs.gov/manuals/Downloads/bp102c01.pdf |
| Medicare Hospital Inpatient Prospective Payment System |
CMS, www.cms.hhs.gov/AcuteInpatientPPS |
| Medicare Hospital Prospective Payment System |
CMS, www.cms.hhs.gov/AcuteInpatientPPS/01_overview.asp |
| Medicare Program Manuals |
CMS, www.cms.hhs.gov/Manuals/IOM/list.asp |
| Physician Certification and Recertification of Services |
CMS, www.cms.hhs.gov/manuals/downloads/ge101c04.pdf |
| Office of Inspector General Compliance Program Guidance |
Department of Health and Human Services Office of Inspector General, http://oig.hhs.gov/authorities/docs/cpghosp.pdf |
Practice Setting: Ambulatory and Physician Practice |
|
Recommended Resource |
Source |
| Accreditation Handbook for Ambulatory Health Care |
Accreditation Association for Ambulatory Health Care, www.aaahc.org/eweb/StartPage.aspx |
| Ambulatory surgery center certification and compliance |
CMS, www.cms.hhs.gov/CertificationandComplianc/02_ASCs.asp |
| Ambulatory Surgical Centers Conditions of Coverage |
CMS, www.cms.hhs.gov/CFCsAndCoPs/downloads/ambsurgreg.pdf |
| Certified inpatient EHRs |
Certification Commission for Healthcare Information Technology, www.cchit.org/choose/index.asp |
| CMS Physician Center |
CMS, www.cms.hhs.gov/center/physician.asp |
| CMS Ambulatory Surgical Centers (ASC) Center |
CMS, www.cms.hhs.gov/center/asc.asp |
| Comprehensive Accreditation Manual for Ambulatory Care |
The Joint Commission, www.jointcommission.org/AccreditationPrograms/AmbulatoryCare |
| Documentation Guidelines for E&M Services |
CMS, www.cms.hhs.gov/MLNEdWebGuide/25_EMDOC.asp |
| Medicare Benefit Policy Manual for Comprehensive Outpatient Rehab |
CMS, www.cms.hhs.gov/manuals/Downloads/bp102c12.pdf |
| Medicare Benefit Policy Manual for Rural Health Centers |
CMS, www.cms.hhs.gov/manuals/Downloads/bp102c13.pdf |
| Rural Health Center |
CMS, www.cms.hhs.gov/center/rural.asp |
Practice Setting: Behavioral Health |
|
Recommended Resource |
Source |
| Behavioral Health Standards Manual |
Commission on Accreditation of Rehabilitation Facilities, www.carf.org/providers.aspx?Content=Content/Accreditation/Opportunities/BH/toc.htm |
| Certification for community mental health |
CMS, www.cms.hhs.gov/CertificationandComplianc/03_CommunityHealthCenters.asp |
| Comprehensive Accreditation Manual for Behavioral Health Care |
The Joint Commission, www.jointcommission.org/AccreditationPrograms/BehavioralHealthCare |
| Conditions of Participation for Drug, Alcohol, and Substance Abuse (42 CFR 2) |
National Archives and Record Administration, Code of Federal Regulations, www.access.gpo.gov/nara/cfr/waisidx_01/42cfr2_01.html |
| Managed Behavioral Healthcare Organization Accreditation Program |
National Committee for Quality Assurance, www.ncqa.org/tabid/94/Default.aspx |
| Medicare Benefit Policy Manual for Inpatient Psychiatric Hospital Services |
CMS, www.cms.hhs.gov/manuals/Downloads/bp102c02.pdf |
| Psychiatric residential treatment provider certification |
CMS, www.cms.hhs.gov/CertificationandComplianc/13_PRTFs.asp#TopOfPage |
| State Operations Manual for Psychiatric Hospitals |
CMS, www.cms.hhs.gov/CFCsAndCoPs/downloads/som107ap_aa_psyc_hospitals.pdf |
Practice Setting: End Stage Renal Disease/Renal Dialysis |
|
Recommended Resource |
Source |
| Conditions of Participation (42 CFR Part 405.2100, Subpart U) |
National Archives and Records Administration, Code of Federal Regulations, http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?TITLE=42&PART=405 &SECTION=2100&YEAR=2001&TYPE=PDF |
| Dialysis |
CMS, www.cms.hhs.gov/GuidanceForLawsAndRegulations/05_Dialysis.asp |
| End Stage Renal Disease Quality Initiative |
CMS, www.cms.hhs.gov/ESRDQualityImproveInit |
| ESRD General Information |
CMS, www.cms.hhs.gov/ESRDGeneralInformation |
| Medicare Benefit Policy Manual |
CMS, www.cms.hhs.gov/manuals/Downloads/bp102c11.pdf |
| Medicare Coverage of Kidney Dialysis and Kidney Transplant Services |
HHS, www.medicare.gov/Library/PDFNavigation/PDFInterim.asp?Language=English &Type=Pub&PubID=10128 |
| Medicare ESRD Center |
CMS, www.cms.hhs.gov/center/esrd.asp |
| National Voluntary Consensus Standards for End Stage Renal Disease Care |
National Quality Forum, www.qualityforum.org/projects/ongoing/esrd/index.asp |
Revised by
Jill Burrington-Brown, MS, RHIA, FAHIMA
The information contained in this practice brief reflects the consensus opinion of the the professionals who developed it. It has not been validated through scientific research.
Article citation:
AHIMA. "Recommended Regulations and Standards for Specific Healthcare Settings (Updated)" Journal of AHIMA 80, no.1 (January 2009): 61-67. |
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