Grievances and Complaints - An overview of the CMS, Joint Commission, DNV and OCR Standards Hospitals should know about

• By: Staff Editor
• Date: July 25, 2018

Grievances and Complaints - An overview of the CMS, Joint Commission, DNV and OCR Standards Hospitals should know about

No hospital wants to receive a statement of deficiencies and plan of correction from the regulatory bodies. Non-compliance with the grievance requirements is the third most problematic area that invites investigation. What if a CMS surveyor shows up at your hospital unannounced? Is your hospital compliant with the all the grievance requirements by CMS, OCR, and the complaint standards by the Joint Commission or your accreditation organization?

Effective management of patient complaints and grievances, can bolster systems and individual performance, and provide quality improvement opportunities.

Understanding the regulations:

• CMS CoP Regulations: Patient rights §482.13
• OCR Section 1557
• TJC has complaint standard RI.01.07.01
• DNV PR 5
• Non-Discrimination Law Section 1557 of the ACA

The CoPs requirements are frequently updated. They first appear in the federal register. The interpretive guidelines are then published by CMS. You may visit these websites once a month to see if there are manual updates.

The CMS website publishes statement of deficiencies on a regular basis. You can count the deficiencies for each by using tag numbers. The grievance deficiencies tags are 118,119,120,121,122, and 123.

To take a deep dive into implementing best practices, managing patient complaints and grievances, you may wish to attend this webinar ‘Grievances and Complaints: What Hospitals Should Know about the CMS, Joint Commission, DNV and OCR Standards.’