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When a patient discharged on a Friday is back in the hospital the following Monday, there can be many reasons.
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Case managers should be involved in their hospitals' efforts to ensure compliance with the Centers for Medicare & Medicaid Services (CMS) regulations that require documentation of conditions that are present on admission and deny payment for certain conditions acquired during the hospital stay, experts say.
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The Centers for Medicare & Medicaid Services (CMS) continues to move at a rapid pace toward value-based purchasing, proposing expansion in hospital quality reporting requirements and increasing the number of hospital-acquired conditions for which Medicare won't reimburse.
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Cognitive Impairment Progression Blunted by Exercise; Incidentalomas in the Knee; Hormone Replacement and Skin Health in Menopausal Women; Reconfirmation of the Death of Homocysteine; Pramlintide as a Weight-Loss Adjunct; Undiagnosed Diabetes in Obese Americans
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Which came first: the chicken or the egg? Likewise, are what the Centers for Medicare & Medicaid Services labels "never events" really never events if they happen?
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The National Quality Forum (NQF) has endorsed 67 clinician-level consensus standards related to cancer care, infectious diseases, perioperative care, and care provided by thousands of medical professionals who are not MDs.
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The National Surgical Quality Improvement Program (NSQIP) began in 1994 in response to concern over the quality of care, specifically operative mortality rates, in VA hospitals. Since then it has expanded to all hospital settings and come under the auspices of the American College of Surgeons (ACS).
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The Joint Commission requires a "thorough and credible" root cause analysis (RCA) for all Sentinel Events, but the process is sometimes less effective than hoped. Quality leaders at the Mayo Clinic came up with a novel solution: An oversight group to keep the process on track.