A working sentinel event policy is more than a document filed with your standards manual. It is a defined chain of identification, reporting, RCA², leadership review, and CAPA follow-through that satisfies Joint Commission, CMS, and state adverse-event reporting laws at the same time.
A candid operator’s guide to credentialing tracking software: what it is, how it stands up to Joint Commission MS chapter scrutiny and CMS §482.22, and how to stop losing revenue while protecting against False Claims Act exposure from excluded providers.
A recent multi-million dollar DOJ Anti-Kickback settlement fits a clear enforcement pattern from OIG and the Civil Division. Here is what compliance officers should tighten now across credentialing, financial-interest disclosures, and CAP workflows before a surveyor or auditor asks.
A practical, operator-side look at what healthcare incident reporting software has to do to satisfy CMS Conditions of Participation, The Joint Commission’s Patient Safety chapter, and state adverse-event statutes. Named regulators, real OIG data, and the connective tissue surveyors actually ask about.
A mock Joint Commission survey works when it mirrors the real on-site methodology: tracers, EP-level document review, leadership session, and SAFER Matrix scoring. Here is how compliance officers, COOs, and quality leaders build a mock program that actually predicts survey day findings.
A clinical chart audit tool structures, samples, and scores medical record reviews against CMS, Joint Commission, ACHC, DNV, and CARF standards. Here is what one should do, what regulators actually cite, and how findings should roll straight into corrective action plans.
An operator’s guide to building an Infection Control Risk Assessment that satisfies CMS §482.42, Joint Commission IC standards, and produces defensible survey evidence in minutes. Real citations, real numbers, and the accreditation evidence chain most facilities miss.
Delegated credentialing lets a health plan hand off provider credentialing to a qualified organization, but the plan keeps accountability. Here is what NCQA, CMS, and Joint Commission auditors actually look for, and how compliance officers can run the monthly cadence without spreadsheets.
A working Environment of Care checklist has to do more than list rooms and dates. It has to map to the seven EC management plans, the Life Safety Code, and the standards Joint Commission surveyors cite most often. Here is how operators build one that holds up.
The National Patient Safety Goals sit at the center of every Joint Commission survey. Here is what operators need to prove, which goals get cited most, how NPSGs map to CMS and DNV, and what surveyors expect during tracers.
