Lydia Elliott, Ed.D
Quiz by , created more than 1 year ago

Test your knowledge based on workbook recommended reading https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_a_hospitals.pdf

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Lydia Elliott, Ed.D
Created by Lydia Elliott, Ed.D about 8 years ago
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CMS Interpretive Guidelines for Complaint/Grievances

Question 1 of 10

10

The hospital must establish a process for prompt resolution of patient grievances and must inform each patient whom to contact to file a grievance.

Select one of the following:

  • True
  • False

Explanation

Question 2 of 10

10

Change in bedding, housekeeping of a room, and serving preferred food and beverages requires a written response.

Select one of the following:

  • True
  • False

Explanation

Question 3 of 10

10

CoP stands for Conditions of Patients

Select one of the following:

  • True
  • False

Explanation

Question 4 of 10

10

If a verbal patient care complaint cannot be resolved at the time of the complaint by staff present, is postponed for later resolution, is referred to other staff for later resolution, requires investigation, and/or requires further actions for resolution, then the complaint is a grievance.

Select one of the following:

  • True
  • False

Explanation

Question 5 of 10

10

The hospital’s governing body must review and resolve grievances, unless it delegates this responsibility in writing to a grievance committee.

Select one of the following:

  • True
  • False

Explanation

Question 6 of 10

10

Quality Improvement Organizations (QIO) are hospital employees charged with reviewing the appropriateness and quality of care rendered to Medicare beneficiaries in the hospital setting.

Select one of the following:

  • True
  • False

Explanation

Question 7 of 10

10

Grievances about situations that endanger the patient, such as neglect or abuse, should be reviewed immediately, given the seriousness of the allegations and the potential for harm to the patient(s).

Select one of the following:

  • True
  • False

Explanation

Question 8 of 10

10

Select ALL of the CMS interpretive guidelines for complaint/grievances:

Select one or more of the following:

  • The grievance process does not require specification of time frames for review of the
    grievance and the provision of a response.

  • The hospital must establish a clearly explained procedure for the
    submission of a patient's written or verbal grievance to the hospital.

  • The grievance process must include a mechanism for timely referral of patient concerns
    regarding quality of care or premature discharge to the appropriate Utilization and
    Quality Control, Quality Improvement Organization.

  • The hospital's governing body must approve and be responsible for the effective operation
    of the grievance process, and must review and resolve grievances, unless it delegates the
    responsibility in writing to a grievance committee.

  • The hospital must establish a process for prompt resolution of patient
    grievances and must inform each patient whom to contact to file a grievance.

  • The hospital can choose to establish a process for prompt resolution of patient grievances.

Explanation

Question 9 of 10

10

A grievance is considered resolved when the hospital is satisfied with the actions taken on the patient's behalf.

Select one of the following:

  • True
  • False

Explanation

Question 10 of 10

10

Medicare patients have the right to appeal a premature discharge

Select one of the following:

  • True
  • False

Explanation

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