Unit outcome(s) addressed in this Assignment:

• Evaluate reasons for sound corporate compliance and penalties for failure to comply
• Compare and contrast abuse and fraud in the health care settings
• Discuss how Qui Tam lawsuits impact the health care industry

Course outcome assessed/addressed in this Assignment:

HA525-1: Illustrate legal principles and laws that affect professional and administrative decisions found in health care services.

Instructions

Much of this course is dedicated to educating you, the student, about compliance with quality standards. It is important to understand that compliance extends to every phone call, computer entry, claim submission, patient contact, visit, provider interaction, nursing care, and so on. For this, your Final Project, you will prepare a report about the role of the Joint Commission (JC).

To begin, please visit the organization’s website:

Source: The Joint Commission: The Joint Commission. Retrieved from http://www.jointcommission.org/

Additional research will be necessary.

Part I

• Write an essay discussing the following:
  • The role of the Joint Commission in accrediting medical facilities
  • Which facilities can be accredited?
  • What are the goals of the Commission?
  • How do existing Joint Commission guidelines impact facilities that are not accredited by the Commission?
  • What does it mean to a facility to be accredited by the Joint Commission?
  • Is it mandatory for organizations to be accredited by the Joint Commission? If not, what impact does not having such accreditation mean in terms of reimbursement?

Part II

• Create a memorandum where:
  • You are the administrator of the health information department for a medium-sized facility. You have just been informed by the compliance officer that the Joint Commission will be visiting your facility and will be focusing on your department.
  • Begin the memorandum by including information you believe will be important for your personnel to know to prepare for the visit.
  • Then, anticipate possible questions that the Commission might have for you in terms of compliance.
  • How will you and your department respond to these questions? How will you manage any negative findings during the visit?
  • Finally, discuss how current noncompliance findings can be avoided in the future in this memorandum.

Requirements

• Complete both part of the Assignment as follows:
  • Part I should cover 4–5 pages
  • Part II should cover 2–3 pages
• Use the Joint Commission website as one source and at least two other sources for your topic — a minimum of three references total.
• All formatting and references should use APA style.
• Total of 8–10 pages including the title page and reference page.

As required by law, every health care facility must maintain a medical record for each patient that it treats (Pozgar, 2004). Although the exact specifications may vary slightly across each state, there are still some basic legal principles to remember when dealing with the medical record. As a part of the risk-management department for an assisted living facility, it has fallen to you to take a look at the facility’s policies on medical records.

It is your responsibility to come up with a new policy that deals with the maintenance and release of medical records.  . The components of Parts I and II are laid out below.

Medical Records Policy: Part I

Develop Part I of the Medical Records Policy that focuses on the maintenance of medical records. In this section, you should consider things such as the following:

• the contents of a medical record (i.e., what information goes in a record)
• guidelines for properly making an entry in a medical record (i.e., how to do so, how to make a correction, etc.)

Develop Part II of the Medical Records Policy.

• ownership of the medical record (only this bullet)
• policies/procedures for the release of records (do not do)
• ways to maintain confidentiality (include any major laws that govern this)(do not do)

Guidelines

Look up sample policies regarding medical records to use as a guide. You may not use a policy found in your research in its entirety. This is meant to be an original policy created by you. The final product of the individual portion should be an actual policy—make sure that it is presented just as policy would be in a real assisted-living facility setting. There is no need for any explanation as to why you chose what you did.