Behavioral Healthcare Compliance for TJC and CMS: Updates and Resources
See behavioral healthcare compliance posts below from our recent newsletters and access our newsletter archive and behavioral healthcare industry links.
Suicide Risk Assessment Now # 2 in Top Ten Compliance Issues for Behavioral Health
TJC recently published the Top Ten Standards Compliance Issues for the First Half of 2014. (See table below.) There is not much new or different from previous years but it's worth noting that suicide risk assessment has now climbed to the # 2 spot on the list with 21%...
Feedback from TJC Hospital Executives Briefings
We attended the annual TJC Hospital Executives Briefings and CMS Update in New York City earlier this month. It was chock full of information on the latest TJC and CMS compliance issues. It was also a glimpse into what some of the key TJC focus areas will be in 2015....
Treatment Plans in Psychiatric Hospitals
As we all know, issues with treatment plans are one of the most frequently cited areas of non-compliance on TJC surveys. This is true for both psychiatric hospitals and behavioral health organizations. Recently, however, a new issue has been identified.
Opportunities for Improvement
Organizations surveyed after July 1, 2014 will see a change in how their findings are written up in their TJC survey reports. There will now be an Opportunities for Improvement section included in the survey report. Included in this OFI section will be single...
Revisions to TJC Behavioral Health Opioid Treatment Standards
If your organization operates an Opioid Treatment Program (OTP), be sure to review the recent changes to the TJC Behavioral Health standards that apply to these programs. There are some changes to the following chapters: Care, Treatment and Services Medication...
Heads Up on Battery Operated Smoke Detectors in Behavioral Health Residential Settings
One of our clients that operates a residential treatment program recently underwent their initial TJC survey. They were surveyed under the Life Safety Code Residential Occupancy requirements for Lodging and Rooming Houses that have from 4 to 16 occupants. The...
TJC Changes to PFIs and Life Safety Equivalencies
[thumbnail alt="Tim O’Rourke, CHFM" type="img-thumbnail" alignment="alignright" image="http://barrins.a3creativeloft.com/wp-content/uploads/TimOrourke-219x300.jpg" ]Tim O’Rourke, CHFM, B&A Engineer[/thumbnail]Barrins & Associates engineer Tim O'Rourke, CHFM...
Competence Assessment in Behavioral Health
During surveys of both psychiatric hospitals and behavioral health organizations, issues continue to arise around how the organization is assessing the competence of its clinical staff. We have seen several survey findings for organizations not clearly defining...
Medication Instructions at Discharge
The TJC focus on the discharge process continues in 2014. During surveys, surveyors will frequently request a sample of closed records. In the past, the focus for closed records was on determining if the discharge summary had been completed on time. More recently,...
High Reliability: Important Topic for TJC Leadership Interview
For several years, the common topic for the leadership interview on the last day of the survey was the five "pillars of leadership" as described in standards LD.03.01.01 - LD.03.06.01: Using data Planning Communicating Changing Performance Staffing This topic is still...