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The Unthinkable: Violence in Healthcare from Bullying to an Active Shooter

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The Unthinkable: Violence in Healthcare from Bullying to an Active Shooter

The healthcare environment creates a major challenge in the prevention and intervention of violence. The rate of injuries and illness to healthcare professionals from violence in the healthcare industry is more than three times greater than violence in all private industry. Nurses are victims of violence more than police officers. Healthcare organizations include hospitals, outpatient clinics, medical office clinics, home health care, home-based hospice, paramedic and emergency medical services, mobile clinics, drug treatment programs and ancillary healthcare organizations. What makes violence in healthcare unique is that it carries negative ramifications for quality patient care. What do you do in your healthcare organization tto protect staff and patients? In the U.S. some states, such as California, have passed legislation specifically addressing violence in healthcare. There are other federal and state laws that require the employer to address the hazards of workplace violence, and laws that protect the victims of workplace violence. OSHA identifies healthcare as one of three “high risk” industries for violence and has written a Guidance document specifically outlining steps healthcare should take to combat the risk. Violence in healthcare is perpetrated not only by patients, their families, and visitors, but as well among the health professionals themselves. It may include a patient admitted to the ER high on drugs and wielding a knife. Or, it may be an enraged physician in the operating room flinging a scalpel at a nurse. And, the violence may be one nurse bullying another nurse – depending how the word “violence” is actually defined. Violence in healthcare is not unique to the United States but occurs all over the world. In 2010, the Bureau of Labor Statistics (BLS) data reported healthcare and social assistance workers were the victims of approximately 11,370 assaults by persons; a greater than 13% increase over the number of such assaults reported in 2009. Almost 19% (i.e., 2,130) of these assaults occurred in nursing and residential care facilities alone. Unfortunately, many more incidents go unreported. Why would that be? Why Should You Attend? The healthcare setting is one of the most violent venues in which to work in the U.S. and internationally. Healthcare is unique in that the violence that occurs here, has negative ramifications to quality patient care. The Joint Commission has even taken a stand on dealing with unsafe patient care due to abusive (which may constitute violence) behavior by health professionals. Your role as leaders in your healthcare organization equates to a responsibility to create and sustain a safe working environment for your employees AND a safe and healing environment for your patients. This webinar will review the critical elements required to plan, design, develop, implement, and evaluate your healthcare organization’s violence prevention plan. Are you prepared to deal with an active shooter on one of your patient floors—which happened in a hospital in Minnesota? As we hear more and more about mass shootings, it causes us to pause and wonder if it could really happen in a hospital, clinic, or when visiting a patient’s home. Fortunately, most violence does not rise to that level, but nonetheless, the violence that commonly occurs in healthcare has profound consequences for all involved. It is essential you prepare to prevent and react to minimize violence that occurs. Areas to be Covered? To define workplace violence To provide examples of workplace violence in healthcare To discuss the relevant laws that address workplace violence To state the impact and consequences of violence to the healthcare victims, the organization and patient care To examine the clinical, occupational, social, and economic factors of violence in healthcare To review 10 de-escalation tips when dealing with an angry individual To examine the causes of healthcare violence To discuss a violence prevention program to ensure patients, families, visitors, and staff are safe using JCAHO guidlines To outline the roles and responsibilities of the organization’s stakeholders To explain how to help the workplace and workers recover following a violent episode Who Should Attend? Director of Risk Management Director of Safety Director of Quality Improvement Occupational Health Nurse VP of Nursing/Chief Nursing Officer Legal counsel Chief Medical Officer Chief Operations Officer

04/14/2025

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HR Auditing - Important Issues For 2025

Does your organization consider the strategic, operational, and compliance related impact of human capital decisions on its ability to achieve its business goals and objectives? Does your human capital help your organization achieve its management goals? Are your employment policies and practices creating material risks and liabilities? Are AI issues now affecting your employment practices? This webinar discusses the development and use of HR Audits in answering these questions and in addressing critical risk management and due diligence issues. The threats and risks from human resource management issues are increasing. No longer measured in only fines, penalties, and awards for non-compliance, human resource management affects keys business metrics, including the organization’s valuation and credit rating. Further, improper human resource management can significantly reduce managerial prerogatives and seriously damage the organization’s reputation and employment brand. As a result, HR audits have become an important tool in identifying problem areas and are increasingly evolving from an ad hoc audit activity to a critical element of an organization’s risk management and compliance processes. Numerous external forces and factors have an impact on the demand for and scope of HR audits. First, in the global economy, human capital has become for many organizations the single most important determinant of competitiveness, productivity, sustainability, and profitability. Increasingly, the organization’s human capital is the source of innovation and a driver of business success. Second, a confluence of economic, political, and social factors, including corporate scandals, the failure of organizations to adequately assess risks, and the increasing number of stockholder initiatives, have resulted in increased statutory and regulatory requirements, a call for greater transparency, and increased internal and external audit activity. Third, governmental agencies have become more active — some would argue more aggressive — and have committed more resources to conducting assessments of employment policies and practices. Importantly, the EEOC, the OFCCP, U.S. DOL, and ICE have advised employers that they consider self-assessments and audits a “best practice.” Fourth, AI is no longer used solely as a tool to support HR activities. AI is quickly becoming a critical element of strategic and tactical management activities. It this environment, identifying and assessing human capital related risks have become a critical element of an organization’s success. As a result, an organization’s ability to audit and manage these risks plays an increasing role in helping it succeed. Why You Should Attend HR audits can assist your organization identify the weaknesses and failures of its human resource management and employment practices compliance activities. HR Audits can further help your organization identity critical issues effecting the management of your human capital asset and provide an indication of your organization’s commitment to identifying and ferreting out unlawful practices and processes. Thus, your use of HR audits should consider strategic and tactical issues, identify risks, assess compliance, and develop both quantitative and qualitative methods and measurements to assess those risks. Your HR audit activities should help you assess your organization’s performance and should provide you with data that will allow you to evaluate human capital outcomes. Areas Covered in this Session A discussion of current trends in HR Auditing A discussion of senior management’s HR auditing goals and issues An understanding of the critical components of an HR audit A discussion of economic, political, regulatory, and social factors affecting HR audits A review the use of HR auditing tools A discussion of the development of the HR Audit Scorecard Who will Benefit HR audits and assessments play an increasingly important role in managing an organization. Like other management tools, HR audits help organizations access, manage, and monitor the successes and failures of their use of key resources and help them plan for future requirements. As a result, attendees will gain an understanding of the required elements of improving their organization’s performance. HR professionals Internal and external auditors Business owners Compliance managers Risk managers CEOs CFOs Topic Background HR audits HR auditing HR risk assessments HR compliance

04/16/2025

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CMS Swing Bed Requirements For Acute and Critical Access Hospitals

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CMS Swing Bed Requirements For Acute and Critical Access Hospitals

Swing Beds can be a financial lifeline for smaller hospitals and Critical Access Hospitals. This webinar will focus on swing bed regulations in Appendix A for Acute hospitals, and Appendix W for Critical Access Hospitals. Interpretive guidelines and survey procedures are under Appendix PP – Long Term Care manual – which will be discussed in the corresponding regulation sections. It is challenging to figure out what the interpretive guidelines and survey procedures are as there is there was no crosswalk between the two Appendices and Appendix PP. The webinar was created to assist hospitals in understanding what needs to be done. Also to be discussed will be common deficiencies involving swing beds and how to avoid them. Objectives Discuss the requirements for a patient to be admitted to Swing Bed status Recall how to locate the regulation and interpretive guidelines and survey procedures for swing beds Describe what is required by CMS to be in the resident assessment which is done to do the care plan Recall the CMS requirements for emergency dental care for swing bed patients Agenda Manual and Introduction to Conditions of Participation Introduction Common Swing Bed deficiencies Special Requirements for Providers of Swing Beds Services Introduction to Swing Beds Eligibility requirements Interpretive guidelines and survey procedure under Appendix PP Three-day stay Eligibility Payment Healthcare literacy SNF Services Patient/Resident Rights Exercise of Rights Notice of Rights and Services Free Choice Privacy and Confidentiality Visitors and notification Work Mail Access and Visitation Rights Personal Property Married Couples Admission, Transfer and Discharge Rights Transfer and Discharge Payment of care Content of notice Resident Behavior and Facility Practices Restraints, Abuse and Neglect Reporting requirements Staff Treatment of Residents Hiring of employees Patient Activities Social Services Resident Assessment Comprehensive Care Plans PASARR or RAI Trauma informed care Discharge Summary Rehabilitation services Dental services Nutrition Appendix and Resources Who Should Attend CEO COO CFO Nurse executives Accreditation and Compliance/Regulation director Nurse managers Pharmacists Quality managers Risk managers Health information management personnel Social workers Dieticians Nurses Nurse educators Nursing supervisors Patient safety officer Director of Rehab (OT, PT, speech pathology, and audiology) Infection preventionist Anyone who is responsible for care of swing bed patients in a CAH Persons responsible implementing the CMS swing bed requirements

04/16/2025

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When Your Payor Disputes Coding Accuracy

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When Your Payor Disputes Coding Accuracy

Many providers have experienced a significant increase in clinical validation denials, citing lack of coding accuracy. This is a specific denial category that occurs when clinical evidence in the patient chart is inadequate to support a billed diagnosis. It is not the same as coding, billing or charging errors. It is important to understand the cause of these denials and develop strategies to improve the process. For example, if the provider documents Acute Respiratory Failure, the chart should include ABG values, whether the patient has chronic respiratory compromise and evidence of aggressive measures of oxygen intake. Documentation that is lacking in these areas may lead to denial of the claim. Regardless of your setting, it is important to quickly identify these denials and work with your providers to adequately support conditions documented in the record. Historically, coders have relied upon provider statements when coding for conditions managed in the current encounter. Recent payor trends of claims review have identified coding and documentation patterns in which provider statements did not contain supporting information necessary to validate the condition and how it was managed. In this webinar we will discuss several examples that will explain how and why providers are seeing these significant increases. Webinar’s Goals Ability to identify clinical validation denials & coding dusputes and why they occur. Understand that diagnostic statements by the provider require supporting evidence of the condition. Can be compounded when the provider is selecting codes. Conflicting provider opinions that are not addressed can contribute to denial activities. Understand that payers often have specific diagnostic protocols that include expected clinical criteria. Review examples of clinical validation denials and common expectations that should be in the record. Areas Covered Recognize denials associated with clinical validation. Review your top 5-10 denial categories and analyze these claims for patterns with certain diagnoses. What is missing that would support the billed condition? Query providers when diagnostic statements are not clearly supported with clinical evidence. Develop provider education opportunities for stronger evidence of the billed diagnoses. Education can include other departments for better outcomes. Education should include the financial impact of documentation deficiencies and inconsistences. Target Audience Revenue Cycle Managers & staff Billers Coders Clinical Documentation Staff Finance Managers Denial Management Staff Physicians Mid Level Providers Claims Follow Up Staff

04/17/2025

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