CMS Standing Orders, Protocols, Order Sets and Preprinted Orders

Event Information
Product Format
Prerecorded Event
Sue Dill Calloway, RN, MSN, JD
90 minutes
Product Description

CMS and Joint Commission Standards and Guidelines on Standing Orders, Protocols, Order Sets and Preprinted Orders

Standing orders and Medicare conditions of participation that relate to them are some of the most confusing compliance requirements that hospitals face. Both CMS and the Joint Commission address this tricky area, and four separate sections of the hospital CoP manual regulate the issue of standing order requirements. After CMS moved most of the standing order requirements from Tag 405 to Tag 457, your hospital’s staff likely suffered more confusion.

This live webinar by expert speaker Sue Dill Calloway, RN, MSN, JD, will discuss the interpretive guidelines and regulations that are required by the CMS and the Joint Commission regarding protocols, order sets, preprinted orders and standing orders. Sue will provide the history of each of the four sections and what each section requires hospitals to do. Sue will also help clarify confusing areas and make the requirements easy to understand for hospitals.

Session Highlights

  • Hospital compliance with the CMS CoP requirements if they accept federal reimbursement
  • The four separate sections of CMS requirements for standing orders and protocols
  • Approval of all protocols by the medical staff, even if the protocols are department specific
  • The signing off of the standing order along with a date and time
  • Locating a CoP copy
  • Survey and certification website for changes
  • Joint Commission standards on standing orders
  • CMS-required radiology protocols
  • Tag 450 changes
  • New Tag 457
  • Final interpretive guidelines
  • Scope of practice issue for Tags 405 and 406
  • CMS memo on standing orders in hospitals: State law and scope of practice requirements

Session Agenda

  • The conditions of participation (CoPs)
  • CMS standing orders
  • Final interpretive guidelines on standing orders
  • Subscribing to the federal register
  • Location of CMS hospital CoP manuals
  • CMS survey and certification website
  • CMS survey memos
  • Accessing hospital complaint data
  • Updated deficiency data reports
  • Deficiency data CMS hospitals
  • CMS order sets, protocols and standing orders
  • Preprinted orders vs. order sets
  • ISMP guidelines for order sets
  • Revised tag 405 and 406
  • 405 changed compounding BUD
  • Vaccine standing order program
  • Pre-printed orders tag 450
  • Tag 457 standing orders

Who Should Attend

Anyone involved in ensuring compliance with the CMS hospital conditions of participation related to standing orders, protocols, order sets including the:

  • CEO
  • Chief operating officer
  • Chief nursing officer
  • Chief risk officer
  • Chief medical officer
  • Risk management professional
  • Hospital legal counsel
  • Senior leadership
  • Radiology director
  • PI staff
  • Compliance officer
  • Regulatory officer
  • Joint Commission liaison
  • Pharmacy director
  • Nurse educator
  • Pharmacist
  • Rehab and respiratory director and staff
  • Patient safety officer
  • MEC committee members
  • Infection preventionist or manager
  • Anesthesia director
  • Anesthesiologist
  • Staff nurses, nurse managers and nurse supervisors
  • IS department staff
  • Policy and procedure committee members
  • Anyone involved in standing orders, protocols, order sets and preprinted orders
  • Anyone who serves on a committee that reviews standing orders, order sets, and protocols

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About Our Speaker

Sue Dill Calloway - Hospital Coding Expert

Sue Dill Calloway, RN, MSN, JD, is the president of Patient Safety and Healthcare Consulting and Education company with a focus on medical-legal education especially Joint Commission and the CMS hospital CoPs regulatory compliance. She also lectures on legal, risk management and patient safety issues. She was a director for risk management and patient safety for five years for the Doctors Company. She was the...   More Info
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