New CDPH Administrative Penalties for Licensing Violations

Size: px

Start display at page:

Download "New CDPH Administrative Penalties for Licensing Violations"

Lesley Dorsey
7 years ago
Views:

1 New CDPH Administrative Penalties for Licensing Violations CHA Webinar March 21, 2014 Welcome Liz Mekjavich California Hospital Association 1

2 Program Overview and Introductions David Perrott, MD, DDS California Hospital Association Faculty: Bernie Shelley Bernie Shelley is a registered nurse and the manager of the Field Development and Training Unit for the California Department of Public Health, Licensing and Certification Division. In this role Ms. Shelley is responsible for the development and provision of surveyor training needs throughout the state. This includes New Surveyor Orientation Academy, provider-specific trainings and education regarding the implementation and evaluation of new regulations and licensing activities for all health care provider types. Ms. Shelley is a certified CMS Basic Long Term Care Course Instructor. She has collaborated with CMS to provide general acute care hospital, EMTALA and ambulatory surgery center trainings in California. 4 2

3 Regulations Effective April 1, 2014 Understand the process used to determine if a deficiency rises to the level of an administrative penalty Understand the financial impact of the administrative penalties when an IJ does not exist Calculate an administrative penalty using the penalty calculator tool 3

4 Title 22 Division 5 Chapter 1 (General Acute Care Hospitals) Article 10 Hospital Administrative Penalties Effective April 1, 2014 Actual Financial Harm Deficiency Minor Violation Repeat Deficiencies Substantial Compliance Willful Violation Penalty Calculation 4

5 Patient s physical and mental condition Probability and severity of the risk that the violation presents to patient Level - No actual patient harm, but with potential for no more than minimal harm Level 2 - No actual patient harm, but with potential for more than minimal patient harm, but not immediate jeopardy Level 3 - Actual patient harm that is not immediate jeopardy 5

6 Level 4 - Immediate jeopardy to patient health or safety that is likely to cause serious injury or death Level 5 - Immediate jeopardy to patient health or safety that caused serious injury to a patient Level 6 - Immediate jeopardy to patient health or safety that caused the death of a patient Isolated One or a very limited number of patients affected; One or a very limited number of staff involved; or The situation occurred only occasionally; or The situation occurred in a very limited number of locations 6

7 Pattern More than a very limited number of patients affected More than a very limited number of staff involved Situation occurred in several locations Same patient(s) had been affected by repeat occurrences Widespread: Situation was pervasive throughout the hospital Situation represented a systemic failure that affected, or had the potential to affect, a large portion or all of the hospital s patients 7

8 Date of violation is > three years from last issued IJ penalty No additional IJ penalties Substantial compliance over three years prior to date of violation Event date: 4/10/14 Last IJ deficiency was in January 2009 Substantial compliance past four years Is this a first Immediate Jeopardy event? 8

9 Event Date: 4/10/14 Last IJ with AP levied 2/15/2012 Four deficiencies with harm in past two years Is this a first immediate jeopardy event? Without Immediate Jeopardy $ 25,000 With Immediate Jeopardy 1st Deficiency $75,000 2nd Deficiency $100,000 3rd & Subsequent Deficiency $125,000 9

10 Severity Level 3 or 5 Actual Harm & Physical/Mental Impairment One or more major life activities Loss of bodily function Lasts more than seven days or present at discharge Loss of body part Severity Level 3 or 5 Actual Harm & Physical/Mental Impairment One or more major life activities Loss of bodily function Lasts more than three days Loss of body part 10

11 Actual financial harm Factors beyond hospital s control to comply Example: environmental disaster and P&P was followed 11

12 Deficiency was willful Exercise 1 Exercise 2 12

13 Thank you Bernie Shelley, RN, HFEM I (678) Bernadette.Shelley@cdph.ca.gov 25 Questions Online questions: Type your question in the Q & A box, hit enter Phone questions: To ask a question hit 14 To remove a question hit 13 13

14 Upcoming Programs Consent Law Seminars April May, seven programs California Congressional Action Program May 4 7, Washington, D.C Hospital Finance & Reimbursement Seminars June, three programs Physician Leadership Program September April 2015, seven programs 27 Thank You and Evaluation Thank you for participating in today s program. An online evaluation will be sent to you shortly. For education questions, contact Liz Mekjavich at (916) or lmekjavich@calhospital.org

EMTALA UPDATE. Why EMTALA. Basic Requirements. EMTALA Applies To

EMTALA UPDATE. Why EMTALA. Basic Requirements. EMTALA Applies To EMTALA UPDATE January 24, 2013 Bob Olsen, Vice President FACHE, MHA Why EMTALA Hospitals were alleged to be dumping patients on public medical facilities. Patients with emergency medical conditions were