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Grievances and Complaints: Ensuring Hospital Compliance

June 25, 2020 @ 8:00 am - 10:00 am MDT


Due to COVID-19, the registration is per hospital and not per connection for this webinar. Please only select a qty. of “1” under Registration and indicate the number of connections requested (not to exceed 5) when completing the Attendee information.

Not sure if you’ll be able to make the live session? Everyone who registers will receive a link to the recording of the webinar that you will have 120 days to view at your convenience at no additional charge.

Every hospital in the United States that accepts Medicare or Medicaid reimbursement must be in compliance with the Centers for Medicare & Medicaid (CMS) Conditions of Participation (CoPs). This program will cover the CMS grievance requirements, which have been identified as the third most common problematic standard for hospitals and a frequent cause of investigation.

This webinar will review the nondiscriminatory provision of the Affordable Care Act (Section 1557) which is enforced by the Office of Civil Rights (OCR). Section 1557 requires a hospital to have a grievance procedure; a compliance coordinator to investigate any alleged noncompliance, including discrimination; and a process to promptly resolve grievances. This program will also discuss the Joint Commission standards on complaints and DNV Healthcare on grievances and how they interface with the CMS interpretive guidelines.

By the end of this presentation, learners should be able to:

  • Discuss that any hospital that receives reimbursement for Medicare patients must follow the CMS Conditions of Participation on grievances. (This is true whether the hospital is accredited by the Joint Commission, HCFA, CIHQ, DNV Healthcare or not).
  • Identify that the CMS regulations under grievances includes the requirement to have a grievance committee.
  • Discuss that the Joint Commission has complaint standards in the patient’s right (RI) chapter and DNV grievance standard in the patient rights chapter.
  • Recall that in most cases the patient must be provided with a written notice that includes steps taken to investigate the grievance, the results, and the date of completion.
  • Describe that the Office of Civil Rights requires hospitals to have a process to handle grievances related to discrimination under Section 1557.

Chief Medical Officers, Medical Staff Leaders, Chief Nursing Officers, Chief Operating Officers, Nurse Educators, Legal Counsel, Compliance Officers

Sue Dill Calloway is president of Patient Safety and Healthcare Consulting and Education company, where she focuses 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. Previously, Sue was a director for risk management and patient safety for the Doctors Company. She was the VP of legal services at a community hospital and served as the privacy officer and the compliance officer. She as also a medical malpractice defense attorney for 10 years and has three nursing degrees in addition to a law degree.

She is a well-known lecturer and the first in the country to be a certified professional in CMS. She has written 102 books and thousands of articles.

The speaker has no real or perceived conflicts of interest that relate to this presentation.

Thursday, June 18; 5:00 p.m. MDT

Access instructions and materials will be emailed to the person completing the order prior to the program date. If you do not receive the instructions at least 24 hours in advance, please contact IHA. 


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June 25, 2020
8:00 am - 10:00 am MDT
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