Hospital Topics

Overview

2014 Ballot Initiatives
Two initiatives of great importance to California hospitals

CHA has taken positions on two ballot initiatives — listed below with links to their campaign sites. The most recent updates on ballot measures are displayed below.

  • Oppose Proposition 45, which would grant the state Insurance Commissioner the authority to regulate health plan and insurance company premium rates.
    www.stophighercosts.com
  • Oppose Proposition 46, which would quadruple the non-economic damages cap on California’s Medical Injury Compensation Reform Act.
    www.micra.org
CHA News Article

Proposition Numbers Assigned to Rate Regulation, MICRA Ballot Initiatives

The California Secretary of State’s Office on Monday assigned proposition numbers to the six ballot initiatives that will appear before voters on the Nov. 4 general election ballot. Among the measures are Proposition 45, which would grant the state Insurance Commissioner the authority to regulate health plan and insurance company premium rates, and Proposition 46, which would quadruple the non-economic damages cap on California’s successful Medical Injury Compensation Reform Act.

CHA News Article

Campaign to Defeat Anti-MICRA Ballot Initiative Will Host Media Trainings

Representatives from the campaign coalition working to defeat the anti-Medical Injury Compensation Reform Act (MICRA) initiative on the November ballot will conduct speaker’s bureau and media trainings next month throughout the state.

CHA News Article

Anti-MICRA Initiative Qualifies for November Ballot
Oppose to protect access to quality health care

The California Secretary of State announced yesterday that a ballot initiative that would increase the cap on pain-and-suffering damages in medical malpractice lawsuits and require hospitals to drug and alcohol test doctors qualified for the November 2014 ballot.

Overview

CDPH Licensing & Enforcement

The California Department of Public Health (CDPH) Licensing and Certification surveyors may visit a hospital at any time to determine whether the hospital is in compliance with state licensing requirements. Visits may result from a complaint by a patient, employee or other third party; a newspaper article; or a report by the hospital itself regarding an unusual occurrence, privacy breach or adverse event.

CHA News Article

CDPH Launches Open Data Portal

The California Department of Public Health (CDPH) has launched its Open Data Portal, a tool that allows user-friendly access to the data it collects about important health issues. The first data tables available through the portal include birth profiles, poverty rates, the location of vendors who accept vouchers from the Women, Infants and Children program, health care facilities data, and surveillance for West Nile virus and asthma. Upcoming data will include newborn screening disorders, licensed medical device retailers and leading causes of death. Eventually, CDPH will offer data from other state departments within the California Health and Human Services Agency. For additional information, visit the CDPH Open Data Portal.

CHA News Article

CDPH Issues AFL on 2014-15 License Renewal Fees

The California Department of Public Health has issued an All Facilities Letter (AFL) on fiscal year 2014-15 license renewal fees set to take effect July 1. A renewal notice and application will be sent to the licensee of each facility 45-120 days prior to the license expiration date. Licensees that do not receive a notice within 45 days of the expiration date should contact the Grant and Fiscal Assessment Unit at RCollection@cdph.ca.gov, or by telephone at (916) 552-8700 or (800) 236-9747. All fees must be paid in full on or before the license expiration date even if the renewal notice was not received. Late payment penalties cannot be waived. For more information, see the attached AFL.

Recording

Responding to Licensing and Certification Deficiencies Webinar
New CDPH penalties, working with surveyors, plans of correction, appeal process

Webinar Recorded Live on May 21, 2014

Overview

You’ve received a licensing violation. You may have been expecting it from a recent survey, or it may have come as a complete surprise. One thing is for certain, survey activity — and subsequent violations — will be more common now that California Department of Public Health (CDPH) has issued new regulations for hospital penalties, including non-immediate jeopardy violations.

CHA News Article

CDPH Explains Informed Consent Process for SNFs

The California Department of Public Health (CDPH) has issued an All Facilities Letter (AFL) to skilled-nursing facilities (SNFs) explaining the informed consent process. The letter supplements previously issued guidance and reflects revisions that include physician assistants in the process of obtaining informed consent in SNFs. The AFL also reaffirms that when admitting a patient to a SNF with unchanged preexisting orders for psychotherapeutic drugs, physical restraints or the prolonged use of a device that may lead to the inability to regain use of a normal bodily function, the SNF must verify that the patient’s health records contain documentation that the patient gave informed consent for the ordered treatment. A preexisting order is an order written by the attending licensed health care practitioner (including nurse practitioners and physician assistants) prior to and encompassing the admission of a patient to a SNF. For more information, see the attached AFL and its accompanying FAQ regarding informed consent.

CHA News Article

CDPH Updates Title 22 Licensing Fee, Diesel Generator Regulations

The California Department of Public Health has updated sections of Title 22 of the California Code of Regulations related to licensing fees and diesel generator testing so they conform to changes previously enacted in statute. Because the changes were enacted through statute, they do not have a “regulatory effect” and are not required to go through the standard regulatory development process. A list of the affected Title 22 sections that have been amended or repealed is attached. Also attached are the updated sections.

Overview

Community Benefit Programs
Hospitals give back to their communities

Health care is undergoing tremendous change and uncertainty as California implements the federal Affordable Care Act (ACA). Hospitals are working to ensure there will be enough beds and an adequate supply of health care professionals to meet the demands of the millions of Californians who are signing up for health insurance coverage under the ACA. In addition, California hospitals are meeting the needs of their communities through locally developed community benefit plans by supporting health care programs that provide preventative care to those in need.

Tax-Exempt Status of Nonprofit Hospitals

The tax-exempt status of nonprofit hospitals is being reviewed by policymakers, regulators and public interest groups. There are various proposals to impose burdensome and inflexible standards on nonprofit hospitals in order to obtain tax-exempt status and financing. CHA supports the development of appropriate guidelines that are not unduly burdensome and will allow sufficient flexibility to ensure nonprofit hospitals are able to carry out their mission. They must be based on broad measures of community benefit without establishing rigid formulaic thresholds.

CHA News Article

CHA Highlights Innovative Mobile Health Van Threatened by AB 503
Services for underserved at risk

CHA issued the attached press release today highlighting CareVan, a mobile health van that provides free health care services throughout San Joaquin County. The program — along with community benefit programs throughout the state — is threatened by AB 503 (Wieckowski, D-Fremont; Bonta, D-Alameda).

News Release

Innovative Medical Career Program Sponsored by Bay Area Hospital at Risk if AB 503 is Enacted
New Video Profiles Medical Biotechnology Academy at John Muir Hospital in Concord

SACRAMENTO (June 9, 2014) -  The California Hospital Association (CHA) today released a new video highlighting a successful community benefit program that is designed to expose students to possible careers in the medical and health care field.  The program, operated jointly by John Muir Hospital in Concord and Mt. Diablo High School’s Medical Biotechnology Academy, is designed to place students on a career path through a rigorous, hands-on internship program.  Its future is threatened, however, by Assembly Bill (AB) 503 (Wieckowski/Bonta).

CHA News Article

Charity Care Bill Proponents Long on Rhetoric, Short on Facts
CHA fact check shows misinformation prominent in AB 1952 Health Committee discussion

CHA has released a fact check to correct inaccurate claims about AB 1952 (Pan, D-Sacramento), a measure that would impose a 5 percent mandate for charity care on most nonprofit hospitals and create a one-size-fits-all charity care requirement across diverse communities in California.

News Release

New Study by Economist and Former Finance Director Tom Campbell Shows Access to Care At Risk from Mandates
Thousands of Californians Could be Shut Out From Needed Health Care if Legislation Is Passed

(SACRAMENTO – January 16, 2014) – Former Congressman and State Finance Director Tom Campbell released results today of a new study that warns that thousands of Californians could be shut out of the health care they need, even if they have health coverage, if new regulations and mandates are approved by the state Legislature.  

Overview

Clinical Care

Clinical care touches every aspect of hospital operations. Policies and procedures surrounding clinical care are of the utmost importance in meeting regulatory, legal and licensing requirements. CHA has numerous area-specific groups — including specialty centers and committees — that address the many aspects of clinical care. Some areas of clinical care are subject to rapid changes in public policy and regulations, creating additional challenges for hospitals. In addition to providing representation and advocacy to address these challenges, CHA focuses on the unique needs of certain facilities, and the services and programs they offer their communities.

Education event

Minors Health Care — The Basics of Consent, Privacy and More
Learn about the rules, exceptions to the rules, practical solutions to common problems

October 29, 2014
10:00 a.m. – Noon, Pacific Time

This scenario plays out in hospitals every day: grandmother, teacher, neighbor or concerned friend brings a minor to the hospital. No parent in sight. Now what? Can you treat the minor? Whose consent do you need? Who should you talk to about the minor’s treatment options? These questions often challenge the most seasoned health care providers. This webinar will take you back to basics to refresh your knowledge of consent and privacy laws for minors.

Education event

Principles of Consent and Advance Health Care Directives Webinar
A program for those new to health care or professionals seeking to refresh their knowledge

October 1, 2014
10:00 a.m. – Noon, Pacific Time

Consent is more than a signature on a form. Patients have the right to make treatment decisions, but ensuring that they understand their options and associated risks is not easy. And while the responsibility for obtaining informed consent falls to physicians, your hospital is responsible for making sure that consent was obtained and documented. Register for this webinar to hear in clear, simple terms why and when consent is necessary, who may give consent and procedures that require special consent. The authority of an advance health care directive and California’s POLST form will also be discussed along with your obligations when a patient presents these documents.

Recording

Responding to Licensing and Certification Deficiencies Webinar
New CDPH penalties, working with surveyors, plans of correction, appeal process

Webinar Recorded Live on May 21, 2014

Overview

You’ve received a licensing violation. You may have been expecting it from a recent survey, or it may have come as a complete surprise. One thing is for certain, survey activity — and subsequent violations — will be more common now that California Department of Public Health (CDPH) has issued new regulations for hospital penalties, including non-immediate jeopardy violations.

Recording

Using ED Overcrowding Assessment Tools to Improve Care and Throughput Webinar
Learn about the Dignity Health Emergency Department Overcrowding Scale (DEDOCS)

Webinar Recorded Live on May 29, 2014

Overview

When an ED becomes crowded, the entire hospital can suffer
In 2011, CHA’s EMS/Trauma Committee partnered with Dr. Steven Weiss to develop CEDOCS — the Community Emergency Department Overcrowding Scale — to measure and rate ED crowding.

General information

Emergency Department Toolkit
Behavioral health resources for the emergency department

Special resource toolkit developed by CHA’s EMS/Trauma Committee and the Center for Behavioral Health.  Designed to help staff provide support to patients in the ED with psychosis and/or substance abuse disorders, this toolkit provides access to articles, policies, management techniques, assessment tools and more. Click the topic tabs below to access resources and information.

Overview

Construction / Renovation

In the area of construction and renovation, CHA assists hospitals by reviewing and commenting on proposed regulations, attending all Hospital Building Safety Board (HBSB) meetings, nominating hospital representatives to the HBSB Board and serving as liaison between hospitals and the Office of Statewide Health Planning and Development’s (OSHPD) Facility Development Division when issues need to be resolved.

CHA News Article

Architects Present 6th Annual Health Facility Conference

The American College of Healthcare Architects and the American Institute of Architects California Council will host an all-day forum Oct. 9 at the Marriott City Center in Oakland. Themed Overcoming Uncertainty – What the Future Holds, the forum includes a distinguished faculty of hospital designers and construction managers who will cover the impact of the Affordable Care Act, developing technologies, budget and financing requirements, evolving project delivery methods, and changing patient expectations on the planning and design of health care facilities. For more information and to register, visit www.healtharchitects.org/Education/California_Forum.asp. Deadline to register is Sept. 28.

CHA News Article

OSHPD Announces “Hot Topics” Seminar

The Office of Statewide Health Planning and Development (OSHPD) Facilities Development Division has announced  it will hold one-day seminars, featuring current “hot topics,” Oct. 9 in Anaheim and Oct. 30 in Concord. Seminar sessions will include information on the functional program; defining “materially altered;” the use of standard details; preapproved details; the electronic services portal; and an update on Code Application Notices and Policy Intent Notices. Seating is limited at both locations. To register, see the attached registration information. For more information about the program, contact OSHPD at (916) 440-8453 or FDD.seminar@OSHPD.CA.gov.

CHA News Article

FCC Requires Hospitals to Register Wireless Telemetry Devices With ASHE

All hospitals using wireless medical telemetry service (WMTS) devices must register them with the American Hospital Association’s American Society for Healthcare Engineering (ASHE) to avoid possible harmful interference with the operation of their equipment. As the designated WMTS coordinator, ASHE maintains a database of WMTS users, and the Federal Communications Commission (FCC) requires registration with ASHE before an organization operates a WMTS system in the TV channel 37 band (and in the upper bands of 1395-1400 MHz and 1427-1432 MHz). If a WMTS system is not registered, the FCC considers it to be unlicensed and not entitled to protection from interference caused by other transmitters.

CHA News Article

New Regulations Seek to Eliminate Toxins From Hospital Furniture
Webinar to focus on new statewide standards for flame retardant furnishings

The Healthier Hospitals Initiative (HHI) and Health Care Without Harm invite hospitals to a free webinar on the health impacts of flame retardants, the implications of the new regulations for health care, and the opportunities for hospitals to create healthier interior spaces through the elimination of harmful chemicals in furnishings while reducing costs.

CHA News Article

Hospitals Subject to New Requirements for Power Strips and Alternative Equipment Management

The Joint Commission’s (TJC) Department of Engineering reports that the Centers for Medicare & Medicaid Services (CMS) is no longer allowing relocatable power taps, referred to as RPTs or power strips, to be used with medical equipment in patient care areas, including operating rooms, patient rooms and areas for recovery, exams and diagnostic procedures.

Overview

Emergency Preparedness
Is your hospital prepared?

Visit CHA’s Emergency Preparedness website at calhospitalprepare.org

About

Through the Office of the Assistant Secretary for Preparedness and Response, Office of Preparedness and Emergency Operations, Hospital Preparedness Program (HPP) grant, CHA has created a web site specifically devoted to Emergency Preparedness at www.calhospitalprepare.org.

   
Overview

Finance

Hospital finance is complicated, and California hospitals operate in a challenging environment. Hospital executives are faced with the task of developing financial strategies that contain costs yet allow for the provision of health care to the state’s large uninsured population.

Recording

Hospital Presumptive Eligibility Program Webinar
A vital tool for providing potentially-eligible individuals with on-the-spot Medi-Cal coverage

Webinar Recorded Live on June 19, 2014

Hospitals can play an important role in reducing the number of uninsured through the Hospital Presumptive Eligibility (HPE) program. The HPE program will allow all hospital Medi-Cal providers — including any clinic on a hospital’s license — to provide potentially-eligible individuals with temporary, full-scope Medi-Cal benefits.

CHA News Article

CHA Leadership Meets with CMS Deputy Administrator Sean Cavanaugh

Yesterday, as part of the California Congressional Action Program, CHA board leaders and staff met with CMS Deputy Administrator and Director for the Center for Medicare Sean Cavanaugh; Liz Richter, deputy director, Center for Medicare; and Niall Brennan, director, Center for Enterprise Management. Over the past year, CHA has been working with CMS and the Office of Inspector General to identify the regulatory pathways for hospitals to move forward in adopting Modern Pricing, an initiative that supports hospitals in voluntarily adjusting their charges to make them more meaningful to patients and communities. CHA will host a members-only webinar on Modern Pricing May 30; members are encouraged to participate to learn more about the initiative.

General information

Video Describes Vital Role Nonprofit Hospitals Play in Their Communities

In opposition to AB 975 (Wieckowski/Bonta), CHA has embarked on a comprehensive public advocacy campaign to increase awareness of the importance of not-for-profit hospitals and the diverse array of community benefit programs they provide throughout California.  A new video (below) describes the vital role nonprofit hospitals play in the communities they serve. 

AB 975 would establish a “guilty until proven innocent” presumption for hospitals that report an operating margin of more than 10 percent.Under current law, nonprofit hospitals are required to invest their funds int

Overview

Health Care Reform

Our nation’s health care system has entered a new era with the enactment of federal health care reform. This landmark legislation is resulting in many changes in how health care is financed and delivered for years to come. For nearly two decades, CHA has been at the forefront in advocating for meaningful health care reform — and we will continue to help shape the future of hospital care far into the future. CHA’s vision of an “optimally healthy society” is now a reality within reach.

CHA News Article

Report Indicates Hospitals Spend Average 12.3 Percent of Expenses on Community Benefits

According to a new analysis commissioned by the American Hospital Association (AHA), nonprofit hospitals spent an average 12.3 percent of their total expenses on benefits to their communities in 2011, an increase from 11.5 percent in 2010. Additionally, direct benefits to patients, which include charity care, financial assistance and spending to fill gaps in Medicaid underpayments, averaged 6.1 percent of total expenses in 2011, an increase over that reported in 2010. Benefits to the community include charity care, Medicaid underpayments, community health improvement programs, health research and education, subsidized services, bad debt expense attribution to charity care, Medicare shortfall, and other community benefits and building activities. The report acknowledges these financial costs incurred by hospitals do not include all the tangible and intangible benefits of improving their communities’ health and well-being.

CHA News Article

KFF Report Examines 2015 Premium Changes in Health Insurance Marketplaces

The Kaiser Family Foundation (KFF) has issued an analysis of premium changes in marketplace plans for individuals in 15 states plus the District of Columbia, where it was able to find comprehensive data on rates or rate filings for all insurers. Since premiums vary substantially across geographic rating areas even within a state (there are 500 rating areas nationwide), KFF examined premium changes in the rating area that includes a major city in each state. The analysis also includes an examination of the premium changes for the lowest-cost bronze plan and the two lowest-cost silver plans available in each state.

CHA News Article

DHCS Announces Stakeholder Engagement Initiative
Releases stakeholder survey, announces stakeholder engagement website

The California Department of Health Care Services (DHCS) has announced a new Stakeholder Engagement Initiative. The initiative’s goals are to provide clear, transparent and regular stakeholder communication and coordination in advance of and during new initiatives; improve overall communication with stakeholders through various outreach formats; engage stakeholders in developing policy; ensure that each stakeholder effort has a clear purpose and scope, and is connected to the appropriate department teams and other stakeholder efforts; and identify and implement best practices within DHCS to share and integrate stakeholder feedback throughout the department.

CHA News Article

CHHS to Host Webinar on State Innovation Model and Proposed Accountable Communities for Health Pilots

The California Health and Human Services Agency (CHHS) will conduct a State Innovation Model (SIM) Proposed Accountable Communities for Health (ACH) pilots webinar Sept. 26 from 10 a.m. – 11 a.m. (PT). On April 1, 2013, the Centers for Medicare & Medicaid Innovation awarded California a $2.6 million SIM design grant to develop its State Health Care Innovation Plan, which formed the basis of the application CHHS submitted to the federal government on July 18 for a three-year SIM testing grant.

CHA News Article

Moody’s Report: 2013 Revenue Growth, Cash Flow Margins Mark All-Time Lows for Not-for-Profit Hospitals
Balance sheet measures and debt coverage ratios remain stable despite weak performance

Moody’s Investors Service has released a report titled Revenue Growth and Cash Flow Margins Hit All-Time Lows in 2013 US Not-for-Profit Hospital Medians, showing that for fiscal year 2013, U.S. not-for-profit hospitals saw continued slowing revenue growth and weaker operating performance, declining to levels not seen since the recession.

Overview

Health Information Management & Technology

Hospitals are moving away from paper-based records to electronic medical records and electronic health records to retain patient-care data. Electronic formatting facilitates data capture in a “real-time” environment, and allows many users to access the data at the same time.

CHA supports the capture and availability of secure patient-care data through the use of health information technology (HIT) across the continuum of care. CHA believes HIT will serve as a tool to enhance patient safety, promote information for preventative health and reduce health care costs.

CHA News Article

CMS Finalizes Updates to EHR Incentive Program Requirements
Rule finalizes extension of meaningful use stage 2, CEHRT flexibility

The Centers for Medicare & Medicaid Services (CMS) has released the attached final rule extending stage 2 of meaningful use through federal fiscal year (FFY) 2016 and delaying the start of stage 3 until FFY 2017. The rule also grants flexibility to providers who are unable to fully implement the 2014 Edition certified electronic health record technology (CEHRT) for an electronic health record (EHR) reporting period in 2014 due to delays in 2014 Edition CEHRT availability. For 2014 participation, providers may now use EHRs that have been certified under the 2011 Edition, a combination of the 2011 and 2014 editions, or the 2014 Edition. CHA reminds hospitals that failure to attest to meaningful use will result in a 25 percent reduction in their market basket update in FFY 2015 and a 50 percent reduction in FFY 2016.

Education event

Minors Health Care — The Basics of Consent, Privacy and More
Learn about the rules, exceptions to the rules, practical solutions to common problems

October 29, 2014
10:00 a.m. – Noon, Pacific Time

This scenario plays out in hospitals every day: grandmother, teacher, neighbor or concerned friend brings a minor to the hospital. No parent in sight. Now what? Can you treat the minor? Whose consent do you need? Who should you talk to about the minor’s treatment options? These questions often challenge the most seasoned health care providers. This webinar will take you back to basics to refresh your knowledge of consent and privacy laws for minors.

Education event

Principles of Consent and Advance Health Care Directives Webinar
A program for those new to health care or professionals seeking to refresh their knowledge

October 1, 2014
10:00 a.m. – Noon, Pacific Time

Consent is more than a signature on a form. Patients have the right to make treatment decisions, but ensuring that they understand their options and associated risks is not easy. And while the responsibility for obtaining informed consent falls to physicians, your hospital is responsible for making sure that consent was obtained and documented. Register for this webinar to hear in clear, simple terms why and when consent is necessary, who may give consent and procedures that require special consent. The authority of an advance health care directive and California’s POLST form will also be discussed along with your obligations when a patient presents these documents.

CHA News Article

CMS Addresses Role of EHR Navigators During Hospital Survey Process

The Centers for Medicare & Medicaid Services (CMS) has issued the attached Survey and Certification memo addressing the issue of Electronic Health Record (EHR) navigators during the survey process for hospitals and critical access hospitals (CAHs).

CHA News Article

CMS Formally Proposes Extension of Stage 2 Meaningful Use
Stage 2 training call scheduled for May 29

The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) issued a proposed rule yesterday that would extend stage 2 of meaningful use through 2016 and delay the start of stage 3 until 2017.

Overview

Human Resources

California hospitals and health systems employ more than half a million people — from entry-level positions to senior executives. Many health care human resources (HR) departments are responsible for a wide range of issues, such as recruitment, staffing, compensation, benefits, labor/employee relations and employee health. Navigating the complex regulatory environment, while monitoring how it applies to HR in the health care setting, can be a challenging and dynamic task.

Representing hospitals and health systems in California, CHA provides leadership in HR policy on state and federal levels. In addition, CHA advocates on behalf of hospitals and health systems before the federal and state legislatures, federal and state administrative agencies and the public. CHA also provides educational opportunities, such as the annual Labor & Employment Law seminar, to help hospital leaders sharpen their skills and knowledge in health care HR. CHA members also participate on an HR executive e-mail list and receive periodic informational memoranda. 

Education event

Labor and Employment Law Seminar
Updates on wage and hour, safe patient handling, high-profile union agreement

November 5, Glendale
November 13, Sacramento

This program is for executives of CHA-member hospitals only

Every year the HR landscape changes. Hospital employers need to stay on top of new laws and regulations, important case decisions and shifting enforcement positions that will impact operations and employee relations policies. There’s a lot to know. Expert faculty at the annual Labor and Employment Law seminar will do the analysis for you, explaining the issues in the context of health care operations.

Recording

New California Pregnancy and Disability Regulations Webinar DVD
What the new regulations mean to hospitals and employees

Webinar Recorded Live February 28, 2013

Recently, California’s Fair Employment and Housing Commission issued new regulations to guide compliance with pregnancy and disability laws. Some aspects of the new regulations confirm what we “thought” the rules meant. Others impose entirely new standards to follow and raise the bar on existing obligations. It’s imperative for employers to closely review and understand the new state regulations.

Publication

Employee Handbook and Personnel Policies Manual
Covers the full range of policies

Designed for all employers, this manual covers the full range of policies included in personnel handbooks. It is a must-have for employers who want to avoid common pitfalls.

Please note: This manual is available to members only and is offered at a special CHA discount.

730 pages (12th edition, 2011)

 

Publication

Employment Discrimination and EEO Practice Manual for California Employers
A complete, nontechnical guide

Human resources professionals will learn how to comply with applicable state and federal employment discrimination laws and the cost of noncompliance.

Please note: This manual is available to members only and is offered at a special CHA discount.

780 pages (9th edition, 2009)

Publication

Wage and Hour Manual for California Employers
A guide on legal requirements affecting wage and hour practices

Covers state and federal wage and hour laws, the Fair Labor Standards Act, Industrial Welfare Commission wage orders and Labor Commission policies.

Please note: This manual is available to members only and is offered at a special CHA discount.

900 pages (16th edition, 2013)

Overview

Legal

CHA’s legal department advocates vigorously before the courts on behalf of California hospitals, both as a party in litigation and as amicus curiae in important appellate cases. In addition, the CHA legal department prepares legal memoranda and manuals to help hospitals understand and comply with state and federal laws. The CHA legal department also supports CHA staff in their advocacy efforts before the state legislature and regulatory agencies.

CHA News Article

California Supreme Court Extends Deadline for Deciding Whether to Review Hospital Case Against Blue Cross

Last week, the California Supreme Court extended its deadline from Sept. 16 to Oct. 16 to decide whether to grant review in the Children’s Hospital Central California v. Blue Cross California case. The case arose from a dispute between the hospital and Blue Cross of California over the basis for calculating the amount Blue Cross owed the hospital for authorized post-stabilization emergency services provided to beneficiaries enrolled in Blue Cross’s Medi-Cal managed care plan while the hospital and Blue Cross were not in contract.

Education event

Minors Health Care — The Basics of Consent, Privacy and More
Learn about the rules, exceptions to the rules, practical solutions to common problems

October 29, 2014
10:00 a.m. – Noon, Pacific Time

This scenario plays out in hospitals every day: grandmother, teacher, neighbor or concerned friend brings a minor to the hospital. No parent in sight. Now what? Can you treat the minor? Whose consent do you need? Who should you talk to about the minor’s treatment options? These questions often challenge the most seasoned health care providers. This webinar will take you back to basics to refresh your knowledge of consent and privacy laws for minors.

Education event

Principles of Consent and Advance Health Care Directives Webinar
A program for those new to health care or professionals seeking to refresh their knowledge

October 1, 2014
10:00 a.m. – Noon, Pacific Time

Consent is more than a signature on a form. Patients have the right to make treatment decisions, but ensuring that they understand their options and associated risks is not easy. And while the responsibility for obtaining informed consent falls to physicians, your hospital is responsible for making sure that consent was obtained and documented. Register for this webinar to hear in clear, simple terms why and when consent is necessary, who may give consent and procedures that require special consent. The authority of an advance health care directive and California’s POLST form will also be discussed along with your obligations when a patient presents these documents.

Recording

Responding to Licensing and Certification Deficiencies Webinar
New CDPH penalties, working with surveyors, plans of correction, appeal process

Webinar Recorded Live on May 21, 2014

Overview

You’ve received a licensing violation. You may have been expecting it from a recent survey, or it may have come as a complete surprise. One thing is for certain, survey activity — and subsequent violations — will be more common now that California Department of Public Health (CDPH) has issued new regulations for hospital penalties, including non-immediate jeopardy violations.

CHA News Article

Settlement Against Hospital Involves Stark Law Violation Related to Medicaid

A hospital in St. Petersburg, Florida this month entered into a False Claims Act settlement with the U.S. and the state of Florida that could have significant implications for the “Stark law,” which governs physician self-referrals.

Overview

Quality & Patient Safety

CHA is committed to helping hospitals improve quality, reduce medical errors and adverse events, and maximize patient safety.

CHA’s vision is an “optimally healthy society.” CHA’s goal is for “every Californian to have equitable access to affordable, high-quality, medically necessary health care.”

CHA News Article

CMS to Host Dry Run Call on Heart Failure and Pneumonia Measures
Dry run for HCAPHS star rating systems also announced

As an educational component of its “dry run” for measures in the hospital inpatient quality reporting program, the Centers for Medicare & Medicaid Services (CMS) will host a national provider call on heart failure and pneumonia payment measures Sept. 16 from noon – 1:30 p.m. (PT). The call will present hospitals with an overview of the measures and guidance on interpretation of measure data and results. To participate, hospitals must pre-register on QualityNet’s website. The dry run of heart failure and pneumonia payment measures was initiated Sept. 8 and will run through Oct. 7. 

CHA News Article

CMS Extends Review and Corrections Period for Hospital Readmissions Reduction Program

The Centers for Medicare & Medicaid Services (CMS) has extended the review and corrections period for the federal fiscal year 2015 hospital readmissions reduction program to 11:59 p.m. (PT) on Sept. 22. During this time, hospitals may access their hospital-specific report (HSR), which contains detailed information about their excess readmission ratios, prior to public reporting of the data.

CHA News Article For Members

CHA Summary Details Payment, Policy Provisions of FFY 2015 IPPS Final Rule

The Centers for Medicare & Medicaid Services (CMS) estimates that national hospital inpatient payments will decrease by 0.6 percent in FFY 2015 as compared to FFY 2014, despite a positive market basket update. CHA estimates that total payments to California hospitals will increase by 0.8 percent, or approximately $90.7 million, compared to FFY 2014. While overall the impact for California is positive, this masks the continued reductions for documentation and coding, the devastating cuts to Medicare DSH payments, and significant penalties for readmissions and hospital acquired conditions that many hospitals will experience when the policies take effect Oct. 1. Details of the impacts are outlined in the attached CHA summary of the inpatient prospective payment system (IPPS) final rule for federal fiscal year (FFY) 2015.

CHA News Article

CMS Suspends Data Collection of Sepsis Bundle for IQR Program

The Centers for Medicare & Medicaid Services (CMS) has notified hospitals participating in the hospital inpatient quality reporting (IQR) program that it will suspend data collection for the Severe Sepsis and Septic Shock: Management Bundle measure (NQF #0500) until further notice. This measure was adopted for the federal fiscal year (FFY) 2017 payment determination in the FFY 2015 inpatient prospective payment system final rule. In 2013 the measure went through the National Quality Forum’s maintenance process, during which time it was determined newly released data would impact the measure as currently designed. CMS notes that the delay does not affect the data collection period for any other hospital IQR measure.

CHA News Article

NQF Board Ratifies Recommendations on Sociodemographic Risk Adjustment

The National Quality Forum (NQF) board of directors met in late July to ratify the Consensus Standards Approval Committee’s (CSAC) recommendations augmenting the NQF expert panel recommendations on appropriately risk adjusting quality measures for socioeconomic and other sociodemographic factors.

Overview

Reimbursement

California hospitals’ revenue stream is critical to their overall mission of providing care and cures in the communities they serve. While over half of hospitals’ revenue, nearly $30 billion a year, is derived from government-funded programs, including Medicare, Medi-Cal, Healthy Families and county indigent programs – Private Insurance revenues are also significant.

CHA believes that hospitals should be reimbursed adequately to cover the cost of care for enrollees.

CHA News Article

Noridian to Host Open Door Coverage Meeting Sept. 16

Noridian will hold a public Part A open door coverage meeting Sept. 16 from 11 a.m. – 12:30 p.m. in Los Angeles. Discussion will include information on the Recovery Audit Contractor program; local coverage determinations in various stages; medical review; comprehensive error rate testing; contractor medical director updates; and a question-and-answer period.

CHA News Article For Members

CHA Summary Details Payment, Policy Provisions of FFY 2015 IPPS Final Rule

The Centers for Medicare & Medicaid Services (CMS) estimates that national hospital inpatient payments will decrease by 0.6 percent in FFY 2015 as compared to FFY 2014, despite a positive market basket update. CHA estimates that total payments to California hospitals will increase by 0.8 percent, or approximately $90.7 million, compared to FFY 2014. While overall the impact for California is positive, this masks the continued reductions for documentation and coding, the devastating cuts to Medicare DSH payments, and significant penalties for readmissions and hospital acquired conditions that many hospitals will experience when the policies take effect Oct. 1. Details of the impacts are outlined in the attached CHA summary of the inpatient prospective payment system (IPPS) final rule for federal fiscal year (FFY) 2015.

CHA News Article

DHCS Announces Fix for Certain Erroneously Denied Medi-Cal Claims

The California Department of Health Care Services (DHCS) has announced that Medi-Cal has fixed an issue with an erroneous denial of All Patient Refined Diagnosis Related Group (APR-DRG) type of bill code 121.

CHA News Article

Hospitals Encouraged to Complete RACTrac Surveys by Tomorrow’s Deadline

The American Hospital Association’s (AHA) RACTrac survey data is used specifically to analyze the impact of the Medicare Recovery Audit Contractor (RAC) program on hospitals and helps to guide CHA’s advocacy for important and necessary changes in the RAC program. AHA membership is not required to participate in RACTrac; CHA encourages all hospitals to participate regardless of AHA membership status. As part of the survey, participants are asked include information on the number of claims withdrawn from appeal to rebill for Part B payment. For registration information, contact AHA’s RACTrac support at (888) 722-8712 or ractracsupport@providercs.com. For more on the survey, including the latest results, visit www.aha.org/ractrac.

CHA News Article

HRSA Releases Interpretive Rule on 340B Orphan Drug Discounts

The Department of Health and Human Services (HHS) and its Health Resources and Services Administration (HRSA) have issued the attached interpretive rule on the 340B Drug Pricing Program. The rule continues to allow hospitals subject to the “orphan drug” exclusion to purchase those drugs through the 340B program when the drugs are not used to treat the rare conditions for which the orphan drug designation was given. In May, a federal court vacated HHS’ adoption of a regulation to implement the orphan drug exclusion policy. The interpretive rule is effective July 23.

Overview

Workforce

California Hospitals are concerned about the need for an adequate supply of highly skilled health professionals to meet the demands for health care services now and in the future. Numerous studies have been completed that validate the need to address critical health professional shortages in nursing and the allied health occupations.  However, efforts to implement recommended strategies have been hindered by a lack of a coordinated statewide effort involving health employers, as well as other necessary partners. 

Education event

Labor and Employment Law Seminar
Updates on wage and hour, safe patient handling, high-profile union agreement

November 5, Glendale
November 13, Sacramento

This program is for executives of CHA-member hospitals only

Every year the HR landscape changes. Hospital employers need to stay on top of new laws and regulations, important case decisions and shifting enforcement positions that will impact operations and employee relations policies. There’s a lot to know. Expert faculty at the annual Labor and Employment Law seminar will do the analysis for you, explaining the issues in the context of health care operations.

CHA News Article

President Obama Signs Workforce Innovation and Opportunity Act

This week, President Obama signed the Workforce Innovation and Opportunity Act (WIOA). WIOA is designed to help job seekers access employment, education, training and support services to succeed in the labor market, and to match employers with the skilled workers they need to compete in the global economy.

CHA News Article

OSHPD Seeks Primary Care Residency Task Force Members

The Office of Statewide Health Planning and Development (OSHPD) has formed a new Primary Care Residency (PCR) Task Force and is soliciting applications from interested individuals. Task force members will serve as subject matter experts to help develop recommendations and implement the PCR program for a two-year commitment ending in June 2016. An application and a complete list of roles and responsibilities are available on the OSHPD website. Applications are due July 23. For more information about the PCR Task Force contact Melissa Oman, program administrator, at (916) 326-3753, or email questions to SongBrown@oshpd.ca.gov.

CHA News Article

Health Careers Training and Workforce Development Grants Available

The Department of Health and Human Services Health Resources and Services Administration (HRSA) is now accepting applications for its Health Careers Opportunity Program (HCOP) Skills Training and Health Workforce Development of Paraprofessionals grants. The $2 million in grants will be available from Sept. 1, 2014, through Aug. 31, 2017, to train and expand the health paraprofessional workforce to meet community employment needs.

CHA News Article

Hospitals Can Apply for Residency Slots From Closed Teaching Hospital
Applications are due Sept. 2

The Centers for Medicare & Medicaid Services (CMS) this week announced that hospitals can apply for a portion of 27 Medicare residency slots made available after the closure of Long Beach Medical Center in New York. The Affordable Care Act authorizes CMS to redistribute residency cap slots after a hospital that trained residents in an approved medical residency program closes. Guidelines for submitting applications are available on the CMS website. Applications must be received in the CMS Central Office by Sept. 2, and hospitals must notify CMS of their mailed submissions by email.

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