Issues in Medical Staff Credentialing (two-part series)

10-11 a.m. Nov. 4 and Dec. 2 

Program overview

This online seminar series will:

• Describe legal implications for credentialing that doesn’t meet basic standards for medical staff credentialing, negligence as it relates to credentialing and privileging, and lawsuits involving negligent credentialing and the impact on the hospital credentialing practice
• Explore creating a comprehensive criteria-based privileging system – an essential element of the medical staff’s role – and discuss the increased focus on quality by accrediting organizations, the government and the public, emphasizing the need to continually monitor the quality of services and having a robust privileging system
• Identify red flags or information that shows a problem should be addressed, and discuss how to follow up on these issues and appropriately document this follow-up
• Outline the fundamental aspects of credentialing, including primary source verification, criteria for appointment, application reviews, and the roles in the review and approval process

Part One: Credentialing Basics and Privileging
10-11 a.m. Monday, Nov. 4

Part one of this series will:

• Analyze the credentialing process from application through governing body approval
• Define what constitutes a complete application
• Describe the importance of acquiring evidence to document clinical competency
• Discuss CMS’ accrediting requirements for privileging and documenting competency for privileges
• Discuss primary source verification and which sources are appropriate
• Discuss the Centers for Medicare and Medicaid Services regulations and accrediting requirements for credentialing telemedicine practitioners in acute care and critical access hospitals
• Identify sources other than primary that can be used
• Outline the roles of people involved in the review and approval process   

Part Two:  Identifying Red Flags in the Credentialing and Privileging Processes, Peer Review Proceedings and the Risks From Negligent Credentialing
10-11 a.m. Monday, Dec. 2 

Part two of this series will:

• Define credentialing and privileging negligence
• Discuss peer review protections afforded to medical staff members’ evaluations of colleagues’ quality and credentialing/privileging
• Discuss processes that may help reduce the risks of credentialing negligence
• Discuss recent peer review and credentialing negligence cases and their implications for the hospitals
• Discuss the appropriate follow-up of information received in the application process
• Discuss today’s red flags and how they differ from the past
• Identify how to document medical staff red flag evaluations
• Recognize an organization’s duty to exercise due care in credentialing

Speakers
Karen Kiel Rosser is the vice president and chief quality and strategy officer for Mary Greeley Medical Center in Ames. Kiel Rosser is responsible for quality improvement, strategy development and deployment, and organizational excellence at the medical center. She spearheaded the development and implementation of a systemwide framework for performance excellence using Malcolm Baldrige National Quality Award program criteria and Lean and Six Sigma tools.

Alissa Smith is a partner in Dorsey and Whitney’s health group and represents health systems, hospitals, pharmacies, long-term care providers, home health agencies, medical practices, and nonprofit and municipal organizations. Smith’s regulatory practice includes interpreting and applying state and federal fraud and abuse laws, Medicare and Medicaid rules, tax-exemption and privacy laws, EMTALA laws, licensing and employment laws, governmental audits and open meeting matters. She also helps with corporate and health system governance issues and hospital-provider relations.

Registration and fees

• IHA member organization series rate – $150 total for both parts.
• Associate member organization rate – $150 total for both parts.
• IHA nonmember organization rate – $350 total for both parts.

Recordings policy

IHA will provide recordings only to those who have registered for the program. 

Continuing education

IHA Iowa Board of Nursing provider No. 4 will award 1.0 nursing contact hours for each session of this series.