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Essay Available:
Pages:
3 pages/≈825 words
Sources:
4 Sources
Style:
APA
Subject:
Health, Medicine, Nursing
Type:
Coursework
Language:
English (U.S.)
Document:
MS Word
Date:
Total cost:
$ 15.55
Topic:

Health Information Documentation Guidelines

Coursework Instructions:

Instructions
ASSIGNMENT: Create Health Information Documentation Guidelines
Scenario: You are the new HIM Director for Community Healthcare which includes an acute care hospital, an attached clinic and an attached long term health facility. After several weeks on the job you realize that the documentation guidelines are outdated and it appears they have not been updated for nearly 10 years. After asking questions of the staff, it sounds like they are following current documentation standards, it is just that the written guidelines have not been brought up to date. You set out to update the written guidelines.
You first need to compile the guidelines set forth by Joint Commission and CMS since those are the regulatory bodies that monitor your organization.
Instructions:
1. Locate the documentation standards for the Joint Commission and CMS and Conditions of Participation.
2. Create a table listing medical record documentation standards for both the Joint Commission and CMS Conditions of Participation for each segment of Community Healthcare (Acute Care Hospital, Clinic, and Longterm Care). You will have 3 tables, one for each type of facility.
3.Title the document as a policy and write a short explanation of the purpose of the document and how it should be used.
4.Provide 2-3 recommendations for compliance with the JC (Joint Commission) standards.

Coursework Sample Content Preview:


Health Information Documentation Guidelines
Name
Institution
Course Code and Title
Instructor
Date
Health Information Documentation Guidelines
Purpose and Use of the Document
The health information documentation serves as a guide to the policies created under the Joint Commission (JC) and Centers for Medicare and Medicaid Services (CMS) in implementation in Community Healthcare. Joint Commission policies are important in ensuring that a continued progression in creating measures to improve healthcare provision is developed (Joint Commission, 2010). The inclusion of JC measures in the health information documentation helps ensure that safe and effective care is provided to guarantee the best quality and value is derived from healthcare services. On the other hand, CMS policies help enhance an effective process of affordable healthcare by offering effective payment, healthcare management, treatment, and optimization of the quality of healthcare facilities (Hamlet & Regenmorter, 2016). CMS policies in the health information documentation help ensure that optimal healthcare provision is provided without any financial inconveniences. The documentation will offer effective measures to be followed in every segment of the Community Healthcare service provision structure. Therefore, the guidelines in the health information documentation are meant to ensure that JC and CMS measures are applied distinctively in the acute care hospital, clinic, and long-term care.
Guidelines

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