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Regulatory

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Regulatory Services

Keeping track of the regulations for health care management is a daunting task. Identifying which regulations - proposed and existing - apply to your organization can be difficult. Even when you know the proper rules, staying in compliance can be a challenge.

If your organization finds itself overwhelmed by the process or just needs direction on best practices, QCMG Regulatory Services is here to help. Our consultants have decades of experience in the field of health care compliance, including policy development on both the federal and state level.

Our director of Regulatory Services has extensive knowledge in developing and enforcing health care regulations with the Ohio Department of Health (ODH), giving her a unique understanding of the processes and organizational structure within health departments. The QMCG team includes several hundred diverse and talented physicians, health care professionals, administrators, and attorney consultants available to help you.

The services we provide include assisting with:

  • Community Health Needs Assessment to satisfy requirements of The 2010 Affordable Care Act or to identify community needs to best deploy your resources.
  • Health Care Planning to help your organization plan and prepare for the future demands of health care services.
  • Long-Term Care Services to help you stay up-to-date on ever-changing regulations and participate in the regulatory processes.
  • Acute Care Services to monitor regulations, access compliance and guide best practices.

Community Health Needs Assessment

The 2010 Affordable Care Act includes a requirement that all 501(c)(3) hospitals conduct a community health needs assessment (CHNA) in order to maintain their tax-exempt status. QMCG has a team of attorneys and health planning specialists to assist your hospital in complying with this requirement. A CHNA is also a good way to identify the needs of your community in order to make decisions on how best to utilize your resources to serve your community. Visit our Community Health Needs Assessment page for more information.

Read here for Community Health Needs Assessment Frequently Asked Questions.

Health Care Planning

QMCG can help your organization plan and prepare for future demands for health care services. We offer practical options to identify your health service areas and address health needs in your community.

Our health care planning expert can provide:

  • Consultation on existing and proposed regulatory matters governing health care service lines
  • Community Health Needs Assessments
  • Assistance with all aspects of the Certificate of Need (CON) process, including identifying parties interested in long-term care bed relocations; negotiating terms and executing bed purchase agreements; identifying licensure requirements; preparation of the Certificate of Need application; consultation from project design through project development; and assistance through the licensure and certification processes.

We also can assist with the timing of each component to ensure your service can be initiated on time.

Long-Term Care Services

With changes in reimbursement, franchise permit fees and more stringent regulations, providing long-term care services is more challenging now than ever. Our consultants can help you meet those challenges.

We provide expert assistance to long-term care providers in the following areas:

  • Certificate of Need
    We will prepare and submit your Certificate of Need (CON) application and support you throughout the process. See our Certificate of Need Resource Center for further information.
  • Bed Sales and Acquisitions
    Do you need additional long-term care beds? Are you struggling with low occupancy rates? QMCG brings providers together to relocate beds to areas where they can be better utilized and enhance operations. See our Certificate of Need Resource Center for bed purchase price information.

    QMCG experts will assist you throughout the process:
    • Identifying interested parties
    • Negotiating terms for bed transaction agreements
    • Ensuring that your interests are met throughout the process
  • County Home Bed Conversions
    QMCG consultants provide assistance on how to certify, transfer ownership, relocate and license county home beds. Many counties have found the continued operation of county home beds to be financially challenging. We can assist with the licensure of the county home beds that will enable the sale of the beds and ensure the continued availability of long-term care services to the community. Note: County home beds must have been certified and operational on or after July 1, 1993, to be eligible for licensure.
  • Nursing Home Licensure
    We will bring our extensive experience in licensure and variance processes to help your organization comply with state rules and address licensure issues.

    We provide:
    • A plan review to address licensure requirements
    • Consultation on staffing requirements
    • Preparation of variance requests
    • Preparation of requests for a change in licensed capacity
    • Interaction with the Ohio Department of Health throughout the licensure process
  • Nursing Home Certification
    Our extensive knowledge of the certification process will help you maneuver through the system and ensure that your nursing home is in compliance with the Conditions of Participation.
  • Inspections and Enforcement
    Have concerns over inspection findings? QMCG can work with the Ohio Department of Health to help resolve your issues. Our services include assistance through the survey process, preparation of Plans of Correction and consultation for ongoing compliance.
  • Franchise Permit Fee (Bed Tax)
    We can assist with the de-licensure of long-term care beds approved for relocation or long-term care beds that are no longer needed in order to minimize the bed tax. In addition, we can review your bed tax invoice for accuracy and assist with the appeal if the invoice is incorrect.

Acute Care Services

State regulations for acute care services can change without providers having any knowledge of or input on the change. We can monitor regulations, advise you on proposed changes and provide public comment where appropriate. We can help ensure that your interests are addressed and that your service remains compliant.

  • Health Care Services/Quality Rules
    Our Director of Regulatory Services has worked with experts to develop rules for the Health Care Services (HCS) program. She developed and implemented the HCS program for the Ohio Department of Health (ODH) and was the program's administrator from its inception in 1997 through 2009.

    The HCS program oversees organ transplantation, bone marrow transplantation, cardiac catheterization, open heart surgery and pediatric intensive care services. Regulations include standards for notification, patient care, building and site, staffing, medical records, quality assessment and improvement, complaints, patient selection and safety standards.

    Our experience can help ensure that your service is in compliance. In addition, we can prepare your request for a waiver or variance and work with ODH to address specific concerns.
  • Maternity Licensure
    Our extensive experience with maternity licensure rules means we can address your questions regarding state compliance and help you with inspections and enforcement issues with our services:
    • Consultation on licensure standards
    • Preparation of waiver and variance requests to ODH
  • Inspections and Enforcement
    Not sure that your health care service is compliant? We can review your service and identify areas that should be addressed.
  • Hospital Registration
    Our director of regulatory services has 28 years of involvement with hospital registration. Additionally, our director has provided consultation to the Ohio Department of Health regarding registration policy and rules and can help ensure that your registration is accurate. If you are having registration issues, we can work with the ODH to resolve problems and correct mistakes.

Resources

 
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ckenn Christine Kenney
Director of Regulatory Services
ckenney@qmcg.com
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Q: Did you know that you have options for accreditation at your hospital?

Q-Tip:

  1. Centers for Medicare and Medicaid Services (CMS) – conducted by your state’s health department personnel
  2. The Joint Commission on Accreditation of Health Care Organizations (JCAHO)
  3. The American Osteopathic Association (AOA)
The National Integrated Accreditation for Health Care Organizations (NIAHO)

 
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