Accreditation & Survey Preparation | .accreditationqualitycenter

Inside Accreditation & Quality

- Volume

Issue

ACHC reports often-cited standards at acute care, critical access hospitals

March 04, 2024

Accreditation & Survey Preparation

The Accreditation Commission for Health Care’s (ACHC) recent Quality Review Edition of its publication The Surveyor for acute care hospitals and critical access hospitals (CAH) examined the most frequ...

Mac's Safety Space

- Volume

Issue

What do you do when a surveyor tells you (you have to do) something?

December 13, 2025

Accreditation & Survey Preparation

But then, when you get a chance to review the contents of the survey report, what the surveyor told you in the moment isn’t anywhere to be found … It seems that lately, there’s been a spate of folk...

Healthcare Safety Leader

- Volume

Issue

Strategies for safety: Navigating solutions for healthcare workplace violence, Part 1

December 13, 2025

Accreditation & Survey Preparation, Environment and Facilities, Infection Control, Workplace safety

Workplace violence in healthcare remains a serious matter. About 73% of all nonfatal workplace violence-related injuries involved healthcare workers in 2018, according to the US Bureau of Labor Statis...

Inside Accreditation & Quality

- Volume

Issue

Quality review: Most frequent ACHC deficiencies fall under infection control

February 26, 2024

Accreditation & Survey Preparation, Infection Control

Almost 90% of hospitals surveyed by the Accreditation Commission for Health Care (ACHC) between June 1, 2022, and May 31, 2023, were cited for deficiencies under one of the accrediting organization’s ...

Inside Accreditation & Quality

- Volume

Issue

A patient complaint investigation is likely—what are your first steps?

December 13, 2025

Accreditation & Survey Preparation

If you have reason to believe your hospital may be subject to a complaint investigation by your accrediting organization (AO) or CMS, the best strategy is to be prepared with documentation, including ...

Mac's Safety Space

- Volume

Issue

Emergency management moves out into ambulatory care

December 13, 2025

Accreditation & Survey Preparation, Natural & Manmade Disasters

Well, not strictly speaking—I’m pretty sure we’ve been working on preparedness in the ambulatory care settings for a while now. I suspect that this is more of a recalibration to ensure that all applic...

Healthcare Safety Leader

- Volume

Issue

Consider using alternate equipment management to free up staff for critical compliance issues

December 13, 2025

Accreditation & Survey Preparation, Environment and Facilities, Cybersecurity & Technology

Make strategic use of alternate equipment management (AEM) plans to streamline your facility’s workload and eliminate unnecessary testing, suggests Richard L. Parker, CHFM, CLSS-HC, FACHE, FASHE, asso...

Inside Accreditation & Quality

- Volume

Issue

ACHC highlights cited deficiencies at ambulatory surgery centers

February 12, 2024

Accreditation & Survey Preparation

Ambulatory surgery centers (ASC) accredited by the Accreditation Commission for Health Care (ACHC) are being reminded of the importance of having complete documentation in patients’ medical records. ...

Healthcare Safety Leader

- Volume

Issue

Review medication security as high-profile incidents focus AOs on drug diversion

December 13, 2025

Accreditation & Survey Preparation, Quality & Errors

Review security measures designed to stop drug diversion, and educate staff and providers about how to dispose properly of unused controlled substances. ...

Mac's Safety Space

- Volume

Issue

If you don’t properly maintain the environment…

February 05, 2024

Accreditation & Survey Preparation

As we continue our crawl through The Joint Commission standards changes, let’s drop in on the changes in the Infection Control chapter. Although the changes aren’t necessarily pointed at the physical ...

Subscribe to Accreditation & Survey Preparation

ACHC reports often-cited standards at acute care, critical access hospitals

What do you do when a surveyor tells you (you have to do) something?

Strategies for safety: Navigating solutions for healthcare workplace violence, Part 1

Quality review: Most frequent ACHC deficiencies fall under infection control

A patient complaint investigation is likely—what are your first steps?

Emergency management moves out into ambulatory care

Consider using alternate equipment management to free up staff for critical compliance issues

ACHC highlights cited deficiencies at ambulatory surgery centers

Review medication security as high-profile incidents focus AOs on drug diversion

If you don’t properly maintain the environment…

Resource/w tools selected

STET CMS & tools

OSHA Dental Facilities Update - November 2023

OSHA Medical Facilities Update - November 2023

Tab 2, Medical Facilities OSHA Manual- August 2023

Tab 2, Dental Facility OSHA Manual- August 2023

Chapter 2: Chapter Format and Tracer Planning