In what document does CMS require a description of privileging criteria and the procedure for applying these criteria?

The requirement for a description of privileging criteria and the procedure for applying these criteria is found within the medical staff bylaws. Medical staff bylaws serve as the foundational governing documents for the medical staff in healthcare facilities. They outline the structure, responsibilities, and functions, including the process for credentialing and privileging healthcare providers.

Having this information in the bylaws ensures that the procedures are standardized and transparent, which is critical for compliance with the standards set by the Centers for Medicare & Medicaid Services (CMS). This helps to ensure that all medical staff members are credentialed and privileged based on consistent and fair criteria, contributing to the overall quality of care delivered by the institution. The bylaws also provide a framework for accountability and governance within the medical staff, reinforcing the importance of adhering to established regulations and practices in healthcare.

In contrast, while the credentialing manual and operational policies may contain details about specific procedures or practices regarding credentialing and privileging, they do not hold the same authority or comprehensive nature as the medical staff bylaws. Compliance reports generally focus on adherence to regulations and standards rather than serving as the foundational policy documents regarding privilege criteria.