If you are responsible for compliance to accreditation and regulatory requirements at your organization, then the 2025 CIHQ Accreditation & Regulatory Summit is the “must attend” conference of the year! The challenges facing healthcare institutions has never been greater while the future offers amazing opportunities. This is one conference you don’t want to miss! The conference will be in San Antonio at the Pedrotti’s Ranch from October 21-23. 

Here is a sneak peek of the topics for this year’s Summit:

CMS – State of the Union

The regulatory environment is in a period of uncertainty. Get first-hand knowledge on the latest in the CMS certification arena. This opening address will cover current and likely future actions from CMS and their impact on accrediting organizations and hospitals. To be forewarned is to be forearmed!

Update on the Prospective Payment System

Each year CMS publishes changes to the Prospective Payment System (PPS) for hospitals. Failure to comply with these requirements can affect your hospital’s reimbursement from Medicare. This presentation will provide an overview of the PPS regulations and key areas of compliance.

Cybersecurity – Ongoing Threat & Challenges

Malware, ransom attacks, data breaches – the threats to hospitals and healthcare systems is real and growing! This presentation underscores the importance of a vibrant and adaptive cybersecurity program. Learn about the HHS 405(d) Program - a collaborative effort between the Health Sector Coordinating Council and the federal government to align healthcare industry security practices. Get the latest information on the threats we face and how to protect our information systems.

Acute Dialysis in a Complex Environment

This presentation will examine current trends in dialysis regulatory standards and their implications for healthcare providers. Topics include the CMS End Stage Kidney Disease Regulatory Update, review of the top 10 deficiencies that occur during a survey, and strategies to improve patient safety and minimize risk.

The NFPA Life Safety Code & Interim Life Safety Measures

Hospitals must comply with the NFPA 101 Life Safety Code 2012 edition. The code is highly complex and references multiple other NFPA codes. How do you make sense of it all? This presentation will cover the basic structure of the Life Safety Code and how to identify and implement interim life safety measures (ILSM) when deficiencies are identified.

The Times They Are-A-Changin’

2025 ushered in a plethora of uncertainties for laboratories and hospitals. A well-documented shortage of healthcare professionals, apprehension about funding cuts, and regulatory changes have made 2025 a year to adapt to change. This presentation will share actionable information on two movements that are gaining traction in the healthcare industry: Clinical Lab 2.0 and the Workforce Action Alliance.

Construction Risk Assessments

Have you noticed? The hospital industry is undergoing a building boom! New construction, renovation, remodeling; it seems all of us are involved in some construction activity. This presentation will cover the requirements for performing construction risk assessments – both from a building and infection control perspective. You’ll learn about the most common citations during a survey and how to prevent them.

Voice of the Patient: Unleashing the Power of PROMs and PREMs

Patient-reported outcome measures (PROMs) are questionnaires measuring the patients' views of their health status. Patient-reported experience measures (PREMs) are questionnaires measuring the patients' perceptions of their experience while receiving care. This presentation will assist hospitals in implementing strategies to integrate these measures into care practices to improve patient outcomes.

When the Lights Go Out: Strengthening Utilities and Continuity of Operations Through Meaningful Exercises

Hospitals face increasing risks from severe weather, prolonged utility outages, and unexpected system failures that can disrupt patient care and critical operations. While policies and plans are required, true resilience is built through realistic training and exercises that prepare staff for the unexpected. This session will explore practical strategies for protecting utilities and critical systems and demonstrate how to design emergency exercises that go beyond “checking the box.” Attendees will walk away with actionable tools to test their continuity plans, engage staff, and align with CMS emergency preparedness requirements.

Ensuring Compliance and Safety: Navigating NIOSH and USP Updates

This session highlights sterile compounding accreditation compliance strategies. The presenter will include information about the latest NIOSH and USP <795>, <797>, and >800> survey process(es) and include tips for how to always be prepared. The presentation focuses on understanding critical standards, ensuring adequate documentation, and developing an organized approach to achieve compliance.

Legal Update – Challenges for Hospitals

The legal front of the healthcare industry has been active like never before. Changes in law and regulations have hospitals scrambling to make sense of it all. This session will update you on current and future legal issues affecting hospitals so that you can prepare for the impact.

HIPAA Final Rule Update

The US Health Insurance Portability and Accountability Act (HIPAA), enacted in 1996, was established to safeguard patient privacy and secure health information. HIPAA sets strict standards for managing, transmitting, and storing protected health information. This presentation will cover the latest changes to HIPAA and the impact on hospitals.

Human Resources – The Unwritten COP!

While there is no chapter entitled “Human Resources”, requirements for an effective staff training and development program are embedded throughout the Medicare Conditions of Participation. This presentation will address expectations of both CMS and accrediting organizations in designing and implementing compliant human resource processes.

Mock Surveys in a Complex Environment

Hospitals often use mock surveys to prepare for the real thing. This presentation will cover the implementation of a multi-disciplinary robust mock survey process and management of a large survey across multiple hospitals. Effective communication before, during and after the survey will be a highlight.

Life Safety Rounding in Hospitals

Regular, focused life safety rounds are essential to ensuring compliance with NFPA 101, the Life Safety Code. Hear from a prominent pediatric hospital on how they implemented a multi-disciplinary in-house life safety rounding program and review their top findings from 2024. From developing protocols and checklists to fostering a culture of continuous improvement, participants will gain actionable strategies to enhance life safety practices within their healthcare institutions.

CIHQ Accreditation Program Update

This presentation is for CIHQ accredited organizations. Get the latest information on changes to standards, survey procedures, and the top condition-level deficiencies levied over the past 12 months. This will also be your opportunity to seek interpretation of standards and get your questions answered.

TJC/DNV/ACHC Accreditation Program Update

This presentation is for organizations accredited by the other three deeming authorities. You’ll get the latest information on changes to standards, policies, and survey process for each agency.

The House Always Wins: Using Improved Processes to Tip the Odds

This session will explore how automation can streamline compliance workflows, reduce regulatory risks, and support hospitals’ quality improvement efforts. Attendees will learn how to identify improved process opportunities, select the right tools, and overcome implementation barriers.

Managing Infectious Disease Outbreaks – All Hands on Deck

This presentation will discuss how hospitals need to respond in the event of an infectious disease outbreak in their facility. The goal is to educate attendees on critical steps to help maintain control and navigate through stressful events associated with an infectious disease outbreak.

Direct Contracting for Better Patient Care

Eliminating prior authorization, getting paid on time and at 100% of what you agreed to may seem far-fetched but it's happening more than you'd think. Direct contracting with employers and their representatives is proving to be advantageous for all stakeholders and a way forward for improving access and a better experience for patients. In this presentation, we will learn what direct contracting is and what it isn't. We will also come to understand how this model benefits hospitals and employers.

The Politics of Healthcare – Navigating Turbulent Waters

By October we will have been 10 months into the Trump administration. The pace of change and the overall upheaval of the federal government has been striking. This presentation will discuss the political landscape of the healthcare industry. From DOGE to executive orders to new leadership at HHS, you’ll be better prepared to handle the challenges now and into the future.

IRF Quality Reporting Program & Policy Update

This presentation will cover the regulatory basis for what needs to be reported for the IRF QRP (existing and new/modified measures), as well as how it should be reported accurately and completely. This involves a wide variety of access to internal data and external systems, including governmental systems. How to report measures and what should be reported is a complicated issue involving education from a variety of different regulatory sources, including CMS, CDC, and QIES. This presentation will also include the policy landscape around the future of the IRF QRP program.

Laughter Really is the Best Medicine

“Laughter is the Best Medicine”—is funny! The healthcare humor will tickle your funny bone and have you laughing. “The Healthy Humorist®” has been known to skewer such topics as healthcare lingo, diet plans, pharmaceutical ads, medical marijuana and scrubs. Not just your standard comedy show, though, the program is uplifting, too. You may find yourself committing to lightening up and laughing more, or to adopting a new healthy habit.

At the conclusion of the first day, attendees have an opportunity to network with colleagues, get caught up with old friends, and visit with our vendor partners (including Soleran) during the welcome reception.

The ending of the second day gives participants an opportunity to have some more fun at our Casino! There will be plenty of appetizers and a variety of casino games. It’s all about funny money, plenty of action, and a laid back good time.

There will be ample time to visit the booths of our over 40 vendors. Make sure you stop by and see the Soleran booth (#3) while you are there.

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HACP Certifications

CIHQ will be providing in person classes for their three certification programs (October 20 at the Hilton San Antonio Hill Country). CIHQ has the Healthcare Accreditation Certified Profession (HACP) course for:

CMS

The HACP-CMS certification encompasses a broad knowledge of the CMS Conditions of Participation for hospitals, and the federal survey and certification process. Individuals who achieve this certification demonstrate mastery of subject matter addressing a wide variety of standards by CMS and all major accreditation providers (CIHQ, TJC, DNV, and ACHC).

Physical Environment

The HACP-PE certification demonstrates an in-depth knowledge of regulations addressing the physical environment in hospitals. Content addresses key regulations and national standards in safety/security, hazardous materials & waste, emergency power, life safety/fire safety, healthcare facilities code, utilities, and medical equipment.

Infection Control

The HACP-IC certification demonstrates an in-depth knowledge of regulations and industry standards of care addressing infection prevention and control in hospitals. Content addresses CMS requirements under the Conditions of Participation, environmental controls, sterilization and disinfection, management of communicable diseases, surveillance requirements, and much more!

These programs are nationally recognized and provide individuals with an opportunity to increase their knowledge.

Haven't already registered or want more information, visit www.cihq.org for more information. See ya there!