1 / 13

Nursing Home Oversight

Nursing Home Oversight. Survey Activity 50% of the overall surveyor’s time is spent in nursing homes Routine Surveys Complaint Investigations Operation Spot Check. Nursing Home Pilot Project- Background.

Download Presentation

Nursing Home Oversight

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Nursing Home Oversight • Survey Activity • 50% of the overall surveyor’s time is spent in nursing homes • Routine Surveys • Complaint Investigations • Operation Spot Check

  2. Nursing Home Pilot Project- Background • New CMS initiative to publicly report a set of quality measures for all nursing homes in the US • Initial pilot project to occur in six states: • CO, FL, MD, OH, RI, WA • Dates: • April - September 2002 – Six State Pilot • National Rollout for all NHs – Delayed until mid-November • 2003 - Possible rollout into HHA, ESRD & Hospital

  3. Purpose of CMS’s New Initiative • Provide an additional data source to assist consumers’ decision making when selecting a nursing home • Assist facilities to more effectively focus on quality improvement

  4. Quality Improvement Organization Role in National Initiative • Assigned lead role in implementing the pilot project. • Partner with state stakeholders, including AHCA, Ombudsmen, Advocates and Providers. • Provide educational programs and materials to nursing homes in the state. • Work with nursing homes that volunteer to implement quality improvement strategies based on the quality measures.

  5. No Changes to State SurveyProcess • State Survey Agency will still use the current CHSRA Quality Indicators as outlined in the survey process. • Facilities will still have access to their CHSRA QI’s and reports through the state system. • The QIO does not participate in nursing home surveys.

  6. Publicly Reported Quality Measures Utilized in the Project • Derived from MDS data only • Risk adjusted to consider certain factors such as resident characteristics

  7. Measures - Pilot • Post acute: pain management, walking improvement, delirium • Chronic: ADL decline, infections, pain management, pressure ulcers, restraints, weight loss

  8. What is Risk Adjustment? • Risk adjustment takes into account differences between residents so that QM scores can be compared between facilities in our state and in the nation. • Risk adjustment is performed on the QMs through the use of statistical techniques.

  9. Meaning of Adjusted Quality Measure • In general, the lower the score the better the performance. • Walking Improvement measure is the exception. • Higher score for this measure is indicative of better performance.

  10. Pilot vs. National Initiative The national rollout will include 10 measures • Weight loss failed validity testing and was dropped after the pilot project was evaluated • Facility Admission Profile will be included for certain measures

  11. Measures - NationalRoll Out • Post Acute: Pain Management, Walking Improvement (FAP), Delirium (with & w/o FAP) • Chronic: ADL Decline, Infections, Pain Management, Pressure Ulcers (with & without FAP), Restraints

  12. Questions??? If providers have questions about the nursing home project, they should call 1-800-MEDICARE. CMS has committed to a twenty-four hour turnaround in response to these calls.

  13. WEB Sites of Interest • www.medicare.gov click on the Nursing Home Compare heading. • Additional information on the background and purpose of the project can be found at www.cms.hhs.gov.

More Related