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GERIATRICS AND EXTENDED CARE (GEC) KEY POLICY UPDATES FEBRUARY 2012 January 2012 GEC KEY POLICY UPDATES • Proposed elimination of VA annual surveys of Centers for Medicare & Medicaid (CMS) certified State Veteran Nursing Homes • Update on Information Letter concerning reportable events in the State Veterans Homes. VETERANS HEALTH ADMINISTRATION 2 SVH Clinical Oversight Program-Survey Process VA Standards and Centers for Medicare and Medicaid (CMS) Standards •VA standards are established in federal regulation – 38 CFR Part 51 •CMS standards are established in federal regulation – 42 CFR Part 483 •VA standards are same as CMS with the following additional components: Administration - notifications, i.e., notification of change of administrator, state office Credentialing and Privileging of licensed practitioners Basic Per Diem Per Diem and drugs and medicines Social Worker qualifications Nursing Services •Designation of a supervising nurse for each tour of duty •Staffing requirements or Hours Per Patient Day (HPPD) VETERANS HEALTH ADMINISTRATION 3 SVH Clinical Oversight Program- Survey Process Current Survey Process •Mirrors survey process utilized by CMS, three types of inspections: *Recognition - to become eligible for per diem payments *Annual - to determine compliance with VA standards *For cause - investigate specific or a series of incidents. •Survey teams co-led by VAMC representative & contract surveyor •Outcomes •Consistency of survey approaches •Clear protocol - pre, during and post survey •Clear and objective statements of findings VETERANS HEALTH ADMINISTRATION 4 SVH Clinical Oversight Program Information Letter • Information Letter provides guidance and a standardized approach to VA and SVH in the reporting process for reportable events that occur in SVH providing nursing home care to eligible Veterans. • Related Regulation: Title 38 of the Code of Federal Regulations (CFR) Parts 51.120, and 51.210. • Does not reduce or eliminate the requirement of SVH and VA to comply with applicable Federal and State statutes and regulations. VETERANS HEALTH ADMINISTRATION 5 SVH Clinical Oversight Program- Information Letter • This Information Letter will delineate what types of events are reportable. • It will also include reporting timeframes, format and a communication process for use within VA for internal communications and where indicated, with external shareholders. • Status-draft in final stages of development VETERANS HEALTH ADMINISTRATION 6 SVH Clinical Oversight Program GEC – Policy contacts for the clinical and survey process Deborah Stevens State Veterans Home Program Analyst 202-461-6751 [email protected] Nancy Quest Director, Home & Community Based Services 202-461-6064 [email protected] VETERANS HEALTH ADMINISTRATION 7 SVH Clinical Oversight Program QUESTIONS / COMMENTS THANK YOU! VETERANS HEALTH ADMINISTRATION 8