Transcript Child and Adult Care is a Risky Business and it is Our

Performance Standardization
Guidance for Licensure
Steve Lambert, Associate Director
Adult Services and Enforcement
Division of Licensing Programs
Virginia Department of Social Services
“Decisioneering”
PERFORMANCE-BASED
LICENSING AND
MONITORING
Division of Licensing
Programs, VDSS
July 10, 1999
Types of Licenses
•Initial (Conditional)- issued for up to 6
months
•Provisional – issued for up to 6 months
•1-yr
•2-yr
•3-yr
Previous Performance Measures
•In substantial compliance = 1-yr
•Complying substantially with
most standards, but exceeding
with others = 2-yr
•Substantially exceeding with
most standards = 3-yr
OLPHIN
Division Of Licensing Programs Help
and Information Network
CHAPTER 603. An Act to amend and reenact
§ 63.2-1706 and §63.2-1728 of the Code of
Virginia, relating to licensure of a facility;
interview with residents or participants.
[S 339] Approved April 11, 2010
2. That by November 1, 2010, the Department of Social
Services shall, in consultation with key stakeholder
groups, develop specific criteria by which the
Department issues one-, two-, and three-year assisted
living facility licenses. Such criteria shall be separately
stated for each licensure period and shall be
unambiguously communicated to all entities seeking
initial and renewal licenses.
Performance Standardization
Guidance for Licensure
Measurable data reflecting performance
with regulatory requirements
-2
Below
3-yr Lic
-1
2-yr Lic
Average
Average
1-yr Lic
1
2
Above
Prov Lic Sanction
Performance Standardization
Guidance for Licensure
Performance Indicator 3:Negative
1: Degree of
2:
nonrisk
Events:
compliances
or
Avg Risk Score/Inspection
or Avg Violations/Inspection
Having
Being
an avg. by
riskthe
rating
licensing
score
office
of 6
or
tolicensure
higher
submitatan
Being required
sanctioned
anytime
during
the
IPOC
renewal
serious and/or
only tosystemic
issuing an
violations
extended
12
period;for(relevant
months or
license,
i.e.,
less
a 2-ofor
the
3-yr
license’s
license)
expiration date
Risk Assessment Matrix
C) High
C-1
C-2
C-3
B) Medium
B-1
B-2
B-3
A) Low
A-1
A-2
A-3
1) Moderate
2) Serious
3) Extreme
Performance Indicator 1
Performance Indicator 2
FY:2010
[Start Dt:Jul2010
End Dt: Jun2010
Family Day Home
Virginia Department of Social Services
Division of Licensing Programs
Aggregate Facility Risk Profile State Report for Facility Type: FDH
Page: 1
09/14/10
User: sal900
Total # of Fac.
Total
Non
Mets
Avg. #
of NM
Avg. Risk Score Mode Count of Risk Std. Dev. Of
Scores
NM’s
Std. Dev. Of Risk
Scores
1935
13175
4.78
3.2
2.22
2 [# of Viol 7974]
2.32
Std. Dev. = Standard Deviation
Risk Score is computed using Key Standards Violated.
Non-Mets (NM) computed using Key Standards and Non-Key Standards Violated.
Non-Key Standard is a Standard with score of 0
License Determination Table:
-2
3 Year License
-1
2 Year License
Average
1 Year License
1
Provisional
License
2
Summary Suspension|
|Denial|Revocation
The standard deviation table for Key-Violations Performance Indicator 2
-1.24
.98
3.2
The standard deviation table for Non-Mets
.14
2.46
4.78
5.42
7.64
Performance Indicator 1
7.09
9.41
Licensure Condition 1
When values for performance indicators 1 and 2
fall under the same license type
3-yr
2-yr
PI-1
PI-2
1-yr
Provisional
Licensure Condition 2
When values for performance indicators 1 and 2
fall side by side, aligning with two different
license types
3-yr
2-yr
1-yr
PI-1
PI-2
Provisional
Licensure Condition 3
When values for performance indicators 1 and 2
are separated by one or more license types
3-yr
PI-1
2-yr
1-yr
PI-2
Provisional
General Rule: Performance Indicator 3
Select performance
When
the performance
indicators
indicator
1 and
that2aligns
do notwith
alignmore
the
with favorable
the same license
license type
type provided
or when both
that:
align
an extended
license…
1) with
a sanction
was not
issued during the
licensure period;
2) an IPOC was not requested by the
licensing office 12 months or less of the
license’s expiration date; and/or
3) the avg. risk rating score at renewal is
not 6 or higher (relevant only when
considering the issuance of an extended
license)
Day Homeindicators 1 and 2 fall
1) When values for Family
performance
under the same license type
License Determination Table
-2
3 Year License
-1
2 Year License
Average
1 Year License
1
Provisional
License
2
Summary Suspension|
|Denial|Revocation
The standard deviation table for Key-Violations
-1.24
.98
3.2
5.42
7.64
7.09
9.41
The standard deviation table for Non-Mets
.14
2.46
4.78
1 Year
My Joy Is Yours
Performance Indicator 1
Performance Indicator 2
Avg. Non-Mets = 5.0
Avg. Risk Score = 3.5
2) When values for performance indicators 1 and 2 fall
side by side, aligning with two different license types
License Determination Table
-2
3 Year License
-1
2 Year License
Average
1 Year License
1
Provisional
License
2
Summary Suspension|
Denial|Revocation
The standard deviation table for Key-Violations
-1.24
.98
3.2
5.42
7.64
7.09
9.41
The standard deviation table for Non-Mets
.14
2.46
4.78
21 Year
Year
Home Away From Home
Performance Indicator 1
Avg. Non-Mets = 2.96
Performance Indicator 2
Avg. Risk Score = 3.75
3) When values for performance indicators 1 and 2 are
separated by one or more license types
License Determination Table
-2
3 Year License
-1
2 Year License
Average
1 Year License
1
Provisional
License
2
Summary Suspension|
Denial|Revocation
The standard deviation table for Key-Violations
-1.24
.98
3.2
5.42
7.64
7.09
9.41
The standard deviation table for Non-Mets
.14
2.46
4.78
13 Year
Tender Hearts
Performance Indicator 1
Performance Indicator 2
Avg. Non-Mets = .09
Avg. Risk Score = 5.56
Caution!
“Decisioneering”
Comments from Providers on Project:
Pre-Implementation of Pilot Study:
My
recommendation
to
reConsistency
Seems
To
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Pilot Study: January-June 2011
•49% (53 of 108) of adult and children’s
inspectors participated
•169 license renewals were submitted
•80% of the time inspectors agreed with the
license type indicated by the licensure tool
•When inspectors did not agree with the tool,
the average difference was 1 license type,
e.g. a 1-yr vs. a 2-yr or a 2-yr vs. a 3-yr.
Pilot Study: January-June 2011
Type of License 01/01/10 - 06/30/10 01/01/11 - 06/30/11
Conditional
1.14%
(13)
6.5%
(71)
Provisional
3.9%
(44)
4.12%
(45)
1-yr
70.8% (804)
72.2% (789)
2-yr
20.9% (237)
14.46% (158)
3-yr
Total
3.35%
(38)
1136
24%
2.74%
(30)
1093
17%
Virginia Department of Social Services
Division of Licensing Programs
Performance Standardization
Guidance for Licensure
Version <1.0>
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