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National Association of State Veterans Homes

Presentation. Status of Nurse Retention RegulationsStatus of Per Diem RegulationsBrief Description of Survey Process. Status of Nurse Retention Regulations. In OMBDue out for comment on March 21,2008!!!. Status of Per Diem Regulations. In VA Concurrence processWithin that process the LTC work gr

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National Association of State Veterans Homes

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    1. National Association of State Veterans Homes Christa M. Hojlo, PhD, RN, NHA 810 Vermont Avenue, NW (114) Washington, DC 20420 202-461-6779

    2. Presentation Status of Nurse Retention Regulations Status of Per Diem Regulations Brief Description of Survey Process

    3. Status of Nurse Retention Regulations In OMB Due out for comment on March 21,2008!!!

    4. Status of Per Diem Regulations In VA Concurrence process Within that process the LTC work group has reviewed Comments from LTC work group under consideration

    5. Survey Process Core elements of the process 1. Standards 2. The process itself Pre-survey Survey Post-survey 3. Surveyor training and certification

    6. Standards Definition The principle sources for accountability for performance Types of nursing home standards Joint commission - accreditation Federal F tags certification and payment CARF (Committee on Accreditation of Rehab Facilities) - accreditation VA standards VA quality and per diem VA standards

    7. VA Standards Unique sections specified for meeting requirements for VA per diem. Some sections similar to TJC, F-tags, CARF However, other sections are specific to VA State example: States model on CMS CMS contracts with states for surveys State specific each state differs State surveyors must meet CMS but also state standards

    8. Survey Process Regardless of what standards are used, the process is the same Pre survey Survey Post survey

    9. Pre-Survey Conducted prior to arrival Review of QI/QMs form MDS Review of sentinel or other significant events Review of recent past surveys and findings Sample selection

    10. Survey Formal entrance conference with key representatives and entire survey team Tour Observation survey Observation of direct care Review of relevant documents including QI committee reports and incidents Attendance at resident/family council Attendance at team meetings Formal exit conference with key representatives and entire team

    11. Post- Survey Formal report sent to SVH and VA within a specified time frame after survey Corrective Action Plan (CAP) Follow up

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