state veterans home program updates nancy quest office of geriatrics and extended care patient care...
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STATE VETERANS HOMEProgram Updates
Nancy QuestOffice of Geriatrics and Extended Care
Patient Care ServicesDepartment of Veterans Affairs
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STATE VETERANS HOME
Resident Assessment Instrument/ Minimum Data Set (RAI/MDS)
124 of 132 transmitting to VA RAI/MDS 2.0 3.0 requirements
– CMS certified facilities will be required to use MDS 3.0 effective October 1, 2010
– Non-CMS certified facilities may continue using MDS 2.0 until VA regulations are revised
– VA will have capability to receive 2.0 and 3.0 transmissions
Reference – 38 CFR Part §51.110 Resident Assessment
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STATE VETERANS HOME
Recognition and Certification Once a facility has achieved recognition, the
recognition will remain in effect unless the State requests that the recognition be withdrawn or the Under Secretary for Health makes a final decision that the facility or facility management does not meet the standards of subpart D. Recognition of a facility will apply only to the facility as it exists at the time of recognition; any annex, branch, enlargement, expansion, or relocation must be separately recognized
.Reference - 38 CFR §51.20(a)
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STATE VETERANS HOME
Bed Change Request Process Request to withdraw recognition and
certification of current facility must come from the State Official authorized to establish the State home Reference - 38 CFR §51.20(a)
Request recognition and certification of the new reduced bed facility Reference - 38 CFR §51.30(2)(b)
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STATE VETERANS HOME
State should request the withdrawal of the original recognition and certification contingent on and concurrent with recognition of the reduced bed facility
Allow VA to survey the reduced-bed facility Reference - 38 CFR §51.20(b)
Requests for change in the number of recognized beds should be addressed to the Under Secretary for Health
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STATE VETERANS HOME
Status of Federal Regulations / Handbooks
Nursing Home, Adult Day Health Care & Domiciliary regulations – in concurrence– Various sections are identical for all programs
• Subpart A – General (Purpose & Definitions)• Subpart B – Obtaining Per Diem (Recognition Process)• Some standards in Subpart D – Standards
– Resident Rights– Admin, Discharge, Transfer– Resident Behavior and Facility Practices– Quality of Life– Administration
– Standards applicable to each level of care will be identified in separate subsections
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STATE VETERANS HOME
Significant changes include:
– Nursing Home – use of MDS 3.0
– Domiciliary – Primary care provided by physician extender (supervised by physician)
– Adult Day Health – flexibility to establish as a social or medical model, stand alone facilities, no requirement to complete home based MDS
Changes will become effective 30 days after publication of regulation; regulations are in concurrence and can take up to 2 years to publish
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STATE VETERANS HOME
Emergency Evacuation Regulation – Per Diem Payments for Veterans Evacuated During an Emergency from a State Home to a Non-Recognized Facility
– Per diem is the VA established daily rate paid to a State for providing specified levels of care to eligible veterans once a facility is officially recognized by VA and maintains certification.
Changes will become effective 30 days after publication of regulation; regulations are in concurrence and can take up to 2 years to publish
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STATE VETERANS HOME
This regulation would authorize VA to continue to pay per diem payments when veterans for whom VA is paying per diem are evacuated during an emergency from a State home to a facility that is not recognized by VA as a State home.
The regulation would require, in order for per diem payments to continue while the veteran is relocated due to an emergency, that the director of the VA medical center of jurisdiction recognize the emergency and approve the State home’s response.
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STATE VETERANS HOME
Assistance for Hiring and Retention of Nurses at State Veterans Homes– The Secretary shall make payments to
States under this section for the purpose of assisting State homes in the hiring and retention of nurses and the reduction of nursing shortages at State homes
Grant Program that is designed to – promote the hiring and retention of nursing
staff – reduce nursing shortages
Reference - 38 CFR Part 53
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STATE VETERANS HOME
Applications for FY2011 accepted through September 30, 2010
– Additional information can be obtained by contacting Theresa Hayes:
•202-461-6771
Reference 38 CFR Part 53
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STATE VETERANS HOME
Reportable Events HandbookIncludes all reporting requirements currently in the Federal Regulations and supplant all other previous guidanceMinimizes the burden on State Homes and VALimits reporting to those items of greater significanceLimits reporting to those items of greater significance
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STATE VETERANS HOME
Major Elements– A distinction between “Required” and
“Requested” reports– No requirement for RCA– State home may report using their own
format (with some guidelines)– Reporting time frames are provided– Not all adverse events need reporting– Onus on local VA facility to create I.B.
as needed
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STATE VETERANS HOME
Required Reporting– Those reports that are cited in the
Federal Regulation• Sentinel Events• Change in administration
Requested Reports– Change in nursing administration– Substantiated allegations– Elopements pursuant to state regulations
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STATE VETERANS HOME
– Adverse events– Inspections/surveys by oversight agencies– Information regarding the SVH that
appears in local or national media
VAMC of Jurisdiction are responsible to communicate the reporting guidelines and relevant contact information to the SVH in their area
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STATE VETERANS HOME
SVH Regional Training Conferences– Eastern Region (VISN1-8) – Tampa July 20-
22– Central Region (VISN 9-16&23) – Chicago
August 10-12– Western Region (VISN 17-22) – San Antonio
August 24-26
MDS 3.0 conferences (cancelled)
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STATE VETERANS HOME
THANK YOU!!