1. January 2012 FEBRUARY 2012 GERIATRICS AND EXTENDED CARE (GEC) KEY POLICY UPDATES

2. VETERANS HEALTH ADMINISTRATION 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. 2

3. VETERANS HEALTH ADMINISTRATION 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) 3

4. VETERANS HEALTH ADMINISTRATION 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 4

5. VETERANS HEALTH ADMINISTRATION SVH Clinical Oversight Program Information Letter 5 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.

6. VETERANS HEALTH ADMINISTRATION SVH Clinical Oversight Program- Information Letter 6 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

7. VETERANS HEALTH ADMINISTRATION SVH Clinical Oversight Program 7 GEC – Policy contacts for the clinical and survey process Deborah Stevens State Veterans Home Program Analyst 202-461-6751 Deborah.Stevens@va.gov Nancy Quest Director, Home & Community Based Services 202-461-6064 Nancy.Quest@va.gov

8. VETERANS HEALTH ADMINISTRATION SVH Clinical Oversight Program 8 QUESTIONS / COMMENTS THANK YOU!