Daniel McElroy-TX

Document ID: CMS-2010-0211-0006
Document Type: Public Submission
Agency: Centers For Medicare & Medicaid Services
Received Date: July 19 2010, at 12:00 AM Eastern Daylight Time
Date Posted: July 20 2010, at 12:00 AM Eastern Standard Time
Comment Start Date: July 12 2010, at 12:00 AM Eastern Standard Time
Comment Due Date: August 11 2010, at 11:59 PM Eastern Standard Time
Tracking Number: 80b1bce6
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This is comment on Proposed Rule

Medicare and Medicaid Programs: Civil Money Penalties for Nursing Homes

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The July 12, 2010, Notice of Proposed Rulemaking issued regulations required by the Health Care Reform Act. This NPRM opened nursing home enforcement regulations for revision and improvement. However, CMS did include QAPI in the 42 CFR §488.301 definition of substantial compliance. §488.301 states: “Substantial compliance means a level of compliance with the requirements of participation such that any identified deficiencies pose no greater risk to resident health and safety than the potential for causing minimal harm.” This definition does not give CMS authority to require a root cause analysis to identify deficient systems. This precludes developing, implementing, and measurably evaluating systems. That prohibits sustained compliance and continuous performance improvement. A QAPI wording for §488.301: “Substantial compliance means a level of compliance with the requirements of participation such that any identified deficiencies pose no greater risk to resident health and safety than the potential for causing minimal harm and that the facility has measurably shown that it has the ability to sustain compliance and to perform continuous, measured performance improvement in care and services."