AGING AND DISABILITY SERVICES ADMINISTRATION

2005 NH "Dear Administrator" Letters

July 6, 2005

ADSA: NH #2005-018
Changes in Appendix P

Dear Nursing Facility/Home Administrator:

As you may know, the Centers for Medicare and Medicaid Services (CMS) has been working on a new pilot Survey Process based on Quality Indicators and on changes to the Quality Measures/Indicator Reports.

On June 9, 2005, CMS issued a memo that spelled out the changes to Appendix P. The New Quality Indicators Survey (QIS) will be piloted in specific states; Washington State is not part of this pilot. However, Appendix P of the State Operation Manual has been revised to introduce the QIS process to states conducting the study.

The advance issuance has been released in order to permit facilities to study the QIS Pilot Process. If the QIS pilot is approved, the revisions of Appendix P will be used to proceed with a staggered national implementation.

The June 9, 2005 memo also announced the revised survey procedures for the use of the new Quality Measure/Indicator Reports (QM/QI) and additional small changes in language to other sections of Appendix P, which have changed with recent announced revisions to regulatory guidance.

• The new reports are similar to the ones currently in use.
• They have slightly different titles and include some of the current quality measures (QM), some new QMs, and some replaced QMs for the same topics.
• Resident Data is separated into chronic care (long stay) and Post-acute (PAC) items.

RCS Nursing Home Surveyors will begin using the updated QM/QI Reports for survey as soon as they are available after July 1, 2005.

The CMS website is the best source for accessing the most current information available. The changes can be found at: http://www.cms.hhs.gov/medicaid/survey-cert/sc0534.zip

Thank you for your continued commitment to the nursing home residents in the state of Washington.

Sincerely,

Joyce Pashley Stockwell, Director
Residential Care Services