Utah Admin. Code R414-516-3 - Quality Improvement Program Requirements of Participation
(1) A program is required in six of nine
metrics to:
(a) score better than the national
average;
(b) improve from the
earlier state fiscal year (SFY); or
(c) not receive a state survey deficiency of
F, H, I, J, K, or L.
(2)
The metrics and state survey used for the QI Program are in accordance with the
following data:
(a) CASPER percentage of
long-stay residents assessed and appropriately given the seasonal influenza
vaccine;
(b) CASPER percentage of
long-stay residents with a urinary tract infection;
(c) CASPER percentage of high-risk long-stay
residents with pressure ulcers;
(d)
CASPER percentage of long-stay residents experiencing one or more falls with
major injury;
(e) CASPER percentage
of long-stay residents who lose too much weight;
(f) CASPER percentage of long-stay residents
who receive an antipsychotic medication;
(g) CASPER percentage of long-stay residents
whose ability to move independently worsens;
(h) adjusted nursing staff hours for each
resident each day; and
(i) state
survey without a quality of care deficiency of F, H, I, J, K, or L.
(3) If CMS modifies or removes a
metric for any state fiscal year (SFY), the department shall notify the
facilities and consider the metric as achieved for the facilities.
(4) If state licensing does not conduct a
survey for a program in any given SFY, then the survey requirement described in
Subsection (2)(i) of this section is removed from consideration, and the
facility must meet five of eight metrics.
(5) If more than one survey is completed
during the QI SFY, then all surveys are used for the period.
(6) The source of data used to calculate
compliance comes from the CMS website, except for data described in Subsection
(2)(i), which comes from state licensing. The data that represent the SFY are
used for the analysis. Each program provides data to CMS for nursing hours and
CASPER. The data is then made available in the subsequent SFY and downloaded by
DIH.
(7) DIH does not require a
provider that enters the NF NSGO UPL program for only part of an SFY, based on
provider participation start date, to comply with the QI requirements described
in Subsection (2) in the first SFY.
Notes
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