STATE VETERANS HOME
Program Updates
Nancy Quest
Office of Geriatrics and Extended Care
Patient Care Services
Department of Veterans Affairs
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requests that the recognition be withdrawn or the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
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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:
• Theresa.Hayes@va.gov
• 202-461-6771
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STATE VETERANS HOME
Reportable Events Handbook
 Includes all reporting requirements currently in
the Federal Regulations and supplant all other
previous guidance
 Minimizes the burden on State Homes and VA
 Limits reporting to those items of greater
significance
 Limits 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!!
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