I 

110TH CONGRESS 

1ST SESSION H. R. 1448 

To amend title 38, United States Code, to establish a Hospital Quality 

Report Card Initiative to report on health care quality in Department 

of Veterans Affairs hospitals. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 9, 2007 

Mrs. LOWEY (for herself and Mr. EDWARDS) introduced the following bill; 

which was referred to the Committee on Veterans’ Affairs 

A BILL 

To amend title 38, United States Code, to establish a Hospital Quality Report Card Initiative to report on health 

care quality in Department of Veterans Affairs hospitals. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘VA Hospital Quality 

5 Report Card Act of 2007’’. 

6 SEC. 2. PURPOSE. 

7 The purpose of this Act is to establish the Hospital 

8 Quality Report Card Initiative under title 38, United 

9 States Code, to ensure that quality measures data for hosVerDate Aug 31 2005 23:15 Mar 10, 2007 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1448.IH H1448

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1 pitals administered by the Secretary of Veterans Affairs 

2 are readily available and accessible in order to— 

3 (1) inform patients and consumers about health 

4 care quality in such hospitals; 

5 (2) assist Department of Veterans Affairs 

6 health care providers in identifying opportunities for 

7 quality improvement and cost containment; and 

8 (3) enhance the understanding of policy makers 

9 and public officials of health care issues, raise public 

10 awareness of hospital quality issues, and help con11 stituents of such policy makers and officials identify 

12 quality health care options. 

13 SEC. 3. DEPARTMENT OF VETERANS AFFAIRS HOSPITAL 

14 QUALITY REPORT CARD INITIATIVE. 

15 (a) IN GENERAL.—Subchapter III of chapter 17 of 

16 title 38, United States Code, is amended by adding at the 

17 end the following new section: 

18 ‘‘§ 1730A. Hospital Quality Report Card Initiative 

19 ‘‘(a) The Secretary shall establish and implement a 

20 Hospital Quality Report Card Initiative (in this section re21 ferred to as the ‘Initiative’) to report on health care qual22 ity in Department hospitals. 

23 ‘‘(b)(1)(A) Not less than 2 times each year, the Sec24 retary shall publish and distribute, in accordance with sub25 paragraph (F), reports on Department hospital quality. 


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1 The reports shall include quality measures data that allow 

2 for an assessment of health care— 

3 ‘‘(i) effectiveness; 

4 ‘‘(ii) safety; 

5 ‘‘(iii) timeliness; 

6 ‘‘(iv) efficiency; 

7 ‘‘(v) patient-centeredness; and 

8 ‘‘(vi) equity. 

9 ‘‘(B) In collecting and reporting data as provided for 

10 under subparagraph (A), the Secretary shall include De11 partment hospital information, as possible, relating to— 

12 ‘‘(i) staffing levels of nurses and other health 

13 professionals, as appropriate; 

14 ‘‘(ii) rates of nosocomial infections; 

15 ‘‘(iii) the volume of various procedures per16 formed; 

17 ‘‘(iv) hospital sanctions and other violations; 

18 ‘‘(v) the quality of care for various patient pop19 ulations, including female, geriatric, disabled, rural, 

20 homeless, mentally ill, and racial and ethnic minority 

21 populations; 

22 ‘‘(vi) the availability of emergency rooms, inten23 sive care units, maternity care, and specialty serv24 ices; 


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1 ‘‘(vii) the quality of care in various hospital set2 tings, including inpatient, outpatient, emergency, 

3 maternity, and intensive care unit settings; 

4 ‘‘(viii) ongoing patient safety initiatives; and 

5 ‘‘(ix) other measures determined appropriate by 

6 the Secretary. 

7 ‘‘(C)(i) In reporting data as provided for under sub8 paragraph (A), the Secretary may risk adjust quality 

9 measures to account for differences relating to— 

10 ‘‘(I) the characteristics of the reporting Depart11 ment hospital, such as licensed bed size, geography, 

12 and teaching hospital status; and 

13 ‘‘(II) patient characteristics, such as health sta14 tus, severity of illness, and socioeconomic status. 

15 ‘‘(ii) If the Secretary reports data under subpara16 graph (A) using risk-adjusted quality measures, the Sec17 retary shall establish procedures for making the 

18 unadjusted data available to the public in a manner deter19 mined appropriate by the Secretary. 

20 ‘‘(D) Under the Initiative, the Secretary may verify 

21 data reported under this paragraph to ensure accuracy 

22 and validity. 

23 ‘‘(E) The Secretary shall disclose the entire method24 ology for the reporting of data under this paragraph to 

25 all relevant organizations and Department hospitals that 


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1 are the subject of any such information that is to be made 

2 available to the public prior to the public disclosure of such 

3 information. 

4 ‘‘(F)(i) The Secretary shall submit each report to the 

5 appropriate committees of Congress. 

6 ‘‘(ii) The Secretary shall ensure that reports are 

7 made available under this section in an electronic format, 

8 in an understandable manner with respect to various pop9 ulations (including those with low functional health lit10 eracy), and in a manner that allows health care quality 

11 comparisons to be made with local hospitals or regional 

12 hospitals, as appropriate. 

13 ‘‘(iii) The Secretary shall establish procedures for 

14 making report findings available to the public, upon re15 quest, in a non-electronic format, such as through a toll16 free telephone number. 

17 ‘‘(G) The analytic methodologies and limitations on 

18 data sources utilized by the Secretary to develop and dis19 seminate the comparative data under this section shall be 

20 identified and acknowledged as part of the dissemination 

21 of such data, and such dissemination shall include the ap22 propriate and inappropriate uses of the data. 

23 ‘‘(H) On at least an annual basis, the Secretary shall 

24 compare quality measures data submitted by each Depart25 ment hospital with data submitted in the prior year or 


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1 years by the same hospital in order to identify and report 

2 actions that would lead to false or artificial improvements 

3 in the hospital’s quality measurements. 

4 ‘‘(2)(A) The Secretary shall develop and implement 

5 effective safeguards to protect against the unauthorized 

6 use or disclosure of Department hospital data that is re7 ported under this section. 

8 ‘‘(B) The Secretary shall develop and implement ef9 fective safeguards to protect against the dissemination of 

10 inconsistent, incomplete, invalid, inaccurate, or subjective 

11 Department hospital data. 

12 ‘‘(C) The Secretary shall ensure that identifiable pa13 tient data shall not be released to the public. 

14 ‘‘(c)(1) The Secretary shall evaluate and periodically 

15 submit a report to Congress on the effectiveness of the 

16 Initiative, including the effectiveness of the Initiative in 

17 meeting the purpose described in section 2 of the VA Hos18 pital Quality Report Card Act of 2007. The Secretary 

19 shall make such reports available to the public. 

20 ‘‘(2) The Secretary shall use the outcomes from the 

21 evaluation conducted pursuant to paragraph (1) to in22 crease the usefulness of the Initiative. 

23 ‘‘(d) There are authorized to be appropriated to carry 

24 out this section such sums as may be necessary for each 

25 of fiscal years 2008 through 2017.’’. 


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1 (b) CLERICAL AMENDMENT.—The table of sections 

2 at the beginning of chapter 17, United States Code, is 

3 amended by inserting after the item relating to section 

4 1730 the following new item: 

‘‘1730A. Hospital Quality Report Card Initiative.’’. 

5 (c) EFFECTIVE DATE.—Section 1730A of title 38, 

6 United States Code, as added by subsection (a), shall take 

7 effect not later than 18 months after the date of the enact8 ment of this Act. 

Æ 


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