Virginia Administrative Code › Title 12 - HEALTH › Agency 30 - DEPARTMENT OF MEDICAL ASSISTANCE SERVICES › Chapter 10 - STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT MEDICAL ASSISTANCE PROGRAM; GENERAL PROVISIONS › Part IV - General Program Administration › Section 12VAC30-10-800 - Survey and certification process

Current through Register Vol. 40, No. 24, July 15, 2024
A. The state assures that the requirements of
				  § 1919(a)(1)(A) through (C) and § 1919(g)(2)(A) through (E)(iii) of
				  the Act which relate to the survey and certification of non-state owned
				  facilities based on the requirements of § 1919(b), (c) and (d) of the Act,
				  are met.
B. The state conducts
				  periodic education programs for staff and residents (and their
				  representatives).
				  12VAC30-20-272 describes the
				  survey and certification educational program.
C. The state provides for a process for the
				  receipt and timely review and investigation of allegations of neglect and abuse
				  and misappropriation of resident property by a nurse aide of a resident in a
				  nursing facility or by another individual used by the facility.
				  12VAC30-20-274 describes the
				  state's process.
D. The state
				  agency responsible for surveys and certification of nursing facilities conducts
				  the process for the receipt and timely review and investigation of allegations
				  of neglect and abuse and misappropriation of resident property.
E. The state assures that a nurse aide, found
				  to have neglected or abused a resident or misappropriated resident property in
				  a facility, is notified of the finding. The name and finding is placed on the
				  nurse aide registry.
F. The state
				  notifies the appropriate licensure authority of any licensed individual found
				  to have neglected or abused a resident or misappropriated resident property in
				  a facility.
G. The state has
				  procedures, as provided for at § 1919(g)(2)(A)(i), for the scheduling and
				  conduct of standard surveys to assure that the state has taken all reasonable
				  steps to avoid giving notice through the scheduling procedures and the conduct
				  of the surveys themselves.
				  12VAC30-20-275 describes the
				  state's procedures.
H. The state
				  assures that each facility shall have a standard survey which includes (for a
				  case-mix stratified sample of residents) a survey of the quality of care
				  furnished, as measured by indicators of medical, nursing and rehabilitative
				  care, dietary and nutritional services, activities and social participation,
				  and sanitation, infection control, and the physical environment, written plans
				  of care and audit of resident's assessments, and a review of the compliance
				  with resident's rights not later than 15 months after the date of the previous
				  standard survey.
I. The state
				  assures that the statewide average interval between standard surveys of nursing
				  facilities does not exceed 12 months.
J. The state may conduct a special standard
				  or special abbreviated standard survey within two months of any change of
				  ownership, administration, management, or director of nursing of the nursing
				  facility to determine whether the change has resulted in any decline in the
				  quality of care furnished by the facility.
K. The state conducts extended surveys
				  immediately or, if not practicable, not later than two weeks following a
				  completed standard survey in a nursing facility which is found to have provided
				  substandard care or in any other facility at the secretary's or state's
				  discretion.
L. The state conducts
				  standard and extended surveys based upon a protocol, i.e., survey forms,
				  methods, procedures and guidelines developed by HCFA, using individuals in the
				  survey team who meet minimum qualifications established by the
				  secretary.
M. The state provides
				  for programs to measure and reduce inconsistency in the application of survey
				  results among surveyors.
				  12VAC30-20-277 describes the
				  state's programs.
N. The state
				  issues a multidisciplinary team of professionals including a registered
				  professional nurse.
O. The state
				  assures that members of a survey team do not serve (or have not served within
				  the previous two years) as a member of the staff or consultant to the nursing
				  facility or has no personal or familial financial interest in the facility
				  being surveyed.
P. The state
				  assures that no individual shall serve as a member of any survey team unless
				  the individual has successfully completed a training and test program in survey
				  and certification techniques approved by the secretary.
Q. The state maintains procedures and
				  adequate staff to investigate complaints of violations of requirements by
				  nursing facilities and onsite monitoring.
				  12VAC30-20-278 describes the
				  state's complaint procedures.
R.
				  The state makes available to the public information respecting surveys and
				  certification of nursing facilities including statements of deficiencies, plans
				  of correction, copies of cost reports, statements of ownership and the
				  information disclosed under § 1126 of the Act.
S. The state notifies the state long-term
				  care ombudsman of the state's finding of noncompliance with any the
				  requirements of subsection B, C, and D or of any adverse actions taken against
				  a nursing facility.
T. If the state
				  finds substandard quality of care in a facility, the state notifies the
				  attending physician of each resident with respect to which such finding is made
				  and the nursing facility administrator licensing board.
U. The state provides the state Medicaid
				  fraud and abuse agency access to all information concerning survey and
				  certification actions.
Statutory Authority
§ 32.1-325 of the Code of Virginia; §§
						1919(g)(1) through (2) and 1919(g)(4) through (5) of the Act, P.L. 100-203
						(§ 4212(a)).