Medicaid Nursing Home Quality Care Amendments of 1986

Summary

Medicaid Nursing Home Quality Care Amendments of 1986 - Amends title XIX (Medicaid) of the Social Security Act to establish a single set of requirements for skilled nursing and intermediate care facilities (other than facilities for the mentally retarded), and to refer to such facilities as "nursing facilities." Sets forth requirements for nursing facilities, including requirements that such facilities: (1) primarily engage in providing inpatients with nursing care or rehabilitation services directed toward inpatients' mental, psychosocial, and physical well-being; (2) create and revise written plans for patient care after assessing, upon the patient's admission and periodically thereafter, the patient's ability to perform daily life functions; (3) protect specified patient rights; (4) provide care to patients regardless of the source of payment for such care; (5) safeguard a patient's funds upon the patient's authorization; (6) require a physician's supervision of each patient's care, the maintenance of clinical records on all patients, and 24-hour nursing services; (7) adopt certain measures to preserve facility safety and sanitation; and (8) meet such other conditions which the Secretary of Health and Human Services deems necessary for patient health and safety. Directs the Secretary to: (1) designate an instrument(s) for nursing facilities to use in assessing a patient's ability to perform daily life functions; and (2) make appropriate modifications to and periodically report to the Congress regarding the assessment process. Makes the Secretary responsible for certifying that State nursing facilities comply, and States responsible for certifying that other nursing facilities comply with Medicaid nursing facility requirements. Bases such certification on surveys to be conducted upon any change in the ownership of such a facility and, on an unannounced basis, at nine-to 15-month intervals. Subjects facilities with poor compliance records to extended surveys. Directs the Secretary to: (1) develop and test a protocol for conducting surveys; (2) train surveyors in the use of patient assessment instruments; and (3) conduct sample surveys of nursing facilities to test the adequacy of State surveys and reduce Federal payments for State Medicaid administrative costs if such State surveys prove inadequate. Requires States to maintain a process for investigating complaints regarding nursing facilities. Requires that survey results and facility cost report information be available to the public. Sets the Federal matching percentage for nursing facility certification activities at 100 percent for FY 1990 through 1992 and at 75 percent thereafter. Eliminates current penalties applied to a State when its control over the utilization of skilled nursing or intermediate care facility services is deemed inadequate. Requires that when the Secretary or a State determines that a nursing facility's deficiencies immediately jeopardize residents' health and safety, such facility's participation in Medicaid be terminated. Directs States to establish certain other remedies which might be applied where the health and safety of facility residents is not immediately jeopardized.

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1 official file

• Introduced in House

  summary · EN · 15 August 1986

  Open at official source

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