The Center for Quality Health Care Services and Consumer Protection

In 2004, the Center for Quality Health Care Services and Consumer Protection (the Center) continued its efforts to build partnerships with provider organizations, key stakeholders, and other state agencies to improve the quality of health care for Virginia’s vulnerable populations. Notable examples include recognition as a “Quality Partner” by the Virginia Health Quality Initiative (VHQI), a Centers for Medicare and Medicaid Services (CMS) designated quality improvement organization, for “significant contributions to the public reporting of nursing home performance and demonstrated support as a partner with the VHQI to work towards improvement in health care quality for Virginia’s nursing home residents and home health patients.” The Center also partnered with the University of Virginia’s Health System in the national Patient Safety Improvement Corps, a program encouraging public/private partnerships to address state level patient safety concerns. The Center participated in 50 separate educational statewide events on topics including:

• Inspection processes
• Federal data collection and quality measures
• Abuse prevention and reporting
• Hospice services
• Emergent care
• Intermediate care facilities for the mentally retarded services
• Emergency preparedness

The Center administers the state licensing programs for hospitals, outpatient surgical hospitals, nursing facilities, home care organizations, and hospice programs. The Center also administers the certification and registration programs for managed care health insurance plans licensees and private review agents, and the Certificate of Public Need program. In addition to state programs, the Center is the state survey agency for the federal reimbursement programs under CMS.

Inspections activities are used to satisfy both state licensure requirements and federal certification requirements. State and federal regulatory programs guard the health, safety and welfare of the public by establishing and enforcing standards to assure quality health care. The Center’s medical facility inspectors, who conduct both state and federal regulatory inspections, are health care professionals, such as physicians, registered nurses, dietitians, social workers, and laboratory medical technologists. The Center also investigates consumer complaints regarding quality of health care services received. In 2004, the Center conducted 1,600 inspections, including complaint inspections.

The Certificate of Public Need program seeks to contain health care costs while ensuring financial viability and access to health care for all Virginians. In 2004, the program authorized 89 project certificates totaling $981,180,725 and denied nine projects totaling $32,947,407.