The Center for Quality Health Care Services and Consumer Protection

In 2005, the Center for Quality Health Care Services and Consumer Protection continued its collaborative efforts with provider organizations, key stakeholders and other state agencies to improve the quality of health care for Virginia’s vulnerable populations. For example, the center conducted surveys to help six new community-based group homes for the mentally retarded become federally certified for Medicare and Medicaid in response to Virginia’s Olmstead Act initiatives. Seventeen more nursing facility feeding/hydration programs, developed and promoted by the center to assist residents with maintaining good health and hydration, were approved, bringing the number to 52 since the program started in 2003.

Retention of nursing directors was identified as an important criterion for assuring quality care in Virginia’s nursing facilities. The Center assisted the Virginia Health Care Association in identifying the primary causes for director of nursing turnover in nursing facilities and developing retention strategies. Virginia had one of the highest rates of director of nursing turnover in the nation in 2002, at 142.7 percent.

The center continued its statewide provider education series on topics including:

• Home care services
• Long-term care
• Federal data collection and quality measures
• Abuse prevention and reporting
• Hospice services in long-term care settings
• Pressure ulcers
• Survey compliance activities

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 (MCHIPs) and Private Review Agents (PRAs), and the Certificate of Public Need (COPN) program. In addition to state programs, the Center is the state survey agency for the federal reimbursement programs under the Centers for Medicare and Medicaid Services (CMS).

Inspection 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 medical laboratory technologists. The center also investigates consumer complaints regarding quality of health care services received. In 2005, the center conducted 1,900 inspections, including complaint inspections.

The COPN program seeks to contain health care costs while ensuring financial viability and access to health care for all Virginians. In 2005, the program authorized 107 project certificates totaling $831,359,094 and denied 11 projects totaling $38,661,380.