Setting program standards for New York State's periodic medical review

This article describes the methodology used to develop program standards for a new periodic medical review/independent professional review (PMR/IPR) in New York State nursing homes. The new program consists of two stages: a first, cursory stage for the purpose of identifying patients to be subjected to a more thorough process review in the second stage. Program standards consist of (1) norms for the percentage of patients failing Stage 1 before a second stage is undertaken in a nursing home and (2) norms for the percentage of patients failing the second stage before the home is subject to corrective action. The actual standards that were developed are also presented.