Medicare and Medicaid programs; long-term care survey--HCFA. Proposed rule

This proposal responds to a Federal court order requiring that, by October 31, 1985, we publish proposed regulations regarding a survey system that would enable the Secretary to better assess whether high quality care is actually being furnished to Medicaid recipients in nursing homes. This proposal represents a departure from, and an exception to, our position that the survey method used to determine compliance with program participation requirements can be modified without the need for change in our regulations. The proposal would amend the Medicaid regulations to emphasize that the State survey agency must follow the survey methods and procedures prescribed by HCFA that are current at the time of the survey. This preamble also indicates our intent to implement a new outcome-oriented survey process beginning early in 1986. The new survey procedures, which has been tested and refined during the last few years, is expected to provide a better basis for judging the quality of care actually provided to patients because it gives greater emphasis to patient outcomes. This will enable the surveyor to focus more directly on deficiencies that affect the health, safety and well-being of patients and residents.