D.C. Mun. Regs. tit. 29, r. 29-8813

Current through Register 71, No. 45, November 7, 2024

Rule 29-8813 - QUALITY IMPROVEMENT

8813.1

The PACE organization must develop, implement, maintain, and evaluate an effective, data-driven quality improvement program. The program must include all services provided by the PACE organization, and the PACE organization must take actions that result in improvements in its performance in all types of care.

8813.2

The PACE organization must have a written quality improvement plan, which is reviewed, and revised if necessary, annually by the PACE organization's governing body. The plan will be incorporated into the PACE program agreement and must specify how the PACE organization proposes to:

(a) Identify areas to improve or maintain the delivery of services and patient care;

(b) Develop and implement plans of action to improve or maintain quality of care; and

(c) Document and disseminate to PACE staff and contractors the results from the quality improvement activities.

8813.3

The quality improvement program must include the use of objective measures to demonstrate improved performance in the areas identified in 42 CFR § 460.134.

8813.4

Outcome measures must be based on current clinical practice guidelines and professional practice standards applicable to the care of PACE participants. The PACE organization must ensure that all data used for outcome monitoring are accurate and complete.

8813.5

The PACE organization must meet or exceed minimum levels of performance on standardized quality measures, as established by CMS and DHCF in the PACE program agreement.

8813.6

The PACE organization must comply with the internal quality improvement activities requirements described in 42 CFR § 460.136.

8813.7

The PACE organization must establish one or more committees with community input. Duties of the committee(s) shall include:

(a) Evaluate data collected pertaining to quality outcome measures;

(b) Address the implementation of, and the results from, the quality improvement plan; and

(c) Provide input related to ethical decision-making, including end-of-life issues and implementation of the Patient Self-Determination Act (42 U.S.C. §§ 1395cc(f) and 1396a(w)) .

8813.8

The PACE organization must meet external quality assessment and reporting requirements, as specified in the PACE program agreement, in accordance with 42 CFR § 460.202.

D.C. Mun. Regs. tit. 29, r. 29-8813

Final Rulemaking published at 69 DCR 6400 (6/3/2022)