{"ref":"FL-HSP-QA-01","title":"Quality Assurance and Utilization Review (QAUR) and QAPI Program","category":"Quality","summary":"Sets up the Florida quality assurance and utilization review (QAUR) plan, which is also the Medicare QAPI program: the committee and its lead, the written plan and annual report to the governing body, the information the committee must review under Rule 59A-38.006(5), F.A.C., incident or accident reports for every treatment error, adverse reaction or injury, clinical record audits, utilization review and the inpatient limit, national outcome measures and CAHPS Hospice surveys, and performance improvement projects.","inShort":["Any error in treatment, bad reaction to a treatment or medicine, or injury to a patient needs an incident or accident report.","Care for the patient first, tell the physician and family, then complete the report before your shift ends and give it to the supervising nurse.","Write the facts in the clinical record, but do not put the incident report in the record.","If you suspect abuse, neglect or exploitation, also call the Florida Abuse Hotline at once.","Every report goes to the quality committee, led by Lee Sample, which looks for causes and fixes."],"primaryCitation":"Rule 59A-38.006, F.A.C.","citations":["Rule 59A-38.006, F.A.C.","s. 400.610(2)-(3), F.S.","Rule 59A-38.004(4)-(5), F.A.C.","s. 400.60501, F.S.","Rule 59A-38.008(4)(b), F.A.C.","s. 400.609(4), F.S.","Rule 59A-38.004(1)(c), F.A.C."],"federalCitations":["42 CFR §418.58","42 CFR §418.312","42 CFR §418.54(e)","42 CFR §418.108(d)"],"surveyorAsks":["Show me your QAUR/QAPI plan and the minutes where the governing body received the committee’s annual findings.","Who serves on the committee, and how were they trained? Where are your written review criteria, and when were they last updated?"],"forms":[{"ref":"FL-HSP-QA-01-A","title":"Incident or Accident Report"},{"ref":"FL-HSP-QA-01-B","title":"Clinical Record Audit Tool"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (s. 400.610(2), F.S.; Rule 59A-38.006, F.A.C.; 42 CFR §418.58)","5. The QAUR/QAPI Committee","6. The QAUR/QAPI Plan","7. Information the Committee Reviews","8. Incident or Accident Reports","9. Clinical Record Audits","10. Utilization Review","11. National Outcome Measures and Family Surveys","12. Performance Improvement Projects","13. Access, Recommendations and Reports to the Governing Body","14. Responsibilities","15. Records and Compliance Monitoring","16. Staff Training","17. References","18. Related Policies and Forms","19. Approval","20. Revision History"],"version":"1.0","sample":false,"pack":"fl-hospice","state":"Florida","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}