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SMQT- Survey & Certification Background Test | Questions Solved 100% Correct | Verified Answers
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SMQT- Survey & Certification Background Test | Questions Solved 100% Correct | Verified Answers
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SMQT- Survey & Certification BackgroundTest | Questions Solved 100% Correct |
Verified Answers
Social Security Act, Section 1864(a)
Directs the Secretary of the Department of Health & Human Services (DHHS) to use the help of
state health agencies or other appropriate agencies when determining whether health care
entities meet Federal standards.
A) Functions that state agencies perform include the following:
- Identifying potential participants
- Conducting investigations & fact-finding surveys
- Certifying & recertifying
- Explaining requirements
- Operating toll-free home health hotline
B) The state agencies (SA) are authorized to perform numerous other functions under a blanket
clause of the state agency agreement, by exclusive agreement, or by statute. These functions
include the following:
- Identifying Prospective Payment System (PPS) excluded institutions
- Participating in validation surveys of accredited entities
- Monitoring proficiency testing
- Directing data entry
- Nurse Aid Training
- Nurse Aide Registry
- Resident Assessment Instrument (RAI)
- Records & Reports
State Agency function-- Title XVIII, Section 1864(a): Identifying Prospective Payment System
(PPS) excluded institutions
,Certification information helps in identifying institutions or components of institutions that
meet special requirements that qualify them to be excluded from the Medicare PPS.
State Agency function-- Title XVIII, Section 1864(a): Participating on validation surveys of
accredited entities
Ensures validation surveys of accredited entities; surveys furnish DHHS and Congress with a
monitoring ability of CoPs. Surveys establish the validity of "deeming" that accredited entities
meet the CoPs.
State Agency function-- Title XVIII, Section 1864(a): Monitoring proficiency testing
This function allows state agencies to monitor programs of proficiency testing in laboratories
and contribute laboratory compliance findings for use in the CLIA Laboratory Certification
Program.
State Agency function-- Title XVIII, Section 1864(a): Directing data entry
State agencies are responsible for entering data from surveys, conducting follow-up visits, and
conducting complaint investigations into the OSCAR/ODIE system- the national mainframe
computer system that is used for maintaining & retrieving certification data.
State agencies are also responsible for updating information about providers, suppliers, and
CLIA laboratories in the system when indicated.
OSCAR/ODIE System
Online Survey Certification and Reporting System (OSCAR)
Online Data Input and Edit (ODIE)
ODIE is a subsystem of the Online Survey Certification & Reporting (OSCAR) system, which is
a database & retrieval program
OSCAR and ODIE are the original system name under the CLIA data system. The most current
release is known as the Automated Survey Processing Environment/Quality Information
Enterprise System (ASPEN/QIES) for CLIA.
State Agency function-- Title XVIII, Section 1864(a): NURSE AID TRAINING
State agencies are required to specify, review, and certify Nurse Aide Training and Competency
Evaluation Programs (NATCEPs).
NATCEP
Nurse Aide Training and Competency Evaluation Program
, State Agency function-- Title XVIII, Section 1864(a): Nurse Aide Registry
The Nurse Aid Registry is a listing of nurse aides who have met Federal and state training and
competency requirements necessary for employment in nursing homes.
All state agencies are required to establish and maintain a registry for all individuals who have
satisfactorily completed Nurse Aide Training and Competency Evaluation Program (NATCEP) or
a Nurse Aide Competency Evaluation Program (NACEP).
References:
- SOM Ch. 4, §4145
- SSA 1819 (e)(2)
- SSA 1919(e)(2)
State Agency function-- Title XVIII, Section 1864(a): Resident Assessment Instrument (RAI)
State agencies are required to specify a RESIDENT ASSESSMENT INSTRUMENT (RAI) for use in
the LTC facilities participating in Medicare and Medicaid.
REFERENCE:
- SOM Chapter 4, 4145.4
State Agency function-- Title XVIII, Section 1864(a): Records & Reports
State agencies must maintain pertinent survey, certification, statistical, and other records for a
period of at least FOUR years
State agencies must make reports in the form and content as the Secretary may require.
Title XIX (19) of the Social Security Act, Section 1902(a)(9)(A) – MEDICAID
Requires that a State use this same agency to set and maintain additional standards for the
State Medicaid program.
Title XIX (19) of the Social Security Act, Section 1902(a)(33)(B)
This section of the SSA requires the state to use the same agency utilized for Medicare.
If such agency is not the state agency responsible for licensing health institutions, it requires
the state to use the agency responsible for such licensing in order to determine whether
institutions meet all applicable Federal health standards for Medicaid participation.
Licensing under this section is subject to validation by the Secretary.
Social Security Act of 1965
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