As a critical element in a nursing facility's internal controls, a quality assurance and assessment (QA) committee must comply with policies designed to effectively monitor and enhance quality of care standards. In order to promote meaningful quality reviews, such policies must reflect careful consideration of the scope and power of the quality assurance privilege, which protects certain QA-related materials from disclosure. This article summarizes the case law addressing the scope of the QA privilege and provides guidance for nursing facilities that must operate QA committees in an increasingly hostile regulatory environment.
Federal Nursing Home Reform Act
In 1987, the United States Congress passed the Federal Nursing Home Reform Act (FNHRA, or the "Act") which instituted a comprehensive regulatory regime governing nursing facilities that participate in Medicare and Medicaid programs. Aimed at improving the quality and uniformity of care, FNHRA mandates that all participating facilities abide by certain conditions of oversight and inspection. For enforcement purposes, states are enlisted under the Act to conduct annual surveys designed to uncover deficient quality of care. Reports of noncompliance may be forwarded to the Secretary of Health and Human Services, who is authorized to penalize substandard facilities by denying payments, imposing civil monetary fines, or by appointing temporary management to oversee facility operations.
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