Revision 15-0; Effective April 1, 2015
Legislation: Senate Bill 1839, relating to certain long-term care facilities; 77th Legislature, Regular session; signed June 15, 2001.
Statute: Texas Health and Safety Code, Chapter 255, Quality Assurance Early Warning System for Long-Term Care Facilities; Rapid Response Teams
40 Texas Administrative Code (TAC), Chapter 19, Subchapter J, §19.910, Quality Assurance Early Warning System
The above cited law and rule mandates the use of an early warning system (EWS) to prioritize the use of the Quality Monitoring Program's (QMP's) resources.
The EWS calculates a score for each facility that helps identify facilities with a higher-than-average risk of being cited in future surveys for significant deficiencies. The EWS score is based on criteria that includes:
- Findings from the most recent annual survey and complaint investigations conducted in the previous six months;
- Findings from previous quality monitoring visits; and
- Quality measures from the Minimum Data Set (MDS) resident care assessments.
While QMP staff visit all nursing facilities across the state, the Texas Department of Aging and Disability Services (DADS) priority is to visit those facilities with the highest EWS scores first, and to provide the most comprehensive technical assistance to those facilities with the highest risk.
Criteria are reassessed annually by comparing EWS predictions to actual outcomes in the preceding year. Because EWS is a statistical risk model, more often than not it is accurate in its prediction of risk. However, some facilities that appear to be at low risk can subsequently show very poor survey results. Similarly, some facilities that appear to be at high risk can subsequently show excellent survey results.
Rapid response team (RRT) visits are made to those facilities with the highest EWS scores. The purpose is to provide facilities with the most comprehensive assessment and technical assistance to identify systems issues that may adversely impact resident care. These visits help facilities to identify ways to make improvements that could prevent poor resident outcomes and poor survey results.
This document is a report on the risk assessment tool that is used to identify those nursing facilities most likely to need the technical assistance that is available, as required by Senate Bill 1839, 77th Legislature, Regular Session, 2001.