1.This Act may be cited as the
Culture of Safety Hospital
Accountability Act of 2010
.
2.Culture of
Safety Hospital Accountability Study and Demonstration Program
(a)
(1)The Secretary shall conduct a study that—
(A)examines existing
activities and programs in hospitals for quality assurance, patient safety, and
performance improvement and provides an analysis regarding best practices with
respect to such activities and programs; and
(B)identifies best
practices that should be replicated in hospitals to improve patient safety and
quality of care, consistent with the provisions included under the quality
assessment and performance improvement program, as required under the
conditions of participation for hospitals under Medicare.
(2)Not
later than 2 years after the date of enactment of this Act, the Secretary shall
prepare a report containing the results of the study conducted under paragraph
(1). Such report shall be made available on the Internet website of the Centers
for Medicare & Medicaid Services.
(b)
(1)The Secretary shall establish the Culture of Safety
Hospital Accountability demonstration program to provide support for
establishing partnerships and other cooperative approaches between hospitals,
State health care agencies, and the Department of Health and Human Services to
promote and implement the best practices identified under subsection (a), with
the goal of improving the safety and quality of care provided to Medicare
beneficiaries and enhance compliance with the conditions of participation for
hospitals under Medicare.
(2)The
demonstration program shall operate during a period of 3 years, beginning not
later than 12 months after completion of the report described in subsection
(a)(2).
(3)
(A)The
Secretary shall select not less than 4 States, but not more than 6 States, to
participate in the demonstration program.
(B)The
Secretary shall select not more than 24 hospitals, within the States selected
under subparagraph (A), to participate in the demonstration program. The
hospitals selected under this subparagraph shall satisfy criteria, as developed
by the Secretary, relating to compliance with the conditions of participation
for hospitals under Medicare.
(4)A
State or hospital that desires to participate in the demonstration program
shall submit to the Secretary an application at such time, in such manner, and
containing such information as the Secretary may require.
(5)
(A)The Secretary shall provide participating hospitals
with technical assistance in implementation of the best practices identified
through the study under subsection (a).
(B)For each State participating in the demonstration
program, the Secretary shall provide training to State surveyors that is
designed to—
(i)enhance knowledge
of the disciplines of patient safety, quality assessment, and performance
improvement;
(ii)increase skill
in evaluating compliance with quality assessment and performance improvement
programs required under the conditions of participation for hospitals under
Medicare; and
(iii)focus
investigations of complaints regarding hospital care on the hospital's quality
assessment and performance improvement program.
(6)For each State and hospital participating
in the demonstration program, the Secretary shall evaluate the
following:
(A)The level of
implementation of the best practices identified under subsection (a) by the
participating hospitals and whether adoption of such practices—
(i)improved quality
and patient safety (including an analysis of changes in quality measures and
other indicators of outcome and performance); and
(ii)resulted in a
decrease in the seriousness or number of citations for deficiencies under the
conditions of participation for hospitals under Medicare.
(B)The training
provided to State surveyors and whether such training resulted in enhanced
proficiency in evaluations of hospital quality assessment and performance
improvement programs.
(7)Not
later than 12 months after completion of the demonstration program, the
Secretary shall submit to Congress a report containing an evaluation of such
program, including—
(A)the findings of
the evaluation under paragraph (6); and
(B)recommendations—
(i)in
regard to whether the best practices identified under the demonstration program
should be adopted by other hospitals, and how the Secretary can best promote
adoption of such best practices;
(ii)in
regard to whether the training for State surveyors developed under the
demonstration program should be provided to all State surveyors; and
(iii)for such
legislation and administrative action as the Secretary determines
appropriate.
(8)The Secretary may
waive such requirements under titles XI and XVIII of the Social Security Act as
may be necessary to carry out the demonstration program.
(c)For purposes of carrying out this Act, the
Secretary shall provide for the transfer from the Federal Hospital Insurance
Trust Fund under section 1817 of the Social Security Act (42 U.S.C. 1395i) of
$25,000,000, to the Centers for Medicare & Medicaid Services Program
Management Account for the period of fiscal years 2010 through 2017. Amounts
transferred under the preceding sentence shall remain available until
expended.
(d)Section 1866(b) of the Social Security Act (42 U.S.C.
1395cc(b)) is amended by adding at the end the following new paragraph:
(5)(A)The Secretary is
authorized to promulgate regulations that establish enforcement remedies that
are in addition to, or in lieu of, termination of an agreement under this
section for hospitals or critical access hospitals for violations of health and
safety requirements under this title. Such remedies may include directed plans
of correction that are designed to—
(i)ensure compliance
with requirements under this title (including conditions of participation for
hospitals or critical access hospitals);
(ii)prevent
recurrence of non-compliance with such requirements; and
(iii)improve the
internal structures and processes within the hospital or critical access
hospital for provision of continuous quality and safety enhancement.
(B)The regulations
described under subparagraph (A) may be promulgated by the Secretary before,
during, or after the evaluation described under section 2(b)(6) of the
Culture of Safety Hospital Accountability Act
of
2010.
.
(e)Non-Application
of Paperwork Reduction ActChapter 35 of title 44, United States
Code (commonly referred to as the ‘Paperwork Reduction Act of 1995’) shall not
apply to this Act.
(f)In this Act:
(1)The term
demonstration program means the Culture of Safety Hospital
Accountability demonstration program conducted under this Act.
(2)The term hospital
means—
(A)an institution
described under section 1861(e) of the Social Security Act (42 U.S.C.
1395x(e)); or
(B)a critical access
hospital (as described under section 1861(mm)(1) of such Act (42 U.S.C.
1395x(mm)(1)).
(3)The
term Medicare means the program established under title XVIII of
the Social Security Act (42 U.S.C. 1395 et seq.).
(4)The
term Secretary means the Secretary of Health and Human
Services.