State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. 5.0 Funding Mechanisms for Quality Improvement Programs


Typically, states are focused on "quality assurance" activities in nursing homes--that is monitoring and enforcing compliance with nursing home requirements. Most states have avoided nursing home quality improvement activities, particularly technical assistance programs, in large part, due to the limited availability of federal funds for quality improvement and confusion about what funding sources may or may not be used to support such programs.

This chapter reviews the current funding mechanisms used by states to fund state initiated quality improvement including technical assistance programs. It also provides a guide to potential funding sources for states considering quality improvement programs, by describing current and possible future legislation that may provide for federal funding for such programs. We start this discussion by reviewing the requirements for and limits on the Medicare and Medicaid survey and certification programs.

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