A priority assignment model for standards and conditions in a long term care survey.
Presently a survey document is used in New York State to enforce Federal and State regulatory standards for long term care facilities (skilled nursing facilities and related facilities). This document is used to establish Medicare and Medicaid certification for these facilities. This study describes the creation of a new survey process---a first stage consisting of a screening survey followed, if necessary, by an intensive survey. A priority assignment model which utilizes the judgments of experts from the New York State Office of Health Systems Management (OHSM) has been developed. This model is employed to develop ranks, priority weights and classifications for the various standards and the Federal conditions which the standards comprise (as well as equivalent State regulations). Saaty's Analytical Hierarchy Process is used to obtain the ranks and priority weights. The consistency of the experts' judgements is measured using Kendall's coefficient of agreement. An optimal split algorithm is used to subdivide the standards and conditions according to impact (high, moderate or low) on patient care, health and safety. The results are to be used as a management tool in developing decision rules for defining the scope of the intensive survey on the basis of screening survey results.
D000368:Aged; D002568:Certification / Q000592:standards*; D006801:Humans; D006278:Medicare; D008962:Models, Theoretical; D009518:New York; D009735:Nursing Homes / Q000592:standards*