Quality Management

(A) Participation in MassHealth Quality Management. medical respite providers must participate in any quality management and program integrity processes established by the MassHealth agency, including making any necessary data available and access to visit the provider’s place of business upon request by the MassHealth agency or its designee. (B) Quality Improvement Practices. The medical respite provider must establish and annually update a quality improvement (QI) plan that includes information on how the medical respite provider will implement and monitor high quality clinical and enabling services. The QI plan must include: (1) A systematic process with identified leadership, accountability, and dedicated resources, and includes stakeholders such as direct staff and consumers. (2) Use of data and objective measures to determine progress toward relevant, evidence- based benchmarks and quantitative and qualitative outcomes, including patient satisfaction and feedback surveys. (3) Metrics and outcomes used should identify potential disparities in populations referred, care, and outcomes. (4) The manner in which collected data is reported and analyzed to determine if goals are met and outcomes are improved. (5) An action plan to improve outcomes. (6) The provision of staff training to adjust services to address needs and changes identified through the systematic QI process.