M-1, Part III August 24, 1965 j. Special Instructions for Quarterly Statement of Account--Fourth Quarter of Fiscal Year. The quarterly statement of account for the fourth quarter of the fiscal year will make allowances for any over or under payments made during the year. (1) (2) Column (G), Days of Care. Enter the total number of patient or member days of appropriate type care furnished veterans approved for Federal aid by the VA for the entire fiscal year. Column (H), Average Daily Load. Enter the average daily load for the fourth quarter only. This will be computed as follows: (a) (3) Line 10. Divide the sum of the entries on line 9, columns (A), (C) and (E) by 91. (b) Line 11. Divide the sum of the entries on line 9, columns (B), (D) and (F) by 91. Column (I), Per Diem Cost. Enter the per diem cost for the appropriate type of care, recomputed for the entire year in accordance with instructions in paragraph 15.11. (4) Column (J), Per Diem Claimed (5) (a) Line 10. Enter $2.50 or one-half of the amount shown on line 10, column (I) whichever is smaller. (b) Line 11. Enter $3.50 or one-half of the amount shown on line 11, column (I), whichever is smaller. Column (K), Amount Claimed (a) (b) Line 12. Enter the tot amount of Federal aid paid for care in the home during the three preceding quarters. Normally this will be the sum of the entries on line 13, column (K), for the first three quarters of the fiscal year. Line 13. Enter the difference between the sum of the entries on lines 10 and 11 and the entry on line 12. This will be the amount claimed for the fourth quarter. 15. 18 AMIS REPORTS Instructions for the reporting of State home care by VA stations in the AMIS (automated management information system) may be found in MP-6, part VI, supplement No. 1.2, chapter 21. SECTION VI. AUDITS, RECONCILIATIONS AND INSPECTIONS 15.19 ANNUAL INSPECTION An annual inspection of each home will be conducted by appropriate personnel of the VA station, preferably during the fourth quarter of the fiscal year. The Chief, Registrar Division, or Medical Administration Division, will communicate with the Commandant to establish mutually agreeable dates for this inspection which will include reconciliation of records, a muster and a compliance inspection. 15. 20 RECONCILIATION OF RECORDS a. VA Forms 10-2593a in the active file of the VA station or a listing thereof will be checked against the active file of the home. The computation of days of care reported on line 9 of VA Form 10-5588 for at least 2 months will be verified. If significant discrepancies are found, a complete review will be made of the records for the entire period since the last previous reconciliation. August 24, 1965 M-1, Part III b. The fiscal or finance representative will verify the computation of per diem rates used by the home to assure that they were properly computed and that only permitted items of expense have been included. 15.21 MUSTER a. The purpose of a muster is to determine that veterans for whom the VA is paying Federal aid are actually present. b. Normally the muster will be conducted on a 10 percent sample basis, except that all members and patients will be mustered in homes with an average load of less than 20. The sample will consist of at least 20 members or patients in any other case. c. The members or patients to be mustered will be determined by selecting VA Forms 10-2593a from the active file. The sample will begin by random selection of one form from among the first 10 in the file and will continue by selection of every tenth form thereafter. If this does not produce a minimum of 20, sufficient additional forms will be selected by repeating this selection process. d. The muster roll will be prepared by the VA station on plain bond paper. No substitutions will be made of any names selected. The names will not be divulged to State officials prior to the day of the muster. A positive accounting for each veteran on the list must be made. Veterans on authorized absence will be accounted for by reference to the home's absence records. 15.22 COMPLIANCE INSPECTION A tour of the home will be made by VA officials to observe the living conditions of members and patients with particular attention to compliance with applicable laws and regulations. Special attention will be paid to the methods of administration used by the home to assure compliance with title VI of Public Law 88-352 (VA Regulations 7001 through 7013). 15.23 ADDITIONAL MUSTERS AND INSPECTIONS Additional musters and inspections will be made whenever considered necessary or desirable by the Director or Manager of the VA station. 15.24 DOCUMENTATION a. A memorandum, signed by all participants, will be prepared to record the details and results of all reconciliations, musters and compliance inspections. After approval by the Director or Manager, the original will be filed at the VA station and a copy furnished to the Commandant of the home. Any discrepancies, disagreements or evidence of noncompliance which cannot be corrected or resolved within 30 days will be referred to Central Office. b. Within 45 days after each annual inspection a separate "Compliance Report" on plain bond paper, identified by station name and address, date of inspection and RCS 10-231 will be submitted to Central Office (11G), evaluating compliance by the home with title VI, Public Law 88-352 and VA Regulations 7001 through 7013. This report will evidence a careful review of the methods of administration used by the home for this purpose. 31 Department of Medicine and Surgery Veterans Administration Washington, D.C. 20420 Criteria and Construction Standards State Home Facilities for Furnishing Nursing Home Care VA Regulations 6170 - 6176 The purpose of the following comment on the change included in this amendment of VA Regulations is to inform all concerned why these changes are being made. This comment is not regulatory. Paragraph 6173. Subparagraph (D) is changed to eliminate advance payment by VA to the State agency and thus permit payment only by reimbursement. Appendix A. This appendix is revised to reflect current war veteran population and bed quotas in each State. Appendix B. This appendix is also revised: (a) to provide a method for computing VA participation in accordance with suggested criteria; (b) to establish standards for separate and combined nursing care facilities and for new areas of participation; (c) to provide an increase in square footage allowances; (d) to establish participation in equipment not included in the construction contract separately from the cost of construction; (e) to modify the listing and suggested quantity of equipment for new areas of participation (f) to provide information and policy concerning air and water pollution and flood hazard, and (g) to assure a better understanding of instructions and VA policy. Distribution: RPC 1240 FD By direction of the Administrator: Cyril Prick full CYRIL F. BRICKELD |