Quality Management (QM) Program Clause Samples
POPULAR SAMPLE Copied 1 times
Quality Management (QM) Program. A. The Contractor’s QM Program shall improve Contractor’s established treatment outcomes through structural and operational processes and activities that are consistent with current standards of practice.
B. The Contractor shall have a written description of the QM Program which clearly defines the QM Program’s structure and elements, assigns responsibility to appropriate individuals, and adopts or establishes quantitative measures to assess performance and to identify and prioritize area(s) for improvement.
C. Annually, each Contractor must:
1) Measure and report to DHCS its performance using standard measures required by DHCS including those that incorporate the requirements of section 438.204(c) and 438.240(a)(2);
2) Submit to DHCS data specified by DHCS that enables DHCS to measure the Contractor’s performance; or
3) Perform a combination of the activities described above.
D. The QM Program shall be evaluated annually and updated by the Contractor as necessary per 42 CFR 438.240(e).
E. Triennial Review
1) During the triennial reviews, DHCS shall review the status of the Quality Improvement Plan and the Contractor’s monitoring activities.
a) This review shall include the counties service delivery system, beneficiary protections, access to services, authorization for services, compliance with regulatory and contractual requirements of the waiver, and a beneficiary records review.
b) This triennial review shall provide DHCS with information as to whether the counties are complying with their responsibility to monitor their service delivery capacity.
c) The counties shall receive a final report summarizing the findings of the triennial review and if out of compliance, the Contractor must submit a plan of correction (POC) within 60 days of receipt of the final report. DHCS shall follow-up with the POC to ensure compliance.
F. The QM Program shall conduct performance monitoring activities throughout the Contractor’s operations. These activities shall include, but not be limited to, beneficiary and system outcomes, utilization management, utilization review, provider appeals, credentialing and monitoring, and resolution of beneficiary grievances.
G. The Contractor shall ensure continuity and coordination of care with physical health care providers. The Contractor shall coordinate with other human services agencies used by its beneficiaries. The Contractor shall assess the effectiveness of any MOU with a physical health care plan.
H. The Contractor shall have ...
Quality Management (QM) Program. The Contractor’s QM Program shall improve Contractor’s established treatment outcomes through structural and operational processes and activities that are consistent with current standards of practice.
Quality Management (QM) Program. A. CONTRACTOR shall develop, implement, and maintain a comprehensive QM program that assures compliance with this AGREEMENT, minimum performance standards, applicable EMS statutes/regulations, and AGENCY policies/protocols. CONTRACTOR’S QM program shall also include process measurement and process improvement that is integrated with the AGENCY’S QM program.
B. CONTRACTOR shall designate a qualified California licensed paramedic or RN to manage CONTRACTOR’S QM program. This individual shall be readily available to CONTRACTOR’S field personnel and act as a liaison between CONTRACTOR and the AGENCY on clinical related matters. This individual shall be allotted enough scheduled work hours to adequately perform QM related functions required by this AGREEMENT, and to respond to clinical related inquiries from AGENCY representatives and/or other EMS system participants in a timely manner.
C. CONTRACTOR shall retain/employ a California licensed MD or DO Medical Director to provide medical oversight of CONTRACTOR’S personnel, and liaison with AGENCY representatives.
D. CONTRACTOR shall develop, implement, and maintain an AGENCY approved written Emergency Medical Services Quality Improvement Program (EMSQIP), designed to monitor, assess, and improve the quality/appropriateness of patient care and safety.
E. When CONTRACTOR’S EMSQIP identifies a need for improvement, CONTRACTOR shall develop a performance improvement action plan/performance action plan, in cooperation with CONTRACTOR’S Medical Director, the AGENCY’S Medical Director, and other EMS system participants, when applicable.
F. CONTRACTOR’S EMSQIP shall be reviewed annually for appropriateness to CONTRACTOR’S operations. A summary of this review, and any CONTRACTOR actions resulting thereof, shall be provided in writing to the AGENCY.
G. CONTRACTOR shall be responsible for adequately assessing and maintaining the skills competency of its EMT, AEMT, and paramedic personnel on a regular basis, as required by California EMS regulations and AGENCY policies.
H. If CONTRACTOR’S or the AGENCY’S Medical Director determines that CONTRACTOR’S EMT, AEMT, or paramedic personnel need additional training, observation or testing, CONTRACTOR’S and/or AGENCY’S Medical Director may create a specific and targeted program of remediation based upon the identified need(s). If there is disagreement between the CONTRACTOR’S and AGENCY’S Medical Director, the decision of the AGENCY’S Medical Director shall prevail.
Quality Management (QM) Program. A. The Contractor’s QM Program shall improve Contractor’s established treatment outcomes through structural and operational processes and activities that are consistent with current standards of practice.
B. The Contractor shall have a written description of the QM Program which clearly defines the QM Program’s structure and elements, assigns responsibility to appropriate individuals, and adopts or establishes quantitative measures to assess performance and to identify and prioritize area(s) for improvement.
C. Annually, each Contractor must:
1) Measure and report to DHCS its performance using standard measures required by DHCS including those that incorporate the requirements of section 438.204(c) and 438.240(a)(2);
2) Submit to DHCS data specified by DHCS that enables DHCS to measure the Contractor’s performance; or
3) Perform a combination of the activities described above.
D. The QM Program shall be evaluated annually and updated by the Contractor as necessary per 42 CFR 438.240(e).
Quality Management (QM) Program. A. PROVIDER shall retain/employ a California licensed MD or DO Medical Director to provide medical oversight of PROVIDER’S personnel, and liaison with AGENCY.
B. PROVIDER shall designate a California licensed paramedic or RN Quality Management (QM) Coordinator to act as a liaison between PROVIDER and AGENCY on QM related matters. PROVIDER’S QM Coordinator shall be responsible for managing PROVIDER’S quality assurance/quality improvement activities, assisting in the investigation of unusual occurrences, and regularly participating in AGENCY’S local/regional EMS system meetings. PROVIDER’S QM Coordinator shall be allotted enough scheduled work hours to adequately perform PROVIDER’S QM functions, and to respond to QM related inquiries from AGENCY representatives and/or other EMS system participants in a timely manner.
C. PROVIDER shall develop, implement, and maintain an AGENCY approved written Emergency Medical Services Quality Improvement Program (EMSQIP).
D. PROVIDER’S EMSQIP shall be designed to monitor, assess, and improve the quality/appropriateness of patient care and safety objectively, systematically, and
Quality Management (QM) Program. 15 A. CONTRACTOR shall retain/employ a California licensed MD or DO Medical Director 16 to provide medical oversight of CONTRACTOR’S personnel, and liaison with 17 AGENCY representatives.
18 B. CONTRACTOR shall employ a qualified, full-time, California licensed paramedic or