Veterans Health Administration 

The VHA Handbook, 1143.2 (June, 2004), updates new approaches to community nursing home (CNH) oversight that were first introduced in 2002. It draws on the latest research and data systems advances. has developed a new approach to provide VA subscribers with quick, easy, efficient and accurate analysis of the data required for a nursing home review.

The new National Nursing Home Review Wizard© follows and incorporates the requirements in the VHA handbook 1143.2, compares threshold standards based on computed national and state averages and calculates the criteria that can lead to exclusion and termination of nursing homes from the CNH Program based on the scope and severity of a CNH's deficiencies. 

Major Features of the CNH Exclusion Review Database 

  • Save time creating nursing home trend analysis. 
  • As a subscribing VISN, you can quickly review how nearly 16,000 community nursing homes measure up to VHA 1143.2 standards.

VHA Requirements 

  • Complete listing of each program requirement violation OSCAR level G (NH Compare level 3) or higher.
  • Deficiency section Pass/Fail based on 1143.2 guidelines. 
  • Count of health-requirement deficiencies compared to State average with Pass/Fail notation based on 1143.2 guidelines. 
  • Detailed listing of staff treatment of residents and facility licensure program requirements with Pass/Fail notation based on 1143.2. 
  • RN and Total Nursing Staff hours per resident day compared to state average with a Pass/Fail notation based on 1143.2. 
  • Should 1143.2 requirements change during the subscription period, will update the calculation for the review detail. 
  • Life Safety information included. 
  • Percentage of facility residents relative to each of the 14 CMS Quality Measures, the state average for each of the considered QMs and a Pass/Fail section rating based on 1143.2. 
  • Archive feature allows for easy documentation that the results for a home have been followed over time. Users can revisit reports they generated since the archive capability came online. 
  • CMS Identified Persistently Poor Survey Performance: (Yes or No) Home with a Yes has been selected by CMS for more frequent inspections and monitoring. Continued poor performance can lead to decertification. 
  • Quality Indicator Survey (Yes or No). QIS uses a structured review of the medical records and direct observations of the care of larger samples of residents. 
  • Continuing Care Retirement Community: (Yes or No) Specifies whether or not the home is within a Continuing Care Retirement Community. 
  • Summary results including the effect of selected complaints on calculation of VHA exclusion criteria using Nursing Home Compare timeframes. 

Time-Saving Benefits 

  • All information is presented in a single ready-to-print form after selection of facility for review. VHA users can enter comments or notes while online; these comments are included in the printed-out form. 
  • All database source information refreshed at least monthly, so that all Pass/Fail notations will be in sync with CMS data current at the time the review is performed. 
  • Detailed information on previous survey results. 
  • Listing of all substantiated complaints. 
  • Detailed listing of nursing deficiencies with Pass/Fail notation based on 1143.2 guidelines. 
  • Date of last survey for each nursing home is shown with the full list of nursing homes in a state, allowing the VHA user to quickly see if a newer survey is now displayed. 
  • If any of the current QM values differ from prior reports, the prior results are shown for comparison. The program automatically crosschecks against all archived data, but only shows changes in the QMs. 
  • Historical Perspective 
  • Quality Measures of the most recent report generated by VHA subscribers are always shown. 
  • Archive trend grid can contain 6 different reports for analysis. 
  • Archive reports feature allows the user to quickly view any prior report he/she has created.