Department of Health & Human Services

Centers for Medicare & Medicaid Services

7500 Security Boulevard, Mail Stop S2-12-25

Baltimore, Maryland 21244-1850

 

Center for Medicaid and State Operations/Survey and Certification Group

 

                                                                                                           

Ref:  S&C-04-10

DATE:            November 13, 2003

 

TO:                 State Survey Agency Directors            

 

FROM:           Director

Survey and Certification Group

                                                           

SUBJECT:     Guidelines to Support Management of Complaints and Incidents and the National

                        Implementation of the ASPEN Complaints/Incidents Tracking System  (ACTS)

Letter Summary

 

  • ACTS Effective Jan. 1, 2004: The national ACTS implementation date is January 1, 2004.  State survey agencies (SA) may fully implement ACTS now or at any time prior to January.
  • Thanks:  We thank the many state staff who labored with us to create and pilot-test this national electronic complaint tracking and management system.
  • Pilot Successfully Concluded: The pilot phase of ACTS is now ended.  States may fully implement ACTS now, may phase up gradually to 100% on January 1, 2004, or may cease the current 15% sampling in favor of a “transition-rest” until the 100% reporting in January.
  • OSCAR Reporting: Any SA that has not fully implemented ACTS must continue to upload data to the Online Survey, Certification and Reporting (OSCAR) Complaint System.  Use the Quick Entry 562 feature in ACTS or  enter all intake and investigation information in ACTS.
  • Extension Period for Exceptional State Systems:  We may approve an extended transition period for a very limited number of states that have exceptionally capable and fully implemented legacy systems and for whom immediate implementation of ACTS will cause both undue hardship and loss of critical business function.  Such states must agree to provide data equivalent to ACTS data via electronic means during the transition period, produce periodic reports, and ensure that CMS has full information on ACTS-covered complaints for the period beginning January 1, 2004.  Contact your CMS Regional Office (RO) ACTS coordinator (see attachment 4) by December 1, 2003 for an application to request extended transition.  All applications must be submitted to the RO by December 15, 2003.
  • Attachments 1-4 offer guidance on ACTS definitions, tools, and complaint management.

 

 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


In this memorandum we provide direction and guidance in the management of complaints and reported incidents for nursing homes, home health agencies, end-stage renal disease facilities, hospitals, suppliers of portable X-ray services, providers of outpatient physical therapy or speech pathology services, rural health clinics, and comprehensive outpatient rehabilitation facilities. 

 

The management of complaints and reported incidents is supported by the national implementation of the ASPEN Complaints/Incidents Tracking System (ACTS), effective on January 1, 2004.   However, a State survey agency (SA) may fully implement ACTS at any time prior to January 1, 2004.  The pilot phase of ACTS ends effective immediately. 

 

Even if a State chooses not to implement ACTS until January 1, SAs must continue to upload data to the Online Survey, Certification and Reporting (OSCAR) Complaint System either by using the Quick Entry 562 feature in ACTS or by entering all intake and investigation information in ACTS.

 

We recognize that the national implementation of ACTS affects the data entry workload or system integration challenges for some States that have established business processes with supporting legacy systems for tracking activities.  We may approve a limited extension of the transition period for a very small number of states that have exceptionally capable and fully implemented legacy systems and for whom immediate implementation of ACTS will cause both undue hardship and loss of critical business function.  Such states must agree to provide data equivalent to ACTS data via electronic means during the extended transition period, produce periodic reports specified by CMS, and ensure that CMS receives full information on ACTS-covered complaints for the period beginning January 1, 2004.   We believe that the ACTS download capability (expected in mid-2004) will remove the need for any extension except in the most rare of circumstances.  Please convey such requests, together with necessary system description and documentation, to the CMS Regional Office contact by December 1, 2003. 

 

This memorandum replaces the interim guidance issued November 8, 2002 (S&C 03-04).  For nursing homes, this memorandum replaces the October 1999 memorandum, Guiding Principles for Complaint Investigations, as well.

 

Improving the management and oversight of complaints and reported incidents is essential to ensuring protection and quality of service for the citizens we serve.  We believe ACTS will improve our collective capability to track, investigate, and respond to complaints and incidents.  We also believe it will conserve public dollars by virtue of a single national system rather than the creation of many state systems.  We therefore appreciate wholeheartedly the diligent work of participating state and regional staff as together we address policy and procedural challenges related to ACTS and to the effective management of complaints and incidents.  Thank you. 

 

Contacts: Questions about this memorandum may be addressed to Kathy Lochary at Klochary@cms.hhs.gov and Elaine Lew at Elew@cms.hhs.gov.

 

Effective Date:  January 1, 2004

 

Dissemination:  This policy should be shared with all appropriate survey and certification staff, their managers, QIES coordinators, and the state/regional office training coordinators.

 

                                                                                                /s/

Thomas E. Hamilton

 

CC: Survey and Certification Regional Office Management (G-5)

 

Attachment 1 – Guidance to Support Management of Complaints and Incidents

Attachment 2 - Guidance to Distinguish Between the Priorities of Immediate Jeopardy and

 Non-Immediate Jeopardy-High in Nursing Home Allegations

Attachment 3 - ACTS Required Fields

Attachment 4 – ACTS RO Contacts