In return, CMS undertakes to suspend the execution of the termination contract provided for until the health organization fulfills the contract. Hospital and Health Networks Magazine: The Systems Improvement Agreement: The Centers for Medicare & Medicaid Services uses system improvement agreements to give hospitals more time to respond to an immediate danger finding. An AIS is a voluntary legal agreement between the CMS and a Medicare certified hospital. AIS is essentially an alternative to stopping the Medicare hospital. The AIS agreement will define a number of activities to be implemented by the programme and a timetable for conclusion. First, the program must use the services of external consultants, such as Strategic Illuminations, LLC, to support the AIS process. An Independent Assessment Team (IPRT), consisting of a specific transplant surgeon and a transplant physician, a transplant administrator, a social worker, a coordinator and experts from the Quality Assessment Process Improvement (QAPI) must conduct an on-site evaluation of the program. The IPRT team will present CMS with an oral report on its results as well as a full written report to the transplant program and hospital. An on-site advisor, separate from the IPRT team, must be on site for a number of days per month, the frequency set by the CMS being generally 6 to 8 days per month. Based on the results of the IPRT, an action plan should be developed with the help of the local consultant and implemented during the duration of the ASA. Monthly calls are made with CMS to report on progress and verify certain results that the program needs to prepare and submit. In addition to the necessary issues identified by the IPRT, the program must perform a number of tasks that CMS outlines in the SIA agreement. These include a letter of notification to patients in the programme informing them of the ITA, the creation of a fund to support patients wishing to move to another programme, a staff analysis, a targeted review of certain guidelines relevant to the shortcomings required by AIS, a detailed analysis of the data to demonstrate competence in data management, which must be included in the ongoing efforts within the AQPI.
Identify quality indicators and demonstrate the activities of the AQPI. Any transplant loss or death of patients that occurs within one year after transplantation should be immediately reported to the CMS and an analysis of the causes should be performed. If CMS does not accept the request for mitigating factor, it offers the transplant program and the hospital the opportunity to enter into a System Improvement Agreement (AIS). CMS will outline a number of steps that the programme will have to implement in order to satisfactorily satisfy the agreement and avoid desertification. The agreement allows the organization and management of the hospital to influence major organizational and cultural changes that facilitate compliance without limiting a period of 23 days of desertification. By concluding the SIA, the organization undertakes to retain responsibility for compliance with the cmS requirements and also waives its rights to administratively or judicially challenge the findings contained in the declaration of defect. The hospital assumes responsibility for all ASA costs, which are often between 500,000 and 1,000,000 $US, including consultant fees as well as internal resources to devote to AIS efforts. . . .