Quality check by the medical services
The quality tests in accordance with Section 114 of Book XI of the Social Code are intended to test the effectiveness of the care and support measures (the so-called quality of results) in nursing homes or social stations , as well as the process, implementation and evaluation of service provision ( process quality ) and the immediate framework conditions for service provision (structural quality ). The tests are carried out by the Medical Service of the Health Insurance (MDK) on behalf of the regional associations of the long-term care insurance funds . The test results are presented uniformly, also publicly.
The quality tests take place as a regular test at least once a year, as a special test or as a repeat test.
Rule check
During the regular test, the quality of general care services, medical treatment care, social care including additional care and activation, accommodation and board services, additional services and the home nursing services provided in accordance with Section 37 SGB V are checked. The billing of the services mentioned can also be checked.
Event check
Reason checks are carried out if there are valid complaints or indications of grievances in the care facility.
Repeat examination
If quality deficiencies have been identified during a regular or eventual test, a repeat test can be arranged at the expense of the care facility in order to check whether the identified quality deficiencies have been remedied by the measures ordered in accordance with Section 115 (2) SGB XI.
Quality inspection guidelines
To carry out the tests, the Central Association of Statutory Health Insurance, in its capacity as the Central Association of the German Care Funds with the participation of the Medical Service of the Central Association of the German Health Insurance Funds (MDS), has adopted quality test guidelines (QPR).
Regulatory measures
In accordance with the guidelines of the National Association of Statutory Health Insurance Funds , the MDK informs the home supervision and the regional associations of the long-term care insurance funds immediately about findings from the examinations, insofar as these are necessary for the preparation and implementation of supervisory measures in accordance with the provisions of home law. This is particularly the case
- at an acute danger of residents in nursing deficits (. e.g., dehydration , malnutrition , pressure ulcers )
- for unjustified deprivation of liberty
- if the permanent presence of a nurse is not guaranteed, especially on night duty .
Individual evidence
- ↑ Guidelines of the National Association of Statutory Health Insurance Funds on the examination of services provided in care facilities and their quality according to Section 114 SGB XI of June 11, 2009 in the version of June 30, 2009 ( Memento of the original of October 16, 2012 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. (PDF; 47 kB)
