Page:United States Statutes at Large Volume 102 Part 1.djvu/546

 102 STAT. 508

PUBLIC LAW 100-322—MAY 20, 1988

(A) because appropriate space for the conversions is not available in sufficient quantity, or (B) because in areas in which there is sufficient space the numbers of homeless veterans in need of domiciliary care who would likely use the beds are not sufficient to warrant the conversions, the Administrator shall carry out paragraph (1) only to the extent that the Administrator has not determined that it is impractical to do so. (b) PROHIBITION AGAINST DIMINUTION OF CERTAIN OTHER CONVER-

SIONS.—Nothing in this section shall result in the diminution of the conversion of hospital-care beds to nursing-home-care beds by the Veterans' Administration. (c) FUNDING.—The Administrator shall carry out subsection (a) within the limits of available appropriations. TITLE II—HEALTH-CARE ADMINISTRATION AND PERSONNEL MATTERS PART A—ADMINISTRATION

38 USC 4151

SEC. 201. HEALTH CARE QUALITY ASSURANCE ACTIVITIES. (a) ACTIONS TO IMPROVE QUALITY ASSURANCE ACTIVITIES.—Not

later than 60 days after the date of the enactment of this Act, the Administrator shall take actions to improve the operation of healthcare quality assurance programs and activities in the Veterans' Administration, including actions to achieve the following purposes: (1) Upgrading the Office of Quality Assurance within the Department of Medicine and Surgery Central Office and assigning responsibility for risk-management activities (to be carried out with the concurrence of the General Counsel) to it. (2) Expanding, and assigning higher priority and greater resources to, quality-assurance programs and activities at each Veterans' Administration health-care facility, including implementation of the review (known as "occurrence screening") of patient records for adverse events which are not the natural consequence of the patient's disease, injury, or treatment and the maximum use of the facility's computerized management information system for such activities. (3) Upgrading and expanding the office of the Medical Inspector in the Department of Medicine and Surgery Central Office, including increasing the number of employees assigned to such office on a full-time basis, so as to ensure that each medical inspection carried out by that office includes at least one such full-time employee and otherwise ensuring such adequate numbers of, and such skills and training on the part of, the employees assigned to that office as are necessary to ensure the independence, objectivity, and accountability of that office. (4) Upgrading and expanding the activities of the Veterans' Administration s Office of Inspector General in overseeing, monitoring, and evaluating the operations of the Department of Medicine and Surgery's quality-assurance programs and activities and its Medical Inspector office so as to provide the Chief Medical Director, the Administrator, and the Congress with clear and objective assessments of the effectiveness of those

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