Periodic Medical Review: Assessing the Quality and Appropriateness of Care in Skilled-Nursing Facilities

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Abstract
Mandated by Congress in 1969,1 Periodic Medical Review (PMR) is a state-run program of external peer review of the care rendered Medicaid-supported patients in skilled-nursing facilities (SNF). In Massachusetts the Department administers PMR on behalf of the Department of Public Welfare, which is the State Medicaid agency.Based upon observations of patients in the facility and analysis of patients' records, the reviews are performed by three teams, each including two registered nurses, a physician and a social worker. The objectives are to appraise the quality of the care rendered and to assess whether patients are appropriately placed* so that remedial . . .

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