NHIS Conducts Regular Evaluation of Facility Care Long-Term Care Period

[Asia Economy Reporter Lee Chun-hee] The National Health Insurance Service announced on the 19th that it will conduct a regular evaluation of long-term care institutions providing facility benefits from March 2 to November 30.

The evaluation targets a total of 5,246 institutions designated to provide facility benefits as of December 31 of last year. The institutions will be assessed through up to 50 evaluation indicators depending on the facility size, covering areas such as institution management, safety and environment including infection prevention, protection of beneficiaries' rights, and the process and outcomes of benefit provision.

Starting from this year’s evaluation, the revised "Notice on the Evaluation Methods of Long-term Care Institutions," amended last month, provides grounds for re-evaluation of institutions suspected of having received evaluations through false or other fraudulent means. Accordingly, penalties will be strengthened by adjusting and re-announcing the evaluation grades of these institutions, which is expected to provide accurate information to beneficiaries.

In addition, to enhance the objectivity and acceptability of the evaluation, the NHIS has formed and operates an evaluation consultative body to expand the collection of opinions from various stakeholders including not only providers but also beneficiaries’ guardians, civic groups, and academia, allowing the public to directly participate in the process of improving evaluation indicators. Through this, social demands such as protection of facility staff rights, beneficiary safety, and infection control are reflected, and interview and observation evaluation indicators that can verify the service provision process have also been strengthened.

The NHIS publicly recruited 173 external evaluators last month, including academic experts and those with experience in health, welfare, and medical fields, and completed the selection on the 8th. Through this, the NHIS evaluators and external evaluators plan to conduct evaluations focused on service quality together.

The NHIS plans to announce the evaluation plan, including the target institutions and evaluation methods for this facility regular evaluation, on the Long-term Care Insurance website for the elderly on the 19th.

The evaluation results will be disclosed through the Long-term Care Insurance website for the elderly in April next year. The NHIS provides additional payments to top institutions receiving an A grade (90 points or above) to motivate service quality improvement and contribute to better treatment of workers, while institutions receiving C to E grades (below 80 points) are encouraged to improve service quality through occasional evaluations, follow-up management, consulting, and mentoring systems.

Baek Nam-bok, Director of the Long-term Care Review Office at NHIS, said, "We ask for active cooperation from institutions so that the evaluation of facility benefits at long-term care institutions can be successfully completed despite difficult conditions such as the COVID-19 situation," and added, "We hope that through this evaluation, the institutions’ services will improve and the beneficiaries’ satisfaction with services will increase."

This content was produced with the assistance of AI translation services.