Exhibit 300 (BY2009) - Centers for Medicare and Medicaid Services CMS, Health Care Quality Improvement (Formerly QIES)

1. Date of Submission:

2008-02-04

2. Agency:

009

3. Bureau:

38

4. Name of this Capital Asset:

CMS Health Care Quality Improvement (Formerly QIES)

5. Unique Project Identifier:

009-38-01-02-01-1010-00

6. What kind of investment will this be in FY2009?

Operations and Maintenance

7. What was the first budget year this investment was submitted to OMB?

FY2001 or earlier

8. Provide a brief summary and justification for this investment, including a brief description of how this closes in part or in whole an identified agency performance gap.

In the "Control" phase of the CPIC, the Health Care Quality Improvement System (HCQI) is the culmination of many years of work on oversight and information mechanisms that monitor and report on the quality and effectiveness of care and services provided to Medicare and Medicaid beneficiaries. The HCQI project meets the needs of State Survey Agencies, CMS, other Federal Agencies, Quality Improvement Organizations (QIO), beneficiaries, consumers and researchers that use information about the quality of care from Medicare and Medicaid providers. HCQI serves as the focal point for resident assessment, quality indicators, survey/certification, and enforcement information concerning providers. Furthermore, HCQI enables CMS' Center for Medicare Management and CMS' Fiscal Intermediaries to review resident assessment data against nursing homes, Home Health Agency (HHA), and Inpatient Rehabilitation Facility claims for which the payment is based on resource utilization groups. HCQI maintains important information on Federal oversight surveys (FMS and FOSS), enforcement data, and supports the Administrator's Nursing Home and Hospital initiatives. HCQI is the key source of quality data for CMS. HCQI consolidated disparate provider data collection activities into a single system. This system allows information to be shared quickly and conveniently between federal and state governments. It minimizes redundant data collection. It allows federal and state governments to access data from one central location. It collects provider and beneficiary specific outcomes of care and performance data from a multitude of delivery sites, and across multiple provider types (e.g., nursing homes, HHAs, ESRD, Rehabiliation Facilities (IRF-PAI), Swing-beds, Psychiatric hospitals). HCQI data are used to improve the quality and cost effectiveness of services provided by the Medicare and Medicaid programs and enables consumers to make educated choices about providers of care. HCQI operates on the the Quality Net (QNet). QNet is a network environment that uses shared database servers and WAN/LAN resources to monitor and improve utilization and quality of care for Medicare and Medicaid beneficiaries.

9. Did the Agency's Executive/Investment Committee approve this request?

yes

9.a. If "yes," what was the date of this approval?

2007-06-26

10. Did the Project Manager review this Exhibit?

yes

11.a. What is the current FAC-P/PM certification level of the project/program manager?

TBD

12. Has the agency developed and/or promoted cost effective, energy-efficient and environmentally sustainable techniques or practices for this project.

no

12.a. Will this investment include electronic assets (including computers)?

yes

12.b. Is this investment for new construction or major retrofit of a Federal building or facility? (answer applicable to non-IT assets only)

no

13. Does this investment directly support one of the PMA initiatives?

yes

If yes, select the initiatives that apply:

Initiative Name
Eliminating Improper Payments
Expanded E-Government

13.a. Briefly and specifically describe for each selected how this asset directly supports the identified initiative(s)? (e.g. If E-Gov is selected, is it an approved shared service provider or the managing partner?)

HCQI supports E-government by improving information technology management, simplifying business processes and unifying information flows. HCQI directly supports the delivery of high quality customer services and making government more transparent and accountable. It eliminates improper payments through implementing the enforcement provisions for nursing homes which include Civil Money Penalties and denial of payments for nursing homes who fail to meet CMS requirements.

14. Does this investment support a program assessed using the Program Assessment Rating Tool (PART)?

yes

14.a. If yes, does this investment address a weakness found during the PART review?

yes

14.b. If yes, what is the name of the PARTed program?

2003: CMS - Medicare Program

14.c. If yes, what rating did the PART receive?

Moderately Effective

15. Is this investment for information technology?

yes

16. What is the level of the IT Project (per CIO Council's PM Guidance)?

Level 2

17. What project management qualifications does the Project Manager have? (per CIO Council's PM Guidance)

(1) Project manager has been validated as qualified for this investment

18. Is this investment identified as high risk on the Q4 - FY 2007 agency high risk report (per OMB memorandum M-05-23)?

no

19. Is this a financial management system?

no

20. What is the percentage breakout for the total FY2009 funding request for the following? (This should total 100%)

Area	Percentage
Hardware	0
Software	18
Services	71
Other	11

21. If this project produces information dissemination products for the public, are these products published to the Internet in conformance with OMB Memorandum 05-04 and included in your agency inventory, schedules and priorities?

yes

22. Contact information of individual responsible for privacy related questions.

Name	Maribel Franey
Phone Number	410-786-0757
Title	Director, Privacy compliance
Email	Maribel.Franey@cms.hhs.gov

23. Are the records produced by this investment appropriately scheduled with the National Archives and Records Administration's approval?

yes

24. Does this investment directly support one of the GAO High Risk Areas?

yes

1. Provide the total estimated life-cycle cost for this investment by completing the following table. All amounts represent budget authority in millions, and are rounded to three decimal places. Federal personnel costs should be included only in the row designated Government FTE Cost, and should be excluded from the amounts shown for Planning, Full Acquisition, and Operation/Maintenance. The total estimated annual cost of the investment is the sum of costs for Planning, Full Acquisition, and Operation/Maintenance. For Federal buildings and facilities, life-cycle costs should include long term energy, environmental, decommissioning, and/or restoration costs. The costs associated with the entire life-cycle of the investment should be included in this report.

All amounts represent Budget Authority

Note: For the cross-agency investments, this table should include all funding (both managing partner and partner agencies).

Government FTE Costs should not be included as part of the TOTAL represented.

Cost Type	Py-1 & Earlier -2006	PY 2007	CY 2008	BY 2009
Planning Budgetary Resources	0.000	0.000	0.000	0.000
Acquisition Budgetary Resources	56.500	0.000	0.000	0.000
Maintenance Budgetary Resources	70.158	16.901	17.579	18.003
Government FTE Cost	0.386	0.257	0.219	0.219
# of FTEs	3	2	2	2

2. Will this project require the agency to hire additional FTE's?

no

3. If the summary of spending has changed from the FY2008 President's budget request, briefly explain those changes.

No

Agencies must use the following table to report performance goals and measures for the major investment and use the Federal Enterprise Architecture (FEA) Performance Reference Model (PRM). Map all Measurement Indicators to the corresponding Measurement Area and Measurement Grouping identified in the PRM. There should be at least one Measurement Indicator for each of the four different Measurement Areas (for each fiscal year). The PRM is available at www.egov.gov. The table can be extended to include performance measures for years beyond FY 2009.

Row	Fiscal Year	Strategic Goal Supported	Measurement Area	Measurement Grouping	Measurement Indicator	Baseline	Planned Improvement to the Baseline	Actual Results
1	2006	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Number of new quality measures implemented	8 quality measures	12 quality measures	12 measures completed
2	2006	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percent increase in Web-access speed	25%	50% speed increase in web-based access and upload	50% target met
3	2006	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Errors	Percentage validation accuracy found on records in final testing	90% accuracy	95%	greater than 95%
4	2006	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	User Satisfaction	Percentage of users filing complaints	5% of users file complaints	2% of users file complaints	less than 2% complaints
5	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Reliability and Quality	Percentage integration of the Online Survey Certification and Reporting System with HCQI	0% integration	50% integration	50% integraton
6	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percent of surveys that rely on HCQI data	60% of surveys	80% of surveys	80%
7	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Innovation and Improvement	Percent increase in web-based access speed	25%	50%	50%
8	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Innovation and Improvement	Number of State users trained on HCQI reports	0% users trained on new reports	30% users trained	30%
9	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Accuracy of Service or Product Delivered	Number of concurrent users served	1000	1500	1500
10	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Accessibility	Number of minutes to enter survey	60 minutes	30 minutes	30 minutes
11	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percent of surveys that rely on HCQI data	80% of surveys	90% of surveys
12	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Access to Care	Number of OASIS outcome elements added or modified for home health agency pay for performance	0%	30%
13	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Accuracy of Service or Product Delivered	Percent integrationof all CLIA application and Accrediting Organizations upload into HCQI	0%	30%
14	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Innovation and Improvement	Number of State users trained on HCQI reports	30%	60%
15	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Reliability and Quality	Percent integration of the Online Survey Certification and Reporting System with HCQI	50%	100%
16	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Standardization or Tagging	Percent integration of National Provider Identifier into all standard reports and ASPEN	0%	30%
17	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Accuracy of Service or Product Delivered	Percent integration of all CLIA application and Accrediting Organizatons upload into HCQI	30%	60%
18	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Innovation and Improvement	Number of State users trained on HCQI reports	60%	80%
19	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Standardization or Tagging	Percent integration of National Provider Identifier into all standard reports and ASPEN	30%	60%
20	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Access to Care	Number of OASIS outcome elements added or modified for home health aency pay for performance	30%	60%
21	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Accuracy of Service or Product Delivered	Percent integration of all CLIA application and Accrediting Organizatons upload into HCQI	60%	100%
22	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Innovation and Improvement	Number of State users trained on HCQI reports	80%	100%
23	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Standardization or Tagging	Percent integration of National Provider Identifier into all standard reports and ASPEN	60%	100%
24	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Access to Care	Number of OASIS outcome elements added or modified for home health agency pay for performance	60%	100%
25	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of enhancements, new reports and new requirements integrated	0%	30%
26	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Access	Percentage of users having access to new functionality	0%	40%
27	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Innovation and Improvement	Percentage of users trained on new functionality	0%	40%
28	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Reliability	Percentage of system availability	92%	94%
29	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of enhancements, new reports and new requirements integrated	30%	60%
30	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Access	Percentage of users having access to new functionality	40%	80%
31	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Innovation and Improvement	Percentage of users trained on new functionality	40%	80%
32	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Reliability	Percentage of system availability	94%	96%
33	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of enhancements, new reports and new requirements integrated	60%	100%
34	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Access	Percentage of users having access to new functionality	80%	100%
35	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Innovation and Improvement	Percentage of users trained on new functionality	80%	100%
36	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Reliability	Percentage of system availability	96%	98%

1. Is this investment included in your agency's target enterprise architecture?

yes

2. Is this investment included in the agency's EA Transition Strategy?

yes

2.a. If yes, provide the investment name as identified in the Transition Strategy provided in the agency's most recent annual EA Assessment.

CMS Quality Improvement and Evaluation System (QIES)

3. Is this investment identified in a completed (contains a target architecture) and approved segment architecture?

no

4. Identify the service components funded by this major IT investment (e.g., knowledge management, content management, customer relationship management, etc.). Provide this information in the format of the following table. For detailed guidance regarding components, please refer to http://www.whitehouse.gov/omb/egov/.

Component: Use existing SRM Components or identify as NEW. A NEW component is one not already identified as a service component in the FEA SRM.

Reused Name and UPI: A reused component is one being funded by another investment, but being used by this investment. Rather than answer yes or no, identify the reused service component funded by the other investment and identify the other investment using the Unique Project Identifier (UPI) code from the OMB Ex 300 or Ex 53 submission.

Internal or External Reuse?: Internal reuse is within an agency. For example, one agency within a department is reusing a service component provided by another agency within the same department. External reuse is one agency within a department reusing a service component provided by another agency in another department. A good example of this is an E-Gov initiative service being reused by multiple organizations across the federal government.

Funding Percentage: Please provide the percentage of the BY requested funding amount used for each service component listed in the table. If external, provide the funding level transferred to another agency to pay for the service.

Row	Agency Component Name	Agency Component Description	Service Type	Component	Reused Component Name	Reused UPI	Internal or External Reuse?	Funding %
1	Data Cleansing	Defines the set of capabilities that support the removal of incorrect or unnecessary characters and data from a data source.	Data Management	Data Cleansing			No Reuse	5
2	Data Exchange	Defines the set of capabilities that support the interchange of information between multiple systems or applications; includes verification that transmitted data was received unaltered.	Data Management	Data Exchange			No Reuse	6
3	Data Warehouse	Defines the set of capabilities that support the archiving and storage of large volumes of data.	Data Management	Data Warehouse			No Reuse	5
4	Extraction and Transformation	Defines the set of capabilities that support the manipulation and change of data.	Data Management	Extraction and Transformation			No Reuse	6
5	Loading and Archiving	Defines the set of capabilities that support the population of a data source with external data.	Data Management	Loading and Archiving			No Reuse	7
6	Meta Data Management	Defines the set of capabilities that support the maintenance and administration of data that describes data.	Data Management	Meta Data Management			No Reuse	5
7	Data Integration	Defines the set of capabilities that support the organization of data from separate data sources into a single source using middleware or application integration and the modification of system data models to capture new information within a single system.	Development and Integration	Data Integration			No Reuse	7
8	Enterprise Application Integration	Defines the set of capabilities that support the redesigning of disparate information systems into one system that uses a common set of data structures and rules.	Development and Integration	Enterprise Application Integration			No Reuse	4
9	Software Development	Defines the set of capabilities that support the creation of both graphical and process application or system software.	Development and Integration	Software Development			No Reuse	5
10	Ad Hoc	Defines the set of capabilities that support the use of dynamic reports on an as needed basis.	Reporting	Ad Hoc			No Reuse	10
11	Standardized / Canned	Defines the set of capabilities that support the use of pre-conceived or pre-written reports.	Reporting	Standardized / Canned			No Reuse	10
12	Graphing / Charting	Defines the set of capabilities that support the presentation of information in the form of diagrams or tables.	Visualization	Graphing / Charting			No Reuse	3
13	Surveys	Defines the set of capabilities that are used to collect useful information from an organization's customers.	Customer Relationship Management	Surveys			No Reuse	7
14	Community Management	Defines the set of capabilities that support the administration of online groups that share common interests.	Communication	Community Management			No Reuse	10
15	Identification and Authentication	Defines the set of capabilities that support obtaining information about those parties attempting to log on to a system or application for security purposes and the validation of those users.	Security Management	Identification and Authentication	Identification and Authentication	009-38-01-06-01-1030-00	Internal	6

5. To demonstrate how this major IT investment aligns with the FEA Technical Reference Model (TRM), please list the Service Areas, Categories, Standards, and Service Specifications supporting this IT investment.

FEA SRM Component: Service Components identified in the previous question should be entered in this column. Please enter multiple rows for FEA SRM Components supported by multiple TRM Service Specifications.

Service Specification: In the Service Specification field, Agencies should provide information on the specified technical standard or vendor product mapped to the FEA TRM Service Standard, including model or version numbers, as appropriate.

Row	SRM Component	>Service Area	Service Category	Service Standard	Service Specification (i.e., vendor and product name)
1	Software Development	Component Framework	Business Logic	Platform Dependent	MFC++, Visual C++
2	Software Development	Component Framework	Business Logic	Platform Independent	C++, EJB, Java Script, JSF53
3	Data Exchange	Component Framework	Data Interchange	Data Exchange	SOAP
4	Community Management	Component Framework	Data Management	Database Connectivity	TJDBC, ODBC, OCI
5	Ad Hoc	Component Framework	Data Management	Reporting and Analysis	OLAP, XML, Crystal Reports, JASPER iReport
6	Community Management	Component Framework	Presentation / Interface	Content Rendering	CSS, DHTML
7	Software Development	Component Framework	Presentation / Interface	Dynamic Server-Side Display	JSP
8	Software Development	Component Framework	Presentation / Interface	Static Display	HTML
9	Identification and Authentication	Component Framework	Security	Supporting Security Services	JAAS, WS Security
10	Community Management	Service Access and Delivery	Access Channels	Web Browser	Internet Explorer
11	Data Exchange	Service Access and Delivery	Delivery Channels	Internet	TBD
12	Data Exchange	Service Access and Delivery	Delivery Channels	Intranet	TBD
13	Data Exchange	Service Access and Delivery	Service Requirements	Hosting	TBD
14	Community Management	Service Access and Delivery	Service Requirements	Legislative / Compliance	Section 508, Security
15	Community Management	Service Access and Delivery	Service Transport	Service Transport	TCP, IP, HTTP, HTTPS, Secure FTP, SSH
16	Identification and Authentication	Service Access and Delivery	Service Transport	Supporting Network Services	DNS, LDAP, MIME
17	Data Warehouse	Service Interface and Integration	Integration	Enterprise Application Integration	TBD
18	Community Management	Service Interface and Integration	Interoperability	Data Format / Classification	XML
19	Data Warehouse	Service Platform and Infrastructure	Database / Storage	Database	Oracle, MS Access, SQL Server
20	Data Warehouse	Service Platform and Infrastructure	Database / Storage	Storage	SAN
21	Software Development	Service Platform and Infrastructure	Delivery Servers	Application Servers	BEA, Apache Tomcat
22	Software Development	Service Platform and Infrastructure	Delivery Servers	Web Servers	Apache
23	Software Development	Service Platform and Infrastructure	Software Engineering	Integrated Development Environment	Visual Studio, iReport Web Logic Workshop, Eclipse
24	Software Development	Service Platform and Infrastructure	Software Engineering	Software Configuration Management	Serena Dimensions
25	Software Development	Service Platform and Infrastructure	Support Platforms	Platform Dependent	Window 2003, Sun Solaris
26	Software Development	Service Platform and Infrastructure	Support Platforms	Platform Independent	Sun J2EE, Sun J2SE

6. Will the application leverage existing components and/or applications across the Government (i.e., FirstGov, Pay.Gov, etc)?

no

1. Does the investment have a Risk Management Plan?

yes

1.a. If yes, what is the date of the plan?

2007-07-01

1.b. Has the Risk Management Plan been significantly changed since last year's submission to OMB?

no

1. Was operational analysis conducted?

yes

1.a. If yes, provide the date the analysis was completed.

2007-07-27

What were the results of your operational analysis?

The project is currently within the 10 percent cost and schedule variance. We are on target to meet the milestones per the approved baseline. The system continues to meet the State Agency's requirements and needs.