Category: Long Term Care Blog

BNHA Survey

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The Missouri Board of Nursing Home Administrators (MBNHA) requests your input regarding changing the criteria to be qualified to take the nursing home administrator (NHA) exams.  This does not impact the current licensed NHAs.

Anyone in the long-term care industry is welcome to complete the following short survey regarding nursing home administrator criteria: www.surveymonkey.com/s/JQZ9VNN.  MBNHA values your time and input!

Adult Day Care Program Training Webinar

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The Section for Long-Term Care Regulation is hosting a training webinar specifically for anyone involved with Adult Day Care Programs.

During this webinar, attendees will learn:

  • Overview of departments impacting the ADC program (Health & Senior Services, Division of Disability & Senior Services, MO HealthNet and Missouri Medicaid Audit & Compliance, and Department of Mental Health),
  • Most frequently cited deficiencies in ADC programs,
  • Nurse responsibilities in DHSS licensed ADC programs,
  • Culture change and MC5,
  • Informal Dispute Resolution (IDR) Process for ADC programs, and
  • Regulation update and ADC Program Manual.

Those presenting the webinar include:
Kristen Edwards, Section Administrator-SLCR,
Shelly Williamson, Assistant Section Administrator-SLCR,
Tracy Niekamp, Program Manager Licensure and Certification-SLCR
Carla Jennings, Program Manager Regulation and Compliance Unit-SLCR
Carmen Grover-Slattery, Regulation Unit Manager-SLCR

 

UPDATE: The Adult Day Care Program webinar is ready for viewing.
Please click here to view the webinar.  You will also find the slides attached for easy referencing in a printable form. 

If you have any questions, please contact Carmen Grover-Slattery at 573-526-8570.

Holidays & Decorating

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It is that time of year when people are decorating their homes and businesses with festive décor and anticipating upcoming holiday celebrations.  Residents and staff in your care home also look forward to festivities and enjoy holiday decorations.  It is important for residents, staff and visitors to carry on traditions and to feel a sense of joy and peace we all want this time of year.

The Section for Long-Term Care Regulation (SLCR) wants to help you and your residents have a safe holiday season by sending out the following safety tips, references and regulatory reminders.

Fires or other accidents are not something anyone wants!

Safe decorations include:

  • Artificial Christmas trees and decorations that are non-combustible or flame retardant.
  • UL approved decorative lighting (use in supervised areas and turn off when not in use).
  • UL approved outdoor lighting.
  • Holiday decorations, including evergreen wreaths, ornaments, photos, etc. can be used on resident’s doors, and in hallways, as long as they do not exceed 3 ½” in depth and they are not blocking the entrances or exits.*

*Any combustible decorations hung from doors or walls in corridors may be used with a waiver. Non-rated combustible decorations cannot exceed 20% of the wall space in an exit egress corridor.

Although the 2000 Edition National Fire Protection Association (NFPA) 101® Life Safety Code (LSC) is the official reference, the 2012 Edition contains some less restrictive requirements.  Please refer to the CMS memo regarding waivers here: CMS Memo S&C 13-58-LSC 2000 Edition National Fire Protection Association (NFPA) 101® Life Safety Code (LSC) Waivers, or visit the CMS website at www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions.html.

Prohibited decorations include displays, hangings, and other decorations that block exits, visibility of exits, or fire protection appliances.  Never hang decorations from fire sprinkler heads or pipes.

NFPA 101, Section 19.7.5.4: Combustible decorations shall be prohibited in any health care occupancy unless they are flame retardant.

NFPA 101, Section 7.1.10.1: Means of egress shall be continuously maintained free of all obstructions or impediments to full instant use in the case of fire or other emergency.

NFPA 101, Section 7.1.10.2.1: No furnishings, decorations, or other objects shall obstruct exits, access thereto, egress therefrom, or visibility thereof.

Please note, some county or city local ordinances may also require compliance with more restrictive standards, including the International Fire Code (IFC).

  •  F323:  Electrical Safety – Any electrical device, whether or not it needs to be plugged into an electric outlet, can become hazardous to the residents through improper use or improper maintenance.  Electrical equipment such as electrical cords can become tripping hazards.  Halogen lamps or heat lamps can cause burns or fires if not properly installed away from combustibles in the resident environment.  The Life Safety Code prohibits the use of portable electrical space heaters in resident areas.
  • Extension cords may be used on a TEMPORARY basis.  For information regarding the use of extension cords, please visit the SLCR website at http://health.mo.gov/safety/ltcqa/questionsandanswers.php#no13.
  •  Can candles be used in nursing homes under supervision, in sprinklered facilities?

CMS Memo S&C-07-07: Nursing Home Culture Change Regulatory Compliance Questions and Answers

Answer:  Regarding the request to use candles in sprinklered facilities under staff supervision, National Fire Protection Association data shows candles to be the number one cause of fires in dwellings.  Candles cannot be used in resident rooms, but may be used in other locations where they are placed in a substantial candle holder and supervised at all times while they are lighted.  Lighted candles are not to be handled by residents due to the risk of fire and burns.

This holiday season consider using battery-operated flameless candles.  They look and smell real!

We wish you a wonderful and safe holiday season.  If you have any questions regarding the Life Safety Code, please contact SLCR at 573-526-8610.

Care and Conquer Education Series

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The Alzheimer’s Association, St. Louis Chapter announces the fourth annual Care & Conquer Education Series.  This is the region’s premier resource for the latest information on research and early detection of Alzheimer’s disease.
November 6, 2014: Cape Girardeau, Mo.
November 8, 2014: St. Charles, Mo.
November 11, 2014: Fairview Heights, Mo.
November 13, 2014: St. Louis, Mo.
November 15, 2014: North St. Louis
November 18, 2014: Rolla, Mo.
Please visit www.alz.org/stl/in_my_community_56765.asp for more information and registration.

Long Term Care Facility Application for Medicare and Medicaid

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Certified nursing facilities must complete the Long Term Care Facility Application for Medicare and Medicaid (CMS-671) at every annual resurvey.  At the time of the annual resurvey, the survey team leader provides the administrator with the application and instructions for its completion.  The application and instructions are also accessible at http://www.cms.hhs.gov/cmsforms/downloads/CMS671.pdf.

To avoid common errors when completing the application:

  • Fill out the form completely and answer every question. Print all numbers and other information legibly.
  • Facility staffing hours should only be reported for care provided in certified beds.  If a facility is distinct part (not fully certified), then staffing hours for the non-certified beds should not be reported.
  • Ensure all three boxes in each staffing category are completed under Column A, Services Provided. Enter a Y for Yes, or N for No.
    • Do not enter any information in the gray boxes.
    • If there are no staffing hours to report under Columns B, C and D leave the box blank – do not enter zeros in every blank box.
    • Enter all hours in whole numbers. Do not use decimals or fractions.
    • Staffing hours provided by hospice staff or private duty staff (not hired and paid for by the facility) should NOT be included.
    • Report actual hours worked (reference timesheets, electronic time records or calendar notes).
    • Salaried employees should report the actual hours they work.
    • The form must be signed.

It is very important to report data accurately on the application.  The Centers for Medicare & Medicaid Services (CMS) uses this data for calculation of staffing hours on Nursing Home Compare and the star ratings.  This information is available on line, http://www.medicare.gov/nursinghomecompare/search.html.

This coming year, CMS will require Missouri to conduct Minimum Data Set (MDS) Focused Surveys that will be sampled to verify the staffing data self-reported by a nursing home during the most recent recertification survey.

If you have any questions regarding completing the Long Term Care Facility Application for Medicare and Medicaid (CMS-671), please speak to the survey team leader during the survey, or contact Tracy Niekamp in the Licensure and Certification Unit at tracy.niekamp@health.mo.gov or 573-526-8522.

CMS Memo S&C 14-46-LSC: Categorical Waiver for Power Strips Use in Patient Care Areas

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Memo Summary:

  • Categorical Waiver:  CMS has determined that the 2000 edition of the National Fire Protection Association (NFPA) 101® Life Safety Code (LSC) contains provisions on the use of power strips in health care facilities that may result in unreasonable hardship for providers or suppliers.  Further, an adequate alternative level of protection may be achieved by compliance with the 2012 edition of the LSC, which has extended allowances on the use of power strips in patient care areas.

 

  • CMS is permitting a categorical waiver to allow for the use of power strips in existing and new health care facility patient care areas, if the provider/supplier is in compliance with all applicable 2012 LSC power strip requirements and with all other 2000 LSC electrical system and equipment provisions.

 

  •  Resident rooms in long-term care or other residential care facilities that do not use line-operated electrical appliances for diagnostic, therapeutic, or monitoring purposes are not subject to the more restrictive NFPA 99 requirements regarding the use of power strips in patient care areas/rooms.  Resident rooms using line-operated patient-care-related electrical equipment in the patient care vicinity must comply with the NFPA 99 power strip requirement and may elect to utilize this categorical waiver.

 

  • Individual waiver applications are not required:  Providers and suppliers are expected to have written documentation that they have elected to use the waiver.  A provider or supplier must notify the LSC survey team at the entrance conference that it has elected the use the waiver permitted under this guidance and that it meets the applicable waiver requirements. The survey team will review the information and confirm the facility meets the conditions for the waiver.

Please see the complete memo here or visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-14-46.html?DLPage=1&DLFilter=14-46&DLSort=3&DLSortDir=ascending.

Revised RAI Manual

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The complete set of RAI Manual v.1.12 pages and change tables and the Replacement Pages file, both in the Downloads section below, now contain revised versions of Chapter 2; pages A-8, A-10, and A-13 (Chapter 3 Section A); pages E-2 through E-8 (Chapter 3 Section E); page 6-12 (Chapter 6); the Appendix B, F, and H cover pages; and Appendix G. Files affected by this revision contain an R in the version number (“1.12R”) and pages affected include an “(R)” in the page footer.

This most recent version can be located at the following link: www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/MDS30RAIManual.html.
The complete manual can be found in the box labeled “downloads” at the bottom
of that page.

National Partnership Announces New Goal

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The National Partnership to Improve Dementia Care announced a new national goal of reducing the use of antipsychotic medications in long-stay nursing home residents by 25 percent by the end of 2015, and 30 percent by the end of 2016 through a media press call.  Below you will find links to a Press Release and Fact Sheet released in conjunction with this announcement.

Nursing Home Leadership Coaching Service Addition

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The MU Sinclair School of Nursing at the University of Missouri announces the addition of Nicky Martin to The Nursing Home Leadership Coaching Service alongside current coach, Dave Walker.

Nicky Martin, BS, LNHA, functions as the NHA Coach in the southern regions of the state.  Nicky has over 18 years of experience in the long-term care industry.  She began her LTC career as a business office manager in a 60-bed skilled nursing facility in 1996.  Promoted to administrator in 2001, Nicky has been active with all departments within the facility and has experience with operational management, budget analysis and accountability, Medicare/Medicaid billing procedures, facility projects and improvements, and team building.  Nicky also holds a Bachelor’s of Accountancy degree.

For the full news release and information on contacting Nicky, please see the article here.

Accelerating Antipsychotic Reduction While Improving Quality of Life With Personalized Music

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October 2, 2014:  Noon – 1:00 p.m. CT

This is a FREE webinar, presented by Dan Cohen, MSW, Executive Director, Music & Memory, to learn how music benefits and reduces the need for antipsychotic medications for those with dementia.  For more information, please visit www.tmfqin.org/Networks/Nursing-Home-Quality-Improvement and to register.

CMS Memorandum S&C 14-42-NH: Release of Learning Tool on Building Respect for Lesbian, Gay, Bisexual, Transgender (LGBT) Older Adults

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CMS Memorandum S&C 14-42-NH: Release of Learning Tool on Building Respect for Lesbian, Gay, Bisexual, Transgender (LGBT) Older Adults

Summary:

  • Release of Training Materials: The Centers for Medicare & Medicaid Services (CMS) announce the release of a free learning tool on Building Respect for LGBT Older Adults.
  • Program Content and Design: The learning tool addresses the needs and rights of older LGBT adults in long-term care (LTC) and is presented in six online training modules.
  • Target Audience: The learning tool is intended for LTC providers.

View the memo S&C 14-42-NH  or visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-14-42.html.

The Pivotal Role of Nurses in Assuring Quality and Person-Directed Care

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This 4-part webinar series introduces evidence-based framework including person-directed care principles targeting current issues for residents living with dementia.

September 23, 2014:   Nursing Practice Model for Long-Term Care Settings
October 21, 2014: Preventing Hospitalizations of Nursing Home Residents-Focus on the role of the Nurse
November 20, 2014: Eliminating the Use of Antipsychotic Medications- It Can’t BE Done Without Professional Nurses
December 11, 2014: Teamwork: Nurses and Nursing Assistants Working Together to Provide Person-Centered Care

Please visit www.pioneernetwork.net/Events/HotTopics for more information about this webinar series.

The New Face of Leadership in the Household Model

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October 21, 2014:  The New Face of Leadership in the Household Model presented by LaVrene Norton, MSW
Location:  Cider Hill Family Orchard’s Event Barn, Kansas City, KS

Please see the attached flyer or visit http://events.r20.constantcontact.com/register/event?oeidk=a07e9tfvfiy809044a6&llr=aievf5bab for more information or to register for this one-day workshop.

Understanding the Culture Change: Why organizational design is important – Conversations with Carmen

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October 17, 2014:  Understanding the Culture Change: Why organizational design is important
Guest:  LaVrene Norton, MSW, Founder and Executive Leader, Action Pact

To learn more and register for this web-based talk show, please visit www.actionpact.com/calendar/event_details/conversations_with_carmen_webinar.