Category: Nursing Home Administrators

New SNF QRP Report Category and SNF Review and Correct Report

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New SNF QRP Report Category and SNF Review and Correct Report

Effective June 1, 2017, a new report category called the SNF (Skilled Nursing Facility) Quality Reporting Program is available in the CASPER Reporting application. This report category contains the new SNF Review and Correct report.

 

The SNF Quality Reporting Program report category and SNF Review and Correct Report are available to all certified nursing-home and swing bed-based SNFs, corporate and third-party users responsible for submitting MDS 3.0 data for SNF providers, state users; QIO users, CMS Central Office and Regional Office users.

 

Data Calculation and Display

The SNF Review and Correct report displays facility-level results for the assessment-based quality measures listed below. MDS 3.0 data are used to calculate the quality measures.

  • Percent of Residents or Patients with Pressure Ulcers That Are New or Worsened (Short Stay) (NQF #0678).
  • Application of Percent of Residents Experiencing One or More Falls with Major Injury (Long Stay) (NQF #0674).
  • Application of Percent of Long-Term Care Hospital (LTCH) Patients with an Admission and Discharge Functional Assessment and a Care Plan that Addresses Function (NQF #2631).

 

If you have any questions concerning this information, please contact the QTSO Help Desk at help@qtso.com or 1 (888) 477-7876.

Delayed-Egress Locking Systems

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Delayed-Egress Locking Systems

National Fire Protection Association (NFPA) 101 2012 Delayed-Egress Locking Systems. 7.2.1.6.1.1  shows: Approved listed delayed-egress locking systems shall be permitted to be installed on door assemblies serving low and ordinary hazard contents in buildings protected throughout by an approved, supervised automatic fire detection system in accordance with Section 9.6 or an approved supervised automatic sprinkler system in accordance with Section 9.7 and where permitted in Chapters 11 through 43, provided that all of the following criteria are met:

  1. The door leaves shall unlock in the direction of egress upon actuation of one of the following:
    1. Approved, supervised automatic sprinkler system in accordance with Section 9.7
    2. Not more than one heat detector of an approved, supervised automatic fire detection system in accordance with Section 9.6
    3. Not more than two smoke detectors of an approved, supervised automatic fire detection system in accordance with Section 9.6
  2. The door leaves shall unlock in the direction of egress upon loss of power controlling the lock or locking mechanism.
  3. *An irreversible process shall release the lock in the direction of egress within 15 seconds, or 30 seconds where approved by the authority having jurisdiction, upon application of a force to the release device required in 7.2.1.5.10 under all of the following conditions:
    1. The force shall not be required to exceed 15 lbf (67N).
    2. The force shall not be required to be continuously applied for more than 3 seconds.
    3. The initiation of the release process shall activate an audible signal in the vicinity of the door opening.
    4. Once the lock has been released by the application of force to the releasing device, relocking shall be by manual means only.
  4. *A readily visible, durable sign in letters not less than 1 in. (25 mm) high and not less than 1⁄8 in. (3.2 mm) in stroke width on a contrasting background that reads as follows shall be located on the door leaf adjacent to the release device in the direction of egress: PUSH UNTIL ALARM SOUNDS DOOR CAN BE OPENED IN 15 (or 30) seconds.

 

Facilities may receive approval for 30 second release egress doors from the Authority Having Jurisdiction.  For the facility to receive 30 second release approval, the facility must submit in writing to the Section for Long-Term Regulation (SLCR), a letter detailing the risk(s) to the residents and/or hardship.  It will be the SLCR’s final decision on the approval of the extension and will be reflected in a letter to the facility.  It will be the facility’s responsibility to retain the SLCR approval letter for future reference.

 

Failure to obtain an approval letter from the SLCR will place the facility in noncompliance with Federal participation requirements and in the event of a recertification survey or federal monitoring survey for life safety code, result in a citation.

 

The facility letter detailing the risk(s) to the residents and/or hardship and facility layout indicating affected doors, can be submitted to be Scott.Wiley@health.mo.gov

HealthCare-Associated Infections Summer Workshops

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HealthCare-Associated Infections Summer Workshops

  • June 6-7, 2017:  Central District HAI, Primaris, Columbia
  • June 20-21, 2017:  Southeastern District HAI, Saint Francis Medical Center, Cape Girardeau
  • June 27-28, 2017:  Eastern District HAI, Forest Park Drury Inn, St. Louis
  • July 20-21, 2017:  Northwestern District HAI, St. Joseph Medical Center, Kansas City
  • July 25-26, 20107:  Southwestern District HAI, Cox North Hospital, Springfield

 

Healthcare-Associated Infections (HAIs) cut across all care settings – acute, ambulatory and long-term. All settings are currently (or soon will be) required to have an infection control and prevention program including an antimicrobial stewardship plan. These workshops will provide the latest evidence regarding the prevention of HAIs across settings with a strong focus on incorporating this evidence in clinical practice. Regulatory considerations and specific strategies to bridge the gap in coordinating care when patients transition from one setting to another will be included.

 

Please see more information including the brochure and registration on the MU Sinclair School of Nursing’s page.

VOYCE Conference

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VOYCE Conference

  • June 8-9, 2017: 2017 Changing the Landscape of Long Term Care Conference
  • Location:  Renaissance St. Louis Airport Hotel and Friendship Village Sunset Hills

Hear national and local experts discuss dynamic strategies, innovative tools and available long-term care options.

The format has been set with two educational tracks throughout the day; one for professionals working in long-term care and one for the general public who are looking for answers to the complexity of long-term care.

See the registration packet for the full description of the topics and the national and local expert speakers.

Throughout the day there are multiple opportunities to interact with exhibitors who showcase long-term care services across Greater St. Louis.

In addition to hearing thought-provoking speakers, facility administrators and social workers earn 7.25 CEUs.

Registration for all includes breakfast and lunch.

 

Please see the VOYCE event page for more information.

 

2017 ALF Resident Assessment Trainings

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2017 ALF Resident Assessment Trainings

  • June 26-28, 2017:  Best Western Capital Inn, Jefferson City
  • October 30-31, 2017:  Best Western Capital Inn, Jefferson City

As required by 198.005 RSMo and 19 CSR 30-86.047, residents of Assisted Living Facilities are required to undergo a community based assessment performed by an appropriately trained and qualified individual. This individual must complete a DHSS approved 24-hour training program prior to performing resident assessments. The MALA ALF Resident Assessment Training satisfies this regulatory requirement.

The National Consumer Voice for Quality Long-Term Care – New Briefs Available

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The National Consumer Voice for Quality Long-Term Care – New Briefs Available

  • Three New Briefs Available in Series on Revised Nursing Facility Regulations

Consumer Voice, along with the Center for Medicare Advocacy and Justice in Aging, has released three new briefs in their issue brief series, “A Closer Look at the Revised Nursing Facility Regulations.”

  • Return to Facility After Hospitalization – This brief explains bed hold rights when a resident returns to a facility after a hospitalization. The brief provides information on advance notification of bed hold rights and residents’ rights if they return to a facility after a bed hold period has been exceeded.
  • Grievances and Resident/Family Councils – This brief covers the resident’s right to file grievances and the facility’s requirement to work to resolve those concerns promptly. Each facility must have a grievance policy and provide residents with information on how to file a grievance. Also, residents have a right to form a resident council, and family members and resident representatives have the right to form a family council.  The facility must act upon council concerns and recommendations.
  • Quality of Care – The substantive requirements for quality of care are retained in the revised regulations, and CMS has affirmed the regulations’ goals of supporting person-centered care and enabling each resident to attain his or her highest level of well-being. This brief covers those regulations as well as providing information on how the quality of care provisions have been reorganized in the revised regulations.

 

Read the other issue briefs in the series here.

Crimes Against Persons List

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Crimes Against Persons List

  • Crimes Against Persons List

On January 1, 2017, revisions to the Revised Statutes of Missouri (RSMo) resulted in changes to the list of disqualifying crimes.

 

For example:

Involuntary Manslaughter, prior to January 1, 2017, could have been a Class A or B felony under Chapter 565, making it a disqualifying crime. On January 1, 2017, the classification of Involuntary Manslaughter was changed to a C or E felony, making it no longer disqualifying. Any A or B felony conviction of Involuntary Manslaughter prior to January 1, 2017 remains disqualifying.

 

Criminal Water Contamination was listed as a disqualifying crime in RSMo Chapter 569 prior to January 1, 2017. On January 1, 2017, it was moved to RSMo Chapter 577, making it no longer disqualifying. However, convictions prior to January 1, 2017, remain disqualifying.

 

Because of the potential confusion, SLCR is removing the list of disqualifying crimes from the website. Providers must review the criminal background check to determine if the crime is disqualifying. Disqualifying crimes are any A or B felony violation of Chapter 565, 566 or 569, RSMo, or any violation of subsection 3 of section 198.070, RSMo, or of section 568.020, RSMo.

 

  • Good Cause Waiver

An individual who has been disqualified from employment with any Long Term Care provider type has the right to apply for a Good Cause Waiver (GCW), which, if granted, would not correct or remove the finding, but would remove the hiring restriction and allow the individual to be employed. This includes those individuals who have committed a disqualifying crime and thus have been disqualified from employment in a regulated nursing home. More information about Good Cause Waivers can be found on the DHSS website at:  http://health.mo.gov/safety/goodcausewaiver/.

 

If a provider has a question about a disqualifying crime or Good Cause Waivers, please feel free to contact the Section at 573-522-6228.

IRF, LTCH, SNF QRP: Registration Open for Review and Correct Reports Provider Training – Live Webcast on May 2, 2017

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IRF, LTCH, SNF QRP: Registration Open for Review and Correct Reports Provider Training – Live Webcast on May 2, 2017

CMS is hosting a live webcast for Inpatient Rehabilitation Facilities (IRFs), Long-Term Care Hospitals (LTCHs), and Skilled Nursing Facilities (SNFs) on Tuesday, May 2, 2017, from 2:00 to 3:30  p.m. ET.

 

This training will assist providers in better understanding how Review and Correct Reports fit within the overall Quality Reporting Programs. Additionally, the training will provide information about re-submitting data to correct errors prior to the quarterly submission deadlines to ensure the accuracy of the data which will ultimately be publicly displayed.

Visit the following webpages for more information and to register:

 

IRF Quality Reporting Training:  https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/IRF-Quality-Reporting/IRF-Quality-Reporting-Training.html

 

LTCH Quality Reporting Training webpage

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/LTCH-Quality-Reporting/LTCH-Quality-Reporting-Training.html

 

SNF Quality Reporting Training webpage

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-Training.html

Beneficiary Notices

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Beneficiary Notices

Effective April 13, 2017, questions regarding any of the Fee For Service Beneficiary Notice Initiative (BNI) notices may be sent to our new mailbox:  BNImailbox@cms.hhs.gov.

The BNI notices are:

  • FFS Advance Beneficiary Notice of Noncoverage (FFS ABN)
  • FFS Home Health Change of Care Notice (FFS HHCCN)
  • FFS Skilled Nursing Facility Advance Beneficiary Notice (FFS SNFABN) and SNF Denial Letters
  • FFS Hospital-Issued Notices of Noncoverage (FFS HINNs)
  • FFS Expedited Determination Notices for Home Health Agencies, Skilled Nursing Facility, Hospice and Comprehensive Outpatient Rehabilitation Facility  (FFS Expedited Determination Notices)
  • Important Message from Medicare (IM) and Detailed Notice of Discharge (DND) (Hospital Discharge Appeal Notices)
  • FFS Notice of Exclusion from Medicare Benefits – Skilled Nursing Facility (FFS NEMB SNF)

 

There is an exception for the Medicare Outpatient Observation Notice (MOON). Continue to send questions regarding the MOON to MOONMailbox@cms.hhs.gov.

S&C Memo: 17-25-NH: Electronic Staffing Submission – Payroll-Based Journal Update

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S&C Memo: 17-25-NH: Electronic Staffing Submission – Payroll-Based Journal Update

Memorandum Summary

  • Mandatory staffing data submission through the Payroll-Based Journal began July 1, 2016. Providers are reminded that they have until the 45th day after the end of each quarter to submit data.
  • To help providers improve their submissions, the Centers for Medicare & Medicaid Services (CMS) is providing feedback on each facility’s data through their monthly Provider Preview reports.
  • The Nursing Home Compare website now reflects whether providers have submitted data by the required deadline. Additionally, providers that have not submitted any data for two consecutive deadlines will have their overall and staffing star ratings suppressed.
  • We are updating the data submission requirements related to hire and termination dates, and converting three job codes as optional for submission.

Please see the memo attached for more details or visit https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-17-25.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending.

Healthcare Associated Infections Survey

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Healthcare Associated Infections Survey

The MU Sinclair School of Nursing invites your participation in a brief online survey to identify online educational materials you would find most helpful as you seek to prevent and manage healthcare associated infections (HAIs) in your particular work setting. Based on the results of the survey, selected learning resources will be developed and made available in an easily accessible format on the School’s HAI website.

 

This online survey is at https://muno.wufoo.com/forms/needs-assessment-for-hai-educational-resources/ and will take no more than 5 minutes of your valuable time.

 

The due date for your input is May 3, 2017.

 

If you have any questions, please feel free to email www.nursingoutreach.missouri.edu or call 573-882-0215 and ask for Todd. Thank you for your important input. We pledge to use as we attempt to provide what you ask for!

New Vulnerable Citizens Services Unit Within Securities Division

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New Vulnerable Citizens Services Unit Within Securities Division

Secretary of State Jay Ashcroft announced that the Securities Division of the Office of the Secretary of State is boosting investor protection and education through the formation of its new Vulnerable Citizens Services unit.

 

Please see the Securities Release attached for more details.

S&C 17-22-ALL: Save the Date- Medicare Learning Network (MLN) Conference Call National Provider Call (NPC) for Emergency Preparedness Requirements for Medicare & Medicaid Participating Providers and Suppliers Final Rule

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S&C 17-22-ALL: Save the Date- Medicare Learning Network (MLN) Conference Call National Provider Call (NPC) for Emergency Preparedness Requirements for Medicare & Medicaid Participating Providers and Suppliers Final Rule

  • The Centers for Medicare & Medicaid Services (CMS) MLN will host a NPC for the Emergency Preparedness Requirements for Medicare & Medicaid Participating Providers and Suppliers Final Rule.
  • The calls are open to providers, suppliers, State Survey Agencies (SAs), Regional Offices (ROs) and the general public.
  • CMS has received multiple requests by providers, suppliers, States and associations to present at annual conferences regarding the new final rule for Emergency Preparedness Requirements for Medicare & Medicaid Participating Providers and Suppliers. Due to the large number of speaking requests, CMS is offering an additional learning session through the MLN. During the additional session, we will provide an overview of the final rule and discuss the requirements for meeting the training and testing requirements by the implementation date of November 15, 2016.

Date: Thursday, April 27, 2017

Time: 2:30pm-3:30pm ET

Topic: Review of provisions and focus on Training and Testing Requirements

 

Please see the attached memo or you may visit https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-17-22.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending.

S&C 17-21-ALL: Information to Assist Providers and Suppliers in Meeting the New Training and Testing Requirements of the Emergency Preparedness Requirements for Medicare & Medicaid Participating Providers and Suppliers Final Rule

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S&C 17-21-ALL: Information to Assist Providers and Suppliers in Meeting the New Training and Testing Requirements of the Emergency Preparedness Requirements for Medicare & Medicaid Participating Providers and Suppliers Final Rule

  • Information for Implementation: The Centers for Medicare & Medicaid Services (CMS) is providing information to assist providers and suppliers in meeting the Training and Testing requirements of the new Emergency Preparedness Final Rule that was published on September 16, 2016 (81 FR 63860) and became effective on  November 15, 2016.

 

Please see the S&C attached or you may visit https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-17-21.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending.

 

Fire Reporting

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Fire Reporting

19 CSR 30-85.022 (2) (F) for Skilled Nursing Facilities/Intermediate Care Facilities (SNFs/ICFs) and 19 CSR 30-86.022 (2)(C) for Residential Care Facilities (RCFs) and Assisted Living Facilities (ALFs) require that all facilities shall notify the department immediately after the emergency is addressed if there is a fire in the facility or premises and shall submit a complete written fire report (attached) to the department within seven (7) days of the fire, regardless of the size of the fire or the loss involved.

 

The Section for Long-Term Regulation defines fire as used in relation to fire/safety requirements as follows:  Fire is the active principle of burning, characterized by combustion.  This energy is evident when heat and/or smoke and/or light are present as the result of combustion.  Smoke is a product of combustion, and any time smoke is given off, combustion has occurred whether or not there has been a visible flame. Besides the obvious, some often-overlooked examples of fire include but are not limited to the following:

  • Smoking air conditioner unit or heater (whether or not the fire department responded);
  • Smoking pads or mop heads in the dryer (whether or not the fire department responded); and
  • Smoking trash in a waste receptacle (whether or not the fire department responded).

 

The facility submitted fire report must include the following:

  • A brief narrative of the event in the comments section of the report or in an attachment;
  • Documentation regarding whether or not the fire alarm and/or sprinkler system activated (if applicable) and if/when the system was back in service (if applicable);
  • In addition, the narrative must show whether or not fire extinguishers were used, and if so, when they were recharged or replaced;
  • A copy of the fire department report if the fire department responded; and
  • If a fire can be attributed to a particular person, the report must include identifying information for that person.

Expiring Administrator Licenses

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Expiring Administrator Licenses

Administrator licenses expiring June 30, 2017 are up for license renewal. License renewal notifications were sent via email to the email address on file. Please note that once the renewal is complete, an electronic license will be issued via email. The Board office will no longer mail paper licenses.

 

Please visit the Missouri Board of Nursing Home Administrator’s web page for the renewal instructions and renewal application at http://health.mo.gov/bnha. Remember to notify the Board office at BNHA@health.mo.gov with changes in your contact information, especially the email address.

Regulation Unit: Exceptions & Second Businesses – Email Correspondence

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Regulation Unit: Exceptions & Second Businesses – Email Correspondence

The  Regulation Unit is issuing all approval letters, approval certificates, reminder letters, and any other correspondence related to exceptions and second businesses via email. This email process will be the primary mode of communication, when possible. The Regulation Unit staff will contact facility administrators/operators to obtain a viable email address in order to issue correspondence by email. Original approval letters/certificates will no longer be mailed.

 

For approvals received via email, the facility administrator/operator must complete the following for:

  • Exception approval letters/certificates: Facility administrators/operators must print the approval certificate and post it alongside the facility license as required by regulation.  The approval letter must be made available to SLCR staff, upon request. 

 

  • Second business approval letters: Facility administrators/operators must make the approval letter available to SLCR staff, upon request.

 

Should you have any questions about this process, please contact the Regulation Unit at (573) 526-8523 or email RegulationUnit@health.mo.gov.

VOYCE Conference

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VOYCE Conference

  • June 8-9, 2017: 2017 Changing the Landscape of Long Term Care Conference
  • Location:  Renaissance St. Louis Airport Hotel and Friendship Village Sunset Hills

Hear national and local experts discuss dynamic strategies, innovative tools and available long-term care options.

The format has been set with two educational tracks throughout the day; one for professionals working in long-term care and one for the general public who are looking for answers to the complexity of long-term care.

See the registration packet for the full description of the topics and the national and local expert speakers.

Throughout the day there are multiple opportunities to interact with exhibitors who showcase long-term care services across Greater St. Louis.

In addition to hearing thought-provoking speakers, facility administrators and social workers earn 7.25 CEUs.

Registration for all includes breakfast and lunch.

 

Please see the VOYCE event page for more information.