e-Notify

e-Notify

In just a few minutes, nurses can self-enroll into Nursys e-Notify for free and take advantage of a quick and convenient way to keep up-to-date with their professional licenses. They can receive licensure status updates, track license verifications for endorsement and create and manage multiple license expiration reminders. Keeping on top of license status can help nurses prevent fraudulent licenses or certificates being issued in their names.

 

If you only have one license, you may question why you need to do this. We have had cases come before the board where a nurse unknowingly practiced while his/her license was expired. This system will notify you before your license expires and when it expires. It is also possible that your license could be suspended for failure to comply with the tax law. You would receive a notification any time any discipline is attached to your license. Missouri is a member of the nurse licensure compact. Your multi-state license is tied to your primary state of residence. A change to your primary state of residence could change your multi-state license status. This system will notify you if that status changes. When you apply to renew your license or submit your license renewal online, your license is not automatically renewed. If you enroll in this system, you will be notified when your license is renewed. Those are just a few examples of how enrolling yourself in this system will protect the license you have worked so hard to obtain. This system pushes notification of changes to you rather than you having to continually re-query the system.

 

Creating an account is quick and easy. Enroll at www.nursys.com/e-notify and select “As a Nurse” to complete the registration process. Learn more about Nursys e-Notify by viewing an introductory video or visiting the Nursys website. For questions, contact nursysenotify@ncsbn.org.

 

Nursys is the only national database for licensure verification for registered nurses (RNs), licensed practical/vocational nurses (LPN/VNs) and advanced practice registered nurses (APRNs). Nursys is designated as a primary source equivalent database through a written agreement with participating boards of nursing (BONs). Nursys is live and dynamic, and all updates to the system are reflected immediately, pushed directly from participating BON databases through frequent, secured data updates.

NEW FTags and Regulation Text

NEW FTags and Regulation Text

This attachment contains the new regulatory language for long term care. The new regulations will be implemented in three phases. The document is color-coded for ease of identifying the requirements in each phase. The color codes are:

  • Phase 1 – Red – effective 11/28/16
  • Phase 2 – Blue – effective 11/28/17
  • Phase 3 – Green – effective 11/28/19

The training for Phase I is available to providers at the following link: surveyortraining.cms.hhs.gov/pubs/ProviderTraining.aspx

Self-Reporting Update

Self-Reporting Update

SLCR has revised the Self-Reporting guidance (attached) to reflect the new regulatory requirements effective 11/28/16 regarding reporting of allegations of abuse or incidents that result in serious bodily injury. The self-reporting timeframes for these two areas has been reduced significantly. Please make sure these new requirements are implemented and policies and procedures are modified to reflect the changes.

ALERT: ICAPP Voluntarily Recalls Certain Lots of Frozen Strawberries

ICAPP Voluntarily Recalls Certain Lots of Frozen Strawberries

  • Some facilities in Missouri were identified on ICAPP’s Distribution List.  Please check your inventory if you received shipments from ICAPP.

The International Company for Agricultural Production & Processing (ICAPP) is voluntarily recalling certain lots of its frozen strawberries out of an abundance of caution in response to a U.S. Food and Drug Administration (FDA) investigation of an outbreak of Hepatitis A. For more information about this investigation, please visit FDA’s outbreak investigation website at www.fda.gov/Food/RecallsOutbreaksEmergencies/Outbreaks/ucm518775.htm. The recalled products were all distributed for sale to and use in food service establishments nationwide — not for use in food products offered for retail sale to consumers. Nonetheless, ICAPP is issuing this news release publicly to help mitigate any possible risk to the public health and to fully ensure that all recalled products are recovered. Although none of ICAPP’s own testing through an established surveillance program or through third party testing of retained samples has identified the presence of Hepatitis A in any of its products, ICAPP has decided to recall all frozen strawberries that it has imported into the United States since January 1, 2016 out of an abundance of caution. No other ICAPP products, frozen or fresh, are covered by this voluntary recall. ICAPP is conducting this voluntary recall after learning that frozen strawberries that it distributed may be linked to a recent Hepatitis A outbreak in the United States. ICAPP has been engaged with FDA in its investigation of this outbreak and is taking this action in consultation with FDA because Hepatitis A virus was detected in four lots of frozen strawberries that were exported to the U.S. by ICAPP. ICAPP is working closely with all of the U.S. distributors of this product to ensure that this recall is effective. Hepatitis A is a contagious liver disease that results from exposure to the Hepatitis A virus, including from food. It can range from a mild illness lasting a few weeks to a serious illness lasting several months. Illness generally occurs within 15 to 50 days of exposure and includes fatigue, abdominal pain, jaundice, abnormal liver tests, dark urine and pale stool. Hepatitis A vaccination can prevent illness if given within two weeks of exposure to a contaminated food. In rare cases, particularly consumers who have a pre-existing severe illness or are immune compromised, Hepatitis A infection can progress to liver failure. Persons who may have consumed affected product should consult with their health care professional or local health department to determine if a vaccination is appropriate, and consumers with symptoms of Hepatitis A should contact their health care professionals or the local health department immediately. ICAPP is fully committed to producing safe and high quality products; consumer safety is its top priority. ICAPP is conducting a comprehensive review of all of its operations and its suppliers to ensure that the food it produces is safe. ICAPP continues to work closely with federal and state authorities and is conducting this recall in cooperation with FDA. For questions or more information, consumers may contact ICAPP by email at customerservice@icapp.com.eg or by phone, between 9:00 am and 5:00 pm Cairo local time, at (201)-541-1624.

Reminder to Use Forms for Administrator and Director of Nursing Change

Use Forms for Administrator and Director of Nursing Change

  • Please remember the SLCR has developed forms for your convenience to use to notify the Licensure and Certification Unit if a change in Administrator or Director of Nursing has occurred in your facility.
  • The forms are located on LTC Application and Forms web page. The instructions for submission are included on the bottom of each form.

Oral Liquid Docusate Sodium Recall

The FDA and CDC announced the voluntary nationwide recall of oral liquid docusate sodium manufactured by PharmaTech and distributed by Rugby Laboratories.  The agency confirmed the product has been contaminated with Burkholderia cepacia, a bacteria linked to an outbreak in five states.  The bug, with resistance to some antibiotics, is more harmful in immunocompromised individuals.

 

More information can be found here.

Region 6 – Manager

Laura Smith

Laura Smith is the new Section for Long-Term Regulation Region 6 Program Manager. Laura has been with the Section for over 16 years, and has held various positions as a Facility Advisory Nurse. She has served as the interim Region 6 Program Manager in the past and most recently has been the complaint supervisor. Laura may be reached at 573-751-2270 or by email at laura.smith@health.mo.gov.

New State Law Effective August 28, 2016

Senate Bill 732

  • Senate Bill 732 established requirements for long-term care facilities to have policies and procedures that require the facility to give advance notification to emergency medical services personnel prior to the transportation of any at-risk behavioral health patient. An at-risk behavioral health patient is defined as any patient who displays violent, homicidal, or suicidal ideation or behavior.
  • There are other provisions of this law regarding emergency transports of at-risk behavioral patients that are of interest, but do not impose additional requirements on long-term care facilities.
  • Please review the bill and ensure appropriate policies and procedures are developed and implemented by the effective date of the legislation. Please contact Shelly Williamson, Assistant Administrator of the Section, at shelly.williamson@health.mo.gov with any questions regarding these new requirements.

2016 Annual Provider Meetings

Please join us for one of the 2016 Annual Long Term Care Provide Meeting.

  • Region 1 – September 15, 2016
    Cox Medical Center, South Foster Auditorium
    3801 South National Avenue, Springfield
  • Region 2 – November 4, 2016
    Southeast HEALTH, Harrison Room
    1701 Lacey Street Cape Girardeau
  • Region 3 – September 28, 2016
    Hilton Garden Inn Independence, Independence Room
    19677 E. Jackson Drive, Independence
  • Region 4 – September 27, 2016
    Stoney Creek Inn, Frontier Room
    1201 Woodbine Road, St. Joseph
  • Region 5 – September 22, 2016
    Macon Comfort Inn, Trophy/Maple Room
    1821 North Missouri, Macon
  • Region 6 – October 17, 2016
    Governor’s Office Building, Room 450
    200 Madison Street, Jefferson City
  • Region 7 – October 6, 2016
    Embassy Suites St. Louis Airport, Missouri Ballroom
    11237 Lone Eagle Drive, Bridgeton

The Provider Meetings will continue to be held in two sessions, the first session will be for Residential Care Facilities/ Assisted Living Facilities and the second session will be for the Skilled Nursing Facilities/Intermediate Care Facilities.  This year in order to avoid repetition in the program we will conduct a combined session for all provider types to cover topics of interest relevant to all.  The combined session will run from 10:15 until noon.  This session will include a presentation by the Missouri State Highway Patrol as well as a presentation regarding involuntary discharge.  Registration is not required.  CEU’s will be available for Nursing Home Administrators.

Presentation handouts will not be available on the day of each meeting but may be printed from the attachments.  Please see the attached 2016 Provider Meeting Agenda and Handouts.

CMS S&C Memo 16-40-NH/HHA/CLIA: Notice of Interim Final Rule (IFR) Agjusting Civil Monetary Penalties (CMPs)

The Department of Health and Human Services (HHS) has published in the Federal Register on September 6, 2016 an IFR which adjusts for inflation CMP amounts authorized under the Social Security Act.  (See Adjustment of Civil Monetary Penalties for Inflation)

The IFR establishes new section 45 CFR Part 102, which lists the new CMP amounts and ranges as adjusted by the IFR for affected regulations.  The changes made by the IFR are effective on September 6, 2016.

The IFR addresses all applicable CMPs under the authority of HHS but we are highlighting only on those CMPs assessed for Skilled Nursing facilities (SNFs), Nursing Facilities (NFs), SNFs/NFs, Home Health Agencies (HHAs), and Clinical laboratories.

Please see Attachment A for this S&C here.

For more information about this memo you may visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-16-40.html?DLPage=1&DLEntries=10&DLFilter=nh&DLSort=2&DLSortDir=descending.

CMS S&C Memo 16-37-ALL: Office of Civil Rights (OCR) Clearance

The Centers for Medicare & Medicaid Services (CMS) worked collaboratively with the OCR to revise the OCR clearance process for new providers and Changes of Ownership (CHOW).

The new process requires that providers successfully submit electronically an attestation of compliance with the civil rights requirements to the OCR before the State Survey Agencies (SA) and Regional Offices (RO) may process requests for initial surveys or CHOWs.

Confirmation from OCR of successful submission of the attestation will meet the requirements for OCR clearance and eliminates the need for CMS ROs to issue provisional provider agreements.

OCR will begin receiving electronic attestations on September 1, 2016.

Please see the attached Medicare Application Instructions.

For more information about this memo you may visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-16-37.html?DLPage=1&DLEntries=10&DLSort=2&DLSortDir=descending.

CMS has published the updated Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual and forms which will be effective 10/1/2016

Section GG Part 1: www.youtube.com/watch?v=pNgQ3OSaxYg
Section GG Part 2: www.youtube.com/watch?v=M1JdQxjNOqE
Section GG Part 3: www.youtube.com/watch?v=ok3U2-mQymk
Section GG Part 4: www.youtube.com/watch?v=oRmMT_uYS8Y

New Region 6 Manager

Laura Smith is the new Section for Long-Term Regulation Region 6 Program Manager.  Laura has been with the Section for over 16 years, and has held various positions as a Facility Advisory Nurse.  She has served as the interim Region 6 Program Manager in the past and most recently has been the complaint supervisor.  Laura may be reached at 573-751-2270 or by email at laura.smith@health.mo.gov.

FCSR IMPORTANT NOTICE – Registration Fee increase

Effective October 1, 2016, the Family Care Safety Registry Worker Registration fee will increase to $13.00. The fee increase results from a change in state law and is required by the Missouri State Highway Patrol.

The Family Care Safety Registry will return Worker Registration forms, submitted with the incorrect fee, that are postmarked on or after 10/01/2016. Updated Worker Registration forms will be available to download at http://health.mo.gov/safety/fcsr no later than September 15, 2016, or may be obtained by contacting the FCSR toll free at 866-422-6872.

This information is available on the FCSR website and the Registration and Background Screening System (BSEES).

CMS Memo S&C 16-21-ALL: Guidance to Surveyors on Federal Requirements for Providing Services to Justice Involved Individuals

Surveyor Guidance:  The Centers for Medicare & Medicaid Services (CMS) are clarifying requirements for providing services to justice involved individuals in skilled nursing facilities (SNFs), nursing facilities (NFs), hospitals, psychiatric hospitals, critical access hospitals (CAHs), and intermediate care facilities for individuals with intellectual disabilities (ICFs/IID). Specifically, this guidance seeks to assure high quality care that is consistent with essential patient rights and safety for all individuals.

Please see the attached memo and scenarios below or you may visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-16-21.html?DLPage=3&DLEntries=10&DLSort=3&DLSortDir=descending.

SC16-21.01 Final Memo Justice-Involved
SC16-21.02 Scenarios Justice-Involved Individuals

New MDS Updates

New MDS 3.0 Quality Measure User’s Manual Available

The MDS 3.0 QM User’s Manual Version 10 was posted April 28, 2016, which includes new Quality Measures.  The MDS 3.0 QM User’s Manual v10.0 contains detailed specifications for the MDS 3.0 quality measures that are only MDS based.  The new manual can be found in the Download section at the bottom of the page at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-instruments/NursingHomeQualityInits/NHQIQualityMeasures.html.

 

New Measures Technical Specifications

There are also now QMs that are claims based in addition to being MDS based.  The specifications for these Quality Measures can be found in the download section at the bottom of the page at www.cms.gov/Medicare/Provider-Enrollment-and-certification/CertificationandComplianc/FSQRS.html.

 

Nursing Home Compare Five-Star Rating

Beginning in July 2016, five of the new measures (all except for the antianxiety medication measure), will be used in the calculation of the Quality Measure rating.  Gradual phase-in of the new measures will occur between July 2016 and January 2017.  Prior to July, the Technical Users’ Guide, which is also available in the downloads section of the CMS website (same link as above), will be updated to reflect the changes to the Quality Measure rating calculation.

 

Payroll-based Journal (PBJ)

Beginning in July 2016, all Medicare- and Medicaid-participating nursing homes must submit staffing

data to CMS through a new electronic system called the Payroll-based Journal (PBJ).  More information about staffing data submission is available at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html

For additional assistance with or questions related to PBJ registration process, please contact the QTSO Help Desk at 877-201-4721 or via email at help@qtso.com.

 

Draft RAI Manual v1.14

On May 11, 2016, CMS posted a new DRAFT RAI Manual v1.14 in the Related Links section at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursinghomeQualityInits/MDS30RAIManual.html so that users can preview significant changes before they become effective October 1, 2016.  There are many item set changes, including the new Chapter 3, Section GG: Functional Abilities and Goals. Chapter 2 and Chapter 3, Section A provide information on the new Part A PPS Discharge assessment.  Please note that it does not include Appendices F and H or replacement pages, which will be published with the final version 1.14 in September 2016.

 

If you have any questions about the above information, please contact Stacey Bryan, BSN, RN, State RAI Coordinator, Department of Health & Senior Services, Telephone 573-751-6308 or E-mail stacey.bryan@health.mo.gov.

CMS Memo S&C 16-22-LSC: Notification of Final Rule Published: Adoption of 2012 Life Safety and Health Care Facilities Code

Fire Safety Requirements for Certain Health Care Facilities:  On May 4, 2016, the Centers for Medicare & Medicaid Services (CMS) published a final rule titled “Medicare and Medicaid Programs; Fire Safety Requirements for Certain Health Care Facilities,” which updates the fire safety requirements for health care providers and suppliers.  This regulation requires certain providers and suppliers to meet the requirements of the 2012 edition of the Life Safety Code (LSC), National Fire Protection Association (NFPA) 101 and the 2012 edition of the Health Care Facilities Code, NFPA 99.

Please see the Press Release attached stating health care providers affected by this rule must comply with all regulations within 60 days of the date of the publication of the final rule (May 4, 2016).  More information is coming from CMS and we will provide updates as we receive them.

SC16-22 – Release of Final Rule LSC
Press Release for Fire Safety Requirements