Licensure and Certification Unit Update
Effective immediately the Licensure and Certification Unit will be conducting business primarily by email. Licensure and Certification Unit staff will be contacting facilities and/or operators to obtain email addresses. Items that will be emailed to providers include the facility license, relicensure application reminder letters, and any other correspondence when possible. Facility administrators/operators shall print the facility license and post as required in Chapter 198.015.5, RSMo., “Licenses shall be posted in a conspicuous place on the licensed premises”, as copies will not be mailed. If you have any questions about this process, please email firstname.lastname@example.org.
The middle of Flu season is a perfect time to think about the benefits of handwashing and recognizing signs and symptoms. Staying informed about reported cases in Missouri and which areas have the highest confirmed cases, is just a click away! 2017 Influenza Reports
Most Frequently Cited Deficiencies 4th Quarter 2016
Please view the quarterly report from the Section for Long-Term Care Regulation attached.
Life Safety Code Updates and Reminders
Please see the attached Life Safety Code Updates and Reminders for the latest information.
CMS Direction Regarding IDR’s
The Section for Long Term Care had a conversation with CMS in 2016 regarding the IDR/IIDR Review Release Process. CMS Regions V and VII recently provided guidance on this topic. The Missouri IDR process for certified homes has been to send the Primaris decision letter along with our own letter upon review and completion of the IDR process. We have been instructed by CMS that the third party (Primaris) decision and rationale can no longer be shared with the providers. Following is an excerpt of this guidance. The S&C referenced below is attached for your review.
S&C Memo 12-08-NH provided Interim Advance Guidance for IIDRs and provided some information that is one of the bases for our decision to take this approach: “[T]he documents and written report created by the Independent IDR entity, the State and CMS, other than the final decision of the Independent IDR process, are pre-decisional and deliberative, and therefore are protected from disclosure under the deliberative process privilege. See EPA v. Mink, 410 U.S. 73, 88 (1973); see also 5 U.S.C. § 522(b)(5) (inter-agency and intra-agency memoranda and letters generated before adoption of final agency policy or decision are protected from disclosure under Exemption 5 of the Freedom of Information Act).” (Please note the correct U.S. Code citation is actually 5 U.S.C § 552(b)(5).) Therefore, CMS asserts this privilege to not disclose documents used in our deliberative processes. Although the quoted language from the S&C Memo is not in SOM Chapter 7, the rationale remains sound.
We have communicated with the IDR Contractor about this change. Primaris will no longer prepare a letter to the provider and will simply provide their decision and rationale through memo format. Our office will continue to review the Primaris information and prepare a letter to the providers with the final decision. The Section will then forward the SLCR Decision letter to the provider. At no time can we disclose the Primaris decision and rationale. This change applies only to certified facilities. The process will not change for those facilities that are state-licensed only.
2017 Annual Provider Meetings Input
It’s a new year and your 2017 Provider Meetings are already in the works! The Quality Assurance and Education Unit staff are currently in the planning phase and are considering the best topics to provide the most beneficial information. We would like to hear from you about what LTC related topics you believe would be helpful, informative, and ‘worth the drive’. If you’ve also been thinking- Gee I wish they would do a presentation on……., then you are cordially invited to be part on our planning team! Please feel free to forward your suggestions to:
Trending Life Safety Code Deficiencies
The NFPA 2012 Life Safety Code Requirements were effective November 1, 2016. Included in the document attached are areas frequently cited during the last quarter and since the update.
Emergency Protocol Update/Reminder
SLCR developed a protocol for communication between long-term care homes and the Section for Long-Term Care Regulation (SLCR), in the event a disaster occurs that results in a loss of a necessary service (electricity, water, gas, telephone, etc.). This protocol was established to streamline communication so that homes can focus on what is most important – the safety and well-being of the residents.
The phone number for Region 5 (Macon) has changed. This is the only change to the document attached.
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 email@example.com.
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
This attachmentcontains 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: http://surveyortraining.cms.hhs.gov/pubs/ProviderTraining.aspx