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
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
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.
HHS OIG Hotline Scam
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently confirmed that the HHS OIG Hotline telephone number is being used as part of a telephone spoofing scam targeting individuals throughout the country. These scammers represent themselves as HHS OIG Hotline employees and can alter the appearance of the caller ID to make it seem as if the call is coming from the HHS OIG Hotline 1-800-HHS-TIPS (1-800-447-8477). The perpetrator may use various tactics to obtain or verify the victim’s personal information, which can then be used to steal money from an individual’s bank account or for other fraudulent activity. HHS OIG takes this matter seriously. We are actively investigating this matter and intend to have the perpetrators prosecuted.
It is important to know that HHS OIG will not use the HHS OIG Hotline telephone number to make outgoing calls and individuals should not answer calls from 1-800-HHS-TIPS (1-800-447-8477). We encourage the public to remain vigilant, protect their personal information, and guard against providing personal information during calls that purport to be from the HHS OIG Hotline telephone number. We also remind the public that it is still safe to call into the HHS OIG Hotline to report fraud. We particularly encourage those who believe they may have been a victim of the telephone spoofing scam to report that information to us through the HHS OIG Hotline 1-800-HHS-TIPS (1-800-447-8477) or firstname.lastname@example.org. Individuals may also file a complaint with the Federal Trade Commission 1-877-FTC-HELP (1-877-382-4357).
More information is available on the OIG Consumer Alerts webpage.
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 email@example.com.
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: