Issue#11-2016October 2016
Office of Inspector General 
Division of Health Care
Registration Open:  Advanced MDS 3.0 Training
See Training Opportunities Below for Details
 
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MCDC Legionella Resources

In an early release of the Morbidity and Mortality Weekly Report (MMWR), the CDC reports most outbreaks of Legionellosis occurred in hotels/motels, long term care facilities and hospitals. Most importantly CDC notes that most outbreaks were preventable.

Read the public health announcement containing CDC resources.
TB Administrative 
Regulation Toolkit

The Kentucky TB Program in collaboration with the OIG announces the introduction of a social marketing toolkit to assist with providing information and education about two TB administrative regulations.

The toolkit can be found on the OIG homepage.  It provides various training approaches to meet different settings and learning styles.  Individuals may use all tools or select a few to meet their individual or agency needs.

ePOC QUICK TIP


Everyone needs a backup!  Make sure that you obtain accounts for more than one person in your facility.

Email the ePOC Support Team for assistance.  
KARES

Enroll Now!
 
To enroll in KARES voluntarily, please click the icon below and follow the self-directed enrollment process.
 
For additional information about the program, please contact the help desk at (502) 564-2159 or via email. 

Surveyor Training Website

 

Enter Here

This CMS website provides training information to include the preceptor manual, the State Operations Manual and other documents.

 

As always, the survey and certification process is a collaborative effort between CMS and providers.  This website will allow providers the opportunity to take the same courses as surveyors.  

 

 
Division of Health Care Leadership Team
 
Inspector General 

Deputy Inspector General 

Assistant Director
 
Assistant Director
 
Assistant Director
 
Pharmacy Consultant 

Long Term Care Provider Newsletter
October 2016
doctors-nurses.jpg  
 
 
Hello 
Kentucky Providers,

I know everyone has been anxious regarding the revised and expanded federal LTC regulations, of which the final rule was just published a few weeks ago.  There is a lot to read, absorb, and implement for LTC facilities.  Some of you may already be implementing some of the new requirements on a voluntary basis; however, the scope of the changes is fairly large so I am sure that every facility will have some new things to learn and implement.

If it helps to calm any anxiety or fears, we (the State Survey Agency) and providers will all be learning this together.  It is also helpful that the changes will be implemented in 3 phases with the first phase to go into effect on November 28, 2016.

If you have not read it yet, please refer
which was released on October 24, 2016.  CMS has developed an online training that covers information regarding Phase 1 implementation of the new nursing home regulations.  This training will be available to surveyors and PROVIDERS starting November 18, 2016.  The S&C memo describes how to access the training if you are a provider.

Our surveyors and managers will be required to complete this training in order to be allowed to conduct any LTC surveys after November 28, 2016.  CMS has indicated they believe the training will take no longer than three hours.  CMS will also be releasing a revised version of Appendix PP of the State Operations' Manual (SOM) which incorporates the newly effective regulatory language.  In addition, the training will cover how the survey process will be used to address the regulatory requirements.

I strongly encourage each of you to participate in this training prior to November 28th if possible, as we will be required to survey using the new requirements being implemented in Phase 1 on all surveys after November 28th.  The training will be available online until July, 2017; however, it is in your best interests to get up to speed on these new requirements as soon as possible.  I would also strongly encourage each of you to access the revised Appendix PP and use it for training and learning purposes.  There is always lots of good information in there that can be used for staff development and in-services.

I realize there is only a 10 day time-frame, which includes the Thanksgiving Holiday, to participate in this training before the implementation of Phase 1 of the new regulations goes into effect.  However, LTC facility staff and survey staff are a resourceful group, and will do what needs to be done, as always.  We appreciate our providers in Kentucky and look forward to learning and growing through this process with you!      

Sandra Houchen, Director, Division of Health Care 
 
CMS Final Rule on Emergency Preparedness and Health Care Coalitions
The newly-finalized rule on emergency preparedness for long term care facilities includes a new regulation that nursing facilities be members of and engage in Health Care Coalition activities.  These activities include participating in one (1) community level disaster exercise per year as well can include attending regional health care coalition meetings and/or coalition LTC subcommittee meetings.  Many of your regional coalitions have LTC subcommittees that include free trainings, LTC exercises and networking opportunities with peers and other stakeholders.  A list of the upcoming coalition meetings in your region is available at the KY Emergency Preparedness for Aging & LTC Program website.  A Health Care Coalition map is also on this page.  The KY Emergency Preparedness for Aging & LTC Program is already providing training events in most of your regions.  Contact Betty Shiels or Diana Jester for more information.
 
Informal Appeal of Survey Findings
Every Long Term Care provider has the right to both an informal and formal appeal process following receipt of a completed Form CMS-2567.  There are two informal appeal processes Informal Dispute Resolution (IDR)and Independent IDR (IIDR).

Interested in Serving on an IDR Panel?
Kentucky requires one member of the IDR panel to be "a person currently engaged in the prevision of Long Term Care services who has no affiliation with the provider disputing a deficiency." Typically, a Long Term Care Administrator is on each IDR panel. There is no payment or travel reimbursement for an Administrator serving on a panel.  Administrators will be rotated.  If a Long Term Care Administrator is interested in serving on a panel, a confidentiality statement must be signed prior to the participation in the first IDR panel.

Please complete the Confidentiality Agreement and submit via email, fax or mail to:

Jennifer Smith, IDR/IIDR Coordinator
OIG - Division of Health Care
275 East Main Street 5EA
Frankfort, KY 40621
Fax (502) 564-6546
 
It's Not Too Late - Sign Up for ePOC!

Kentucky activated the ePOC process on 
June 1, 2016!  CMS and OIG continue to encourage 100% provider participation.  

If you are a certified nursing home and have not started the enrollment process, please click here for instructions and take a moment to review the FAQs below.
 
A Message from Kentucky's QIN - QIO
 The Office of Inspector General is pleased to provide information from the CMS funded QSource and atom Alliance, the Quality Innovation Network (QIN) - Quality Improvement Organizations (QIOs) for Kentucky. 
 
Click link below to read a message from Kentucky's QIN-QIO: 
   


              
 
Training Opportunities
MDS 3.0 Coding and Interpretation
Advanced Training 
The Advanced MDS 3.0 training will be held November 14, 2016 at 801 Teton Trail, Frankfort, KY 40601.  Due to limited seating, this training will be recorded and an archived webinar will be available on KY TRAIN at a later date.

This course will review the CMS October 1, 2016 updates to the MDS 3.0 and the RAI manual.  A thorough review of the ADL coding per CMS instruction will be offered as well as the RUG III Classification Model and Time-Weighted Reimbursement Methodology.  Upon completion of this training, participants will be able to:
  • Understand updates to the RAI effective October 1, 2016
  • Apply the Activities of Daily Living coding flowchart
  • Describe the RUG-III Classification Model
  • Explain the Time-Weighted Reimbursement Methodology
REGISTER NOW - SPACE IS LIMITED
Registration for this training is open and space is limited.  To register, please logon to the KY TRAIN website and search for Course ID: 1066979

You must have your own individual KY TRAIN account in order to register and receive credit for attending the training.  If you do not have an existing KY TRAIN account, then you will need to create an account.

Deadline for registration is November 10, 2016.

You MUST be preregistered on KY TRAIN to attend.

If you have any questions about this training opportunity, please contact Jami Biggs at 502-564-7963 ext. 3287.
The Younger Adult in LTC Training to be Rescheduled in 2017
Due to simultaneous industry events being held during the first week in November, it has been decided to reschedule the November 1 and November 3 Younger Adult in LTC Trainings that were scheduled to be held in Louisville and Bowling Green. These trainings will be rescheduled for Spring 2017.

Please note - If you have registered for one of these cancelled trainings, you will automatically be notified of new dates for these trainings and have the opportunity to register for the rescheduled trainings.

Thank you for your interest.

 
MDS/RAI UPDATES
Payroll-based Journal (PBJ)

The Payroll-based Journal (PBJ) became mandatory as of July 1, 2016.   In a recent report, 6.53% of Kentucky providers have NOT registered to submit data.  The deadline for the first required submission is November 14, 2016.  For questions or more information, please see the available resources below.
Q & A

Q:  If told today that the ARD was set for last week due to therapy minutes, antibiotics, etc, do you dash the cognitive interview?

A:  Yes, you would dash Section C since it did not occur.  C0100 would be coded as 1 since the interview should have been conducted. From the RAI manual October 2016, page 2-14 -Observation (Look Back) Period is the time period over which the resident's condition or status is captured by the MDS assessment. When the resident is first admitted to the nursing home, the RN assessment coordinator and the IDT will set the ARD. For subsequent assessments, the observation period for a particular assessment for a particular resident will be chosen based upon the regulatory requirements concerning timing and the ARDs of previous assessments. Most MDS items themselves require an observation period, such as 7 or 14 days, depending on the item. Since a day begins at 12:00 a.m. and ends at 11:59 p.m., the observation period must also cover this time period. When completing the MDS, only those occurrences during the look back period will be captured. In other words, if it did not occur during the look back period, it is not coded on the MDS. 
MDS/RAI CONTACT INFORMATION

MDS Assessment/Coding
Jennifer Smith 
502-564-7963, x3301 or e-mail 
    
Transmission or Technical
Rhonda Littleton-Roe 
502-564-7963, x3300 or e-mail
Unbridled Spirit  
The Office of Inspector General is Kentucky's regulatory agency for licensing all health care, day care, long-term care, and child adoption/placing facilities and agencies in the Commonwealth. 
  
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