| Have You Notified Your Residents?
Click the link below to download and/or print the contact list for various agencies.
REQUIRED Agency Contact Information for Residents of LTC Facilities |
| Which Enforcement Branch is Serving You?
To provide the highest level of service, the Division of Health Care operates through four regional offices. Knowing the appropriate Enforcement Branch to contact with questions and concerns will ensure you receive maximum service in minimum time. Review links below for detailed information.
Regional Map Contact Information |
| LTC Facility Self-Reported Incidents & Complaints 
New email addresses have been established for communications regarding LTC Facility Self-Reported Incidents and for use by residents and the general public to report possible violations of regulatory requirements. Click Here for the email addresses and additional contact information. |
|  CMS Survey and Certification memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. Survey and Certification Letters |
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Transfer/Discharge Hearing Appeals
Please
submit your requests for transfer/discharge hearing appeals to Secretary Glisson, Cabinet for Health and Family Services by emailing:
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| Kentucky's Top 10 Citations for Nursing Homes |
| Health Care
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Employment Opportunities
To search and apply for career opportunities with the Office of Inspector General, please visit the Career Opportunities System webpage by clicking below.
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Long Term Care
Provider Newsletter
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Hello Everyone,
I hope everyone is staying warm and well during this cold, snowy and busy January. I have a few items to discuss today that may be of interest to you.
First, our agency has received some clarification from CMS regarding the new regulation at F715 allowing physicians to delegate the writing of dietary orders to qualified dietitians who are acting within their scope of practice under state law. OIG has received several inquiries from providers asking if this regulation and ability for qualified dietitians to write dietary orders only applies to oral diets and nutritional supplements, or if enteral feeding orders are also included.
The response from CMS was that if our state law permits, then qualified dietitians could write orders for enteral feedings. Of course, the physician is still responsible to supervise the overall care of the resident. In addition, the facility needs to develop a policy and procedure to address this process. Additional information regarding assisted nutrition and hydration and the dietitian as a delegate for the physician can be found at F692. Kentucky state law for dietitians does refer back to national Standards of Practice so these standards would cover enteral feedings. Thus, we have determined that from a regulatory perspective, there would not be an issue with a qualified dietitian writing orders for enteral feedings in accordance with accepted Standards of Practice, state law, and with physician supervision of the overall care of the resident.
Second, I would like to spend just a moment to clarify the granting of waivers of regulatory requirements by CMS. OIG has checked with CMS and were told that for a waiver to be reviewed and approved or rejected, a statement of deficiencies must be issued by the survey agency and a plan of correction must be provided by the facility addressing measures that were being put in place to ensure the waived requirement would not adversely impact resident health and safety. It should be noted that there are extremely few federal waivers of LTC requirements, and they are not easily obtained and are reserved for very rare exceptions.
Lastly, the question of whether discharging a resident when their bed hold days are up and/or they do not wish to or cannot pay to hold a bed is considered a facility-initiated or resident-initiated discharge, has come up several times. OIG has asked for input from CMS on this issue.
Based on CMS's response and a close review of the definitions of facility-initiated discharge and resident-initiated discharge, a discharge for inability or unwillingness to pay to hold a bed would in most cases be considered a facility-initiated discharge. Therefore, discharge notice requirements would need to be met and a copy of the discharge notice provided to the state LTC ombudsman at the time it is provided to the resident or family. It is possible that there might be a rare instance where this could be considered a resident-initiated discharge. However, for this to be the case, the discharge would have to be requested by the resident/representative in writing or verbally, and be in alignment with the resident's stated goals and preferences, as described in the definition for resident-initiated discharge.
Well, I think that is about all I have for this newsletter. We will continue to attempt to address issues or concerns about which providers have requested clarification in future newsletters. Hopefully, the information in this issue of the newsletter has provided some clarity on the topics addressed.
I hope everyone has a lovely Valentine's Day, and takes that opportunity to share a hug with someone who needs it! Thanks for all you do every day.
Sandra Houchen, Director
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Free Educational Resources for KY LTC Providers
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Your facility now has free access to the CMS Region IV Long-Term Care Quality Improvement Initiative thanks to a grant funded through CMS and your SSA. This initiative includes a password-protected website, www.cpgltc.org, that offers free access to materials developed by The Society for Post-Acute and Long-Term Care Medicine (AMDA). Please see the attached postcard.
As a program participant, you and your staff will receive the following at no charge:
- Free access to AMDA's Clinical Practice Guidelines
- AMDA's Know it All Before you Call™ Data Collection Series
- Free CME/CE Credits for the disciplines of medicine, nursing, social work and dietetics/nutrition
In order to access the site you will need a user name and password. The user name and password are specific to your facility. If you have not received your user name and password, please let us know at [email protected]. The user name and password are for exclusive use by your facility for your management, staff and your facility medical professionals.
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ePOC Accounts
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Is your facility signed up for ePOC? If so,
be diligent about keeping your account and password up to date.
Click here for the CMS security rules.
If your facility is not signed up, see the
Account Setup instructions.
Not sure if your facility has any ePOC accounts or have other questions? E-mail
[email protected].
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A Message from Kentucky's QIN - QIO
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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:
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ISTW: Integrated Surveyor Training Website
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Click to Visit ISTW |
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.
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MDS/RAI CONTACT INFORMATION
Jennifer Smith - MDS Assessment/Coding
Rhonda Littleton-Roe - Transmission or Technical
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Division of Health Care Leadership Team
Inspector General
Assistant Director
Assistant Director
Pharmacy Consultant
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