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Cabinet for Health & Family Services
Office of Inspector General
Division of Health Care
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Long Term Care Provider Newsletter
May 2019
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Notice of Proposed Regulation Changes -
Personal Care Homes
On April 15, 2019, the Cabinet for Health and Family Services filed a proposed amendment of 902 KAR 20:036, Operation and services; personal care homes, with the Legislative Research Commission.
The proposed amendment seeks to change the existing personal care home regulation as follows:
- Updates the definitions section, notably by moving language from Section 2 describing a personal care home into Section 1, as well as defining “specialized personal care home (SPCH)” as a personal care home that participates in the mental illness or intellectual disability supplement program pursuant to 921 KAR 2:015 or otherwise serves residents in which thirty-five (35) percent or more of the resident population has a serious mental illness;
- Adds a definition of “qualified mental health professional”, “serious mental illness”, and updates other definitions for clarity;
- Deletes obsolete language related to the age of admission to a PCH and inserts a cross-reference to KRS 216.765(2) which states that “no person under the age of eighteen (18) shall be admitted to a personal care home”;
- Requires each SPCH to develop and implement written transition procedures to ensure cooperation with an individual or entity that assists with transitioning residents with an SMI to a community living arrangement;
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MDS with PDPM Training
In collaboration with Myers and Stauffer LC, OIG-DHC is once again offering a free educational opportunity for Kentucky LTC Providers, which has been tentatively scheduled for:
September 25-26, 2019
in Louisville
This course will review the MDS (version 1.17.0) and Resident Assessment Instrument manual (RAI-version 1.17) updates and revisions from the Center for Medicare and Medicaid Services (CMS) effective October 1, 2019. A significant change in the reimbursement methodology for Medicare residents will also be implemented October 1, 2019. This new methodology, Patient-Driven Payment Model, will be a featured portion of the course.
More details will be available in future newsletters.
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A Message from Kentucky's QIN-QIO
OIG 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 the link below to read a message from Kentucky's QIN-QIO:
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KEPRO Updates
As KEPRO prepares for their next contract period with CMS, beginning June 8th, they would like to make you aware of a two important items that need addressed:
- KEPRO’s helpline numbers will be changing. To ensure your Medicare beneficiaries are able to contact KEPRO to make timely appeals, please update the notices you provide them with the correct phone number for your region (Kentucky is in Region 4: 888-317-0751). Provide this number to beneficiaries beginning June 8th.
- Complete a Memorandum of Agreement (MOA) and Provider Update Form. Visit www.keproqio.com/moa after June 7, 2019, to complete the MOA and Provider Update Form and submit it to KEPRO.
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Protecting Residents from
Financial Exploitation
As Kentucky’s nursing homes have been sending notices of involuntary discharge to the State Ombudsman Program, Ombudsmen across the Commonwealth have seen an increase in discharges due to non-payment. Upon further investigation, many of those notices are issued to residents who appear to be experiencing financial exploitation. Bluegrass District Ombudsman Denise Wells has written and printed a manual, “Protecting Residents from Financial Exploitation,” for Kentucky’s long-term care homes. This manual will provide your staff with practical tips for preventing, identifying, and reporting the financial exploitation of residents in your home. For more information or to schedule a training in your long-term care home, call Wells at 859-277-9215 or email
denise@ombuddy.org.
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SNF Quality Reporting Program Spotlights
- SNF QRP Pre-Training Materials Are Now Available on the SNF Quality Reporting Training webpage.
- Data collection timeframes and final submission deadline documents are available in the Downloads section of the SNF QRP Data Submission Deadlines webpage.
- Policy Change for Assessment Submission Timeframe - Effective October 1, 2019, the CMS policy for patient assessment submission will be changed to 24 months from the assessment target date.
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Juniper VPN Network Client Upgrade
An upgrade is required to the Juniper VPN Network Client software (Network Connect Client) currently used by the QIES community to log into CMSNet for required submission and reporting. The upgrade for Nursing Home providers will occur on 06/30/2019. This will affect employees who use CMSNet for MDS, EPOC, and PBJ.
Upgrade Details
Users must have Administrator rights on their workstations or have an IT staff member with Administrator rights available to complete the upgrade. The upgrade will be initiated automatically when users launch the Juniper VPN Client beginning on 06/30/2019. Upon connection, the automated process will begin and
users will be prompted to start the installation of the new Pulse Secure Desktop Client on their workstations.
For questions or assistance, please contact the CMSNet Help Desk at 888-238-2122.
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Patient-Driven Payment Model
Effective October 1, 2019, CMS will be using a new case-mix model for Medicare, the Patient-Driven Payment Model, which focuses on the patient’s condition and resulting care needs rather than on the amount of care provided in order to determine Medicare payment.
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Informal Appeal of Survey Findings
Interested in Serving on an IDR Panel?
Kentucky requires one member of the IDR panel to be "a person currently engaged in the provision 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.
Chrystal Daugherty, IDR/IIDR Coordinator
Office of Inspector General
116 Commerce Ave.
London, KY 40744
Fax: (606) 330-2054
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Improve Quality Measures for
Pressure Ulcers and Other Wounds
and Earn FREE CE Credits for LTC Nurses, Social Workers, Dietitians/Nutritionists
Access the newest AMDA Clinical Practice Guideline on
Pressure Ulcers and Other Wounds as part of the Kentucky initiative to prevent pressure ulcers! Staff can earn FREE CE/CPE hours by completing the exam for nurses, social workers, and dietitians/nutritionists. Other staff can earn a Certificate of Completion!
Access the other
FREE training resources at the password-protected website
www.cpgltc.org
with the CMS Region IV Quality Improvement Initiative, a 6-state CMS CMP program.
- 20 CE Exams with 1-3 contact hours – up to 42 total hours for LTC Nurses
- 15 CE Exams with 1-3 contact hours – up to 29 NASW approved hours for LTC Social Work
- 14 CE Exams with 1-3 contact hours – up to 20.5 hours for LTC Dietitians/Nutritionists from Becky Dorner Associates
- CPG Implementation Series (Heart Failure, Pain Management, Urinary Incontinence) with accompanying training resources including narrated Power Points for nurses and nurse aides
- 4-part Disease Awareness Video Series (COPD, Diabetes, Pain Management, Moderate Alzheimer’s)
- Know-it-All™ Before You Call (for LTC staff) data collection tools for 70+ common health conditions
- Know-it-All™ When You’re Called (for physicians and practitioners) data collection tools for 70+ common health conditions
LTC administrators receive facility-specific passwords and usernames. Please share with staff for access to FREE training materials at
www.cpgltc.org. For facility username and password assistance, contact
help@cpgltc.org.
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Kentucky Annual Utilization Surveys
The Kentucky Annual Utilization Surveys were due on March 15, 2019. All licensed long term care facilities are required to report. To be in compliance with your license, an extension needs to be requested and data submitted. The reporting of this data is required by 902 KAR 20:008 and 900 KAR 5:020.
Any request for an extension of the deadline must go through Elizabeth Tutt, Survey Administrator and Healthcare Data Analyst. You may contact her by
email
or by calling (502) 564-7940 x.3156.
CLICK HERE
for the website for the survey completion. The facility license number is the login and facilities should create their own password the first time they log in each year.
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Kentucky's Top 10 Citations
for Nursing Homes
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MDS/RAI CONTACT INFORMATION
Chrystal Daugherty
MDS Assessment/Coding Issues
Rhonda Littleton-Roe
Transmission or Technical
Please note: Do not send any identifiable patient information through e-mail. This includes patient names, SSNs, dates of birth, or any other data items considered identifiers or Protected Health Information (PHI) under HIPAA. Please redact any PHI prior to sending.
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Is your certified nursing 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?
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Have you notified your residents?
Click the link below to download and/or print the contact list for various agencies.
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Which Branch is Serving You?
To provide the highest level of service, the Division of Health Care operates through four regional offices. Knowing the appropriate Branch to contact with questions and concerns will ensure you receive maximum service in minimum time. Review links below for detailed information.
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CMS Survey and Certification memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices.
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Transfer/Discharge Hearing Appeals
Please submit your requests for transfer/discharge hearing appeals to Secretary Adam M. Meier, Cabinet for Health and Family Services, by emailing:
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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.
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ISTW: Integrated Surveyor Training Website
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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Employment Opportunities
To search and apply for positions within the Office of Inspector General, please visit the Kentucky Personnel Cabinet's web page by clicking below.
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DHC Leadership Team:
Inspector General
Vacant
Deputy Inspector General
Director
Assistant Director
Assistant Director
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Want to Sign Up for This Newsletter?
If you have received a copy of this newsletter from a friend or co-worker, you can click
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and enter your information to join our mailing list, or contact
MelissaD.Richard@ky.gov
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Commonwealth of Kentucky | Office of Inspector General | 275 East Main St., Frankfort, KY 40621
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The Office of Inspector General is the regulatory and licensing agency for all health care, day care and long-term care facilities and child adoption/child-placing agencies in the commonwealth.
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