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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
November 2020
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The Kentucky Office of Inspector General is committed to the protection of patients and residents of healthcare facilities from the spread of infectious disease. Regarding any coronavirus (COVID-19) concerns, you may refer to the following website for the most up-to-date news and information:
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Facilities in the Spotlight
Has your facility experienced any inspirational or uplifting events during these challenging times? Have your residents and staff supported each other in caring, fun, or creative ways? We want to feature you in our Long Term Care Provider Newsletter! Please send submissions to MelissaD.Richard@ky.gov. You may also call 502-564-7963 x.3310 with any questions.
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Compassionate Care Visits
The term “compassionate care” does not exclusively refer to end of life situations. Facilities should allow compassionate care and end of life visitation even though the facility may be located in a hot spot county. Compassionate care visits are necessary to support the psychosocial wellbeing of residents who are declining due to the lack of normal contact they had with loved ones. Examples of compassionate care visits include but are not limited to:
- A resident, who was living with their family before recently being admitted to a nursing home, is struggling with the change in environment and lack of physical family support.
- A resident who is grieving after a friend or family member who recently passed away.
- A resident who needs cueing and encouragement with eating or drinking, previously provided by family and/or caregiver(s), is experiencing weight loss or dehydration.
- A resident, who used to talk and interact with others, is experiencing emotional distress, seldom speaking, or crying more frequently (when the resident had rarely cried in the past).
- A resident, who has an affinity for a familiar domestic pet and would likely benefit from engaging with it (single resident per pet visit).
It is important to work through a person-centered approach to identify residents who need a compassionate care visit and work with the residents, families and the Ombudsman. A resident’s condition can change rapidly, making it very important to keep families and responsible parties aware of the resident’s condition, during these stressful and uncertain times. A change and/or decline in a resident’s condition may also warrant a compassionate visit. Visits should not be limited to family members. Based on the needs of the resident, there may be cases when the resident needs to see their minister or lay person for religious and spiritual support.
In addition, end-of-life care visitation within a resident’s room should expect the visitor to observe all appropriate precautions, consistent with CDC guidelines. It is important not to limit end of life visitation to one visit for the psychosocial benefit of the resident and loved ones.
Compassionate care and end of life visits should follow the core principles and best practices to reduce the transmission of COVID-19. This includes screening, hand hygiene, face coverings and other PPE as appropriate, and social distancing. If indoor visitation is not possible, facilities should continue with visits through technology and outdoor visits as the weather permits.
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Be Safe During the Holidays
There is an inherent risk of exposure to COVID-19 in any place where people are present. Residents of Long-Term Care Facilities (LTCFs) are at high risk of becoming seriously ill with COVID-19. The scope and severity of the situation continues to broaden. The proportion of COVID-19-related deaths accounted for by congregate care settings is now approaching two out of three, and the statewide community test positivity rate has rapidly climbed in recent weeks to over 8%.
Due to the surge in COVID-19, until further notice, elective off-site familial visits (single day visit with a resident’s family or support person(s)) are strongly discouraged. Residents who do leave the facility will have to adhere to the facility’s quarantine protocols upon return.
Facilities should proactively inform residents and their respective responsible parties about ways in which this year’s holiday season will likely require adjustments concerning gifts, activities, visitation and guest dining, etc. The provider should consider:
- Recruiting staff members to assist with supporting residents who do not leave and/or have visitors.
- Establishing criteria and procedures for residents to safely accept:
- gifts or packages;
- commercially prepared and appropriately packaged consumables (fruit or carry-out restaurant food); or
- privately prepared and appropriately packaged consumables (such as baked goods, candy or holiday meal).
Facilities should develop policies and procedures for the holidays and communicate these to each resident and his/her responsible party. Consider having the resident, guardian and visitor sign an acknowledgment form to show agreement to abide by the facilities procedures.
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Holiday Decorations
by Shelley Singleton, OIG LSC Inspector
The year 2020 has brought about so many challenges for all of us. COVID-19 has introduced us to a world none of us would have ever thought we would see. As the year winds down and the Christmas season is upon us, the desire to shed some happiness and bring some light into the lives who have been affected is ever present and seems to be taking shape a little earlier than year’s past. With the desire comes the decorations — to deck the halls with trees, wreaths, garlands, lights, tinsel and other traditional accessories to evoke a spirit of celebration and warmth, that we hope carries into the New Year.
Mindful of the risks, many healthcare facilities develop guidelines for holiday decorations—both in public spaces and residents’ private rooms. Some facilities choose to be more restrictive than others. What follows is a summary of best practices based on regulations and recommendations from a variety of sources, including the National Fire Protection Association, the Consumer Products Safety Commission, and healthcare facilities throughout the country.
Safe Trees, Garlands and Wreaths
- Artificial trees and decorative foliage are generally safer — less likely to catch fire, that is — than natural, cut trees and branches. If you opt for one or more artificial trees and foliage, make sure they are labeled Fire Resistant. (It is best to make sure that claims of fire resistance are documented by Underwriters’ Laboratories (UL) or a similar third-party authority. Some materials sourced from outside the U.S. have been known to carry false labeling.)
- If you have put up a natural tree, check weekly to make sure the needles are still vibrant green and don’t come off easily when touched with fingers.
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Keep natural trees hydrated by placing them in a stand that has a receptacle for water at the base. Keep it filled, and don’t leave a natural tree in place indoors for more than four weeks. That means for many facilities, the tree needs to come down by Jan. 6.
- Keep trees away from heat sources such as fire places and heaters.
Safe Lighting and Electrical Cords
- Use only lighting strands that carry the UL label.
- Inspect wires, plugs and sockets for corrosion and other damage before hooking them up and displaying them. Repair or replace any deficient parts. Test lights by plugging them in and letting them stay on for 15 minutes to ensure that they’re safe and sound.
- Check the amperage rating of the circuit that will serve a lighting array, and add up the total draw of the combined lighting strings. Generally speaking, it’s best not to join more than three light strings (200 miniature bulbs or 50 large bulbs) and plug them into a single receptacle.
- Do not string holiday lights on metallic trees.
- Use heavy-duty, three-wire extension cords with three-prong plugs to power holiday lights. Plug them into power strips with built-in ground-fault circuit interrupters (GFCIs). Never extend a circuit by plugging one power strip into another.
- For outdoor lighting displays, make sure that the lights, extension cords and GFCI-equipped power strips are rated for outdoor use.
- Arrange extension cords used to power holiday lights so that they don’t present a trip hazard.
More Holiday Decorating Issues
- The NFPA Life Safety Code® limits the amount of combustible materials that can be displayed on interior walls and ceiling finishes to 10% of the aggregate wall and ceiling areas of any room or space covered in combustible materials. This includes paintings and photographs. Any decorations beyond the initial 10 percent must be documented as flame retardant, and the documentation must be maintained by the department responsible for mounting the display.
- Many facilities prohibit hanging decorations from ceilings. In any case, decorations should not be placed closer than 18 inches from sprinkler heads.
- Decorations should not interfere with the visibility of exit signs.
- Some facilities prohibit trees other decorative displays that occupy floor space in entryways and hallways, in deference to NFPA rules against blocking means of egress.
While the code regulations and most of the suggestions above must be observed in the common areas of healthcare facilities, it’s also a good idea to keep an eye on how residents decorate their private rooms and suites. Unsafe lights and extension cords present risks for fire, tripping and electrocution.
None of this is meant to dampen the holiday spirit, but rather to suggest practices to ensure that colleagues and residents alike — everyone in your care — enjoys a happy, healthy and safe holiday season.
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jRAVEN v1.7.6
jRAVEN v1.7.6 is now available for download under the Downloads section of the MDS 3.0 Technical Information webpage. Users do not need a previous version of jRAVEN to download, install or use jRAVEN v1.7.6.
jRAVEN v1.7.6 includes the following enhancement:
- The new PDPM Grouper, V1.0008, included in this are the six ICD-10 codes that were added in the 1.0007 version
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SNF QRP Training Events
Brief Interview for Mental Status (BIMS) Video Tutorial
Confusion Assessment Method (CAM©) Video Tutorial
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Centers for Medicare & Medicaid Services Region IV
Long Term Care Quality Improvement Initiative
Resource Center
CMS Region IV LTC Quality Improvement Initiative ends December 31, 2020
Less than 90 Days Left to Obtain Free CE/CPEs
- Nurses: up to 42 CE credits
- Social Workers: up to 29 CE credits
- Dietitians/Nutritionists: up to 4.0 CE credits
The CMP grant that has funded this Quality Improvement Initiative is ending. Starting January 1, 2021, the password-protected website will no longer be accessible.
All Clinical Practical Guidelines (CPGs) and other resources will be taken down and the CE program will end.
Take advantage of these resources, especially the FREE Continuing Education Credits, through December 31, 2020.
The Archive of awarded CEs and Certificates of Completion will remain available during this time.
All Facilities have been assigned a unique username and password. For assistance, please contact the Help Desk at help@www.cpgltc.org.
CMS Region IV LTC Quality Improvement Initiative is a collaboration between CMS Region IV, State Survey Agencies, and the University of Louisville Kent School of Social Work. CMS Region IV Partner States: Alabama, Florida, Georgia, Kentucky, Mississippi, South Carolina
Materials were produced pursuant to the Long Term Care (LTC) Quality Improvement Initiative/ AMDA Clinical Practice Guidelines and CMS Region IV Website: Sponsored by University of Louisville Research Foundation, Inc., Alabama Medicaid Agency; State of Florida, Agency for Health Care Administration; Georgia Department of Community Health, Grant #16051G; Kentucky Cabinet for Health and Family Services, Office of the Inspector General, Grant #PO2 723 1600004042 1; Mississippi State Department of Health, Mississippi Division of Medicaid in the Office of the Governor; and South Carolina Department of Health and Human Services. CMS Project Numbers: 2015-04-AL-UOL-0303; 2015-04-FL-UOL-0303; 2015-04-GA-UOL-0303; 2015-04-KY-UOL-0303; 2015-04-MS-UOL-0303; 2015-04-SC-UOL-0303.
Copyright by University of Louisville Kent School of Social Work 2019. All rights reserved.
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Kentucky's Top 10 Citations
for Nursing Homes
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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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MDS/RAI CONTACT INFORMATION
Chrystal Daugherty
MDS Assessment/Coding Issues
Rhonda Littleton-Roe
Transmission or Technical
Please 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. All correspondence is handled in the ePOC system, including the plan of correction. Furthermore, if there is a change in administrator, it is incumbent upon the facility to update the system.
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 ePOC.Support@ky.gov or call Rhonda Littleton-Roe at 502-564-7963 x.3300.
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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 Eric C. Friedlander, 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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Quality, Safety & Education Portal
CMS's QSEP provides the full curriculum of surveyor training and guidance on health care facility regulations. All training is available on-demand on a top-notch self-service portal. 24/7 access means you have the freedom to learn what you want, where you want, when you want.
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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
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 here 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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