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Cabinet for Health and Family Services
Office of Inspector General
Division of Health Care
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Long Term Care Provider Newsletter
April 2022
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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 websites for the most up-to-date news and information:
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Requesting an Informal Dispute Resolution
The purpose of the informal dispute resolution (IDR) process is to give the facility an opportunity to informally dispute a finding of a cited deficiency at a nursing facility or skilled nursing facility after any survey.
A provider shall have one (1) opportunity to informally dispute a cited deficiency or scope and severity assessment that constitutes substandard quality of care or immediate jeopardy.
If a facility requests an IDR, they must submit the request in writing on or before the 10th calendar day following the receipt of the Statement of Deficiencies (SOD). The day the facility receives the SOD is considered day 0. The request must be submitted to the IDR Coordinator, Jennifer Smith, either by mail at 275 E. Main Street, 5E-A, Frankfort, KY 40621, or via email at jennifersmith@ky.gov. Sending a request via email will alert the IDR Coordinator of the request and ensure that the request is documented within the 10 day timeframe, however, any supporting documentation must be received on or before the 10th calendar day of receipt of the SOD. The request must include an explanation of the deficiencies that are being disputed, supporting documentation to explain the facility’s reason why the deficiency should not have been cited, and the desired outcome for each disputed deficiency. Please remember that no new information may be introduced after the 10-day timeframe.
There are three (3) types of IDR’s that can be requested: a Desk Review is available for any cited deficiency, a Telephone Review is available for any cited deficiency, or a Face-to-Face Review/Panel is available for a deficiency that is cited at a scope/severity of a G, H, I, J, K, or L or a cited deficiency that is substandard quality of care. Listed above are the basic requirements for submitting a request, however, please see Federal regulation 42 CFR 488.301, or State regulation 906 KAR 1:120 for further information concerning additional requirements to submit a request for an IDR.
Requesting an IDR does not limit the legal appeal processes that are afforded to Long Term Care Facilities under federal laws and regulations. Requesting an IDR does not relieve the facility of the requirement to provide a plan of correction or to implement corrective action and does not delay the effective date of an enforcement action that may result from the survey findings.
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PPS and Consolidated Billing for SNF; Updates to the QRP and
VBP Program for FY 2023 CMS-1765-P
On April 11, 2022 the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1765-P) that provides updates to and proposals for the fiscal year (FY) 2023 Skilled Nursing Facility Quality Reporting Program (SNF QRP). This rule includes one new measure proposal: the Influenza Vaccination Coverage among Healthcare Personnel (HCP) (NQF #0431) measure. In addition, CMS is also proposing to revise the compliance date for the updated version of the Minimum Data Set (MDS) 3.0 assessment instrument. We are also proposing to revise regulatory text that pertains to data submission requirements for the SNF QRP. Finally, we are seeking comment on three subjects: future measure concepts for the SNF QRP; overarching principles for measuring equity and healthcare disparities across CMS programs, including the SNF QRP; and the inclusion of the CoreQ: Short Stay Discharge Measure in the SNF QRP.
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Upcoming QIES/iQIES Service Center Hold Times
Due to the upcoming PBJ submission period, the QIES/iQIES Service Center is expecting an increase in call volume and emails between May 1st and May 15th, 2022, which may result in longer hold times.
To minimize wait times and ensure successful PBJ submission, CMS recommends the following:
*Use One Method to Report Issues:
Due to the increase in volume at the QIES/iQIES Service Center, and to minimize backlog of contacts, please use only one method of reporting for the same issue (email or phone).
Note: Cases are processed in the order they are received, regardless of the manner in which the Service Center was contacted. Please allow time for processing.
*Submit Your Data Early:
We encourage you to submit your PBJ data early during the submission period. Early submission will allow you plenty of time for Service Center assistance if needed.
*Call the Service Center at Off-peak Hours:
We strongly recommend calling the Service Center during off-peak hours (8:00 AM-10:00 AM ET or 2:00 PM-8:00 PM ET).
For additional information on PBJ, please visit this page to review new and existing PBJ resources.
Contact the QIES/iQIES Service Center at 1-800-339-9313, Monday through Friday, 8:00 AM - 8:00 PM ET or by e-mail at iQIES@cms.hhs.gov. Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.
Reminder: To receive assistance more quickly, consider calling during non-peak hours—before 10:00 AM and after 2:00 PM ET.
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FREE to Kentucky Nursing Homes:
The Kentucky Wound Care Excellence Program
In July 2021, the Kentucky Office of Inspector General announced that Vohra Wound Physicians Management, LLC has been approved by the Centers for Medicare and Medicaid Services (CMS) to use Civil Money Penalty (CMP) funding to provide 150 scholarships for the Vohra Wound Care Course. The Program is designed specifically for registered nurses (RNs) and licensed practical nurses (LPNs) in certified nursing facilities to improve the care they deliver, raise their level of education, and close the existing knowledge gap in wound care provided across the State of Kentucky.
This opportunity will be offered on a first-come, first-serve basis until all the 150 scholarships are claimed. Nurses completing the course will receive 20 continuing education credits (CEUs). The course includes 11 downloadable learning modules, technical support/customer assistance, and program reporting. The program’s training structure ensures that scholarship recipients will have access to the materials indefinitely as an ever-present guide to sustain lessons learned.
For more information and to register for the program:
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Grant Opportunity for Purchase of Aids to Increase or
Improve Air Quality for In-person Visitations
As of February 2, 2022, certified nursing facilities may apply for up to an additional $3,000 of Civil Money Penalty (CMP) Nursing Home Visitation Aid Grant funds for the purchase of indoor portable fans and/or indoor portable air cleaners with high-efficiency particulate air (HEPA, H-13 or -14) filters, to increase or improve air quality to aid in-person visitation for residents. Expenses incurred on or after the release of Memorandum QSO-20-39-NH FAQ Revised, February 2, 2022, are eligible for reimbursement.
CMP Nursing Home Visitation Aid Grant funds are still available for the purchase of tents or other shelter for outdoor visitation and/or clear dividers, installation, installation materials and shipping costs for in-person visitation aids. All eligible expenses incurred on or after September 17, 2020, are eligible for reimbursements, up to a maximum of $3,000.
For more information and to apply for CMP Nursing Home Visitation Aid Grant funds:
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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.
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Jennifer Smith, RN
RAI/Oasis/IDR-IIDR Coordinator
Office of Inspector General
Division of Health Care
275 E. Main St., 5E-A
Frankfort, KY 40621
Fax: (502) 564-6546
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MDS/RAI CONTACT INFORMATION
For questions regarding MDS Assessment, Coding, Transmission or
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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All certified nursing facilities must sign up for ePOC. Please 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 yet 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
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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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