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Cabinet for Health and Family Services

Office of Inspector General

Division of Health Care

Anti-psychotic Use: Differential Diagnosis, Gradual Dose Reduction

and Alternative Causes

Kentucky Medicaid Polypharmacy Initiative

By: Reyna VanGilder PhD PharmD, Fatima Ali PharmD and Muhammad Babar MD MBA MSc

CMS measures antipsychotic use in the long-term care facility as a quality metric and patients with a diagnosis of schizophrenia, Huntington’s Disease or Tourette’s Syndrome are excluded from these numbers (1). CMS has noted a national decrease in the use of antipsychotic medications in nursing homes, but inappropriate diagnoses and prescribing still occur. It becomes increasingly more important to link anti-psychotic use to the diagnosis for use. We would like to highlight a comprehensive free reference on the Drive to Deprescribe highlighting tools for differential diagnosis (2,3). 

Gradual-dose reduction for antipsychotics. Surveyors assess it and quality metrics depend upon it. Our team wanted to share an anti-psychotic deprescribing algorithm to provide additional guidance, if you should need it (4). We acknowledge that the list of antipsychotics page 2 is not up-to-date because of when the reference was developed. If you have used this algorithm before or something similar, we would love to hear about any lessons learned or best practices – our emails will be listed in the last paragraph.

CLICK HERE to continue reading.

Preparedness Planning Using GIS Mapping Tools

In 2023, the Kentucky Department for Public Health Emergency Preparedness and Response Branch began a new collaborative project with the Kentucky Environmental Public Health Tracking Program to strengthen current emergency preparedness and response planning strategies. The purpose of the ongoing partnership between the two entities has been to develop the means to visualize information using geographic information system (GIS) mapping tool solutions.

The series of interactive maps was initially created to make location-based community information easy to access by public safety officials across Kentucky. The Access and Functional Needs (AFN) Assessment mapping tool uses various social vulnerability indicators to prepare for, and respond to, emergency events and disasters.

CLICK HERE to continue reading and view maps.

REGISTRATION REMINDER

SNF QRP: Achieving a Full APU Webinar – Update

The Centers for Medicare & Medicaid Services (CMS) is offering a webinar to provide updated instructions to help providers understand how to achieve a full Annual Payment Update (APU) in the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP).

For more information and to register for the webinar, please visit the SNF Quality Reporting Program (QRP) Training page.

Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2025 (CMS-1802-P)

On March 28, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1802-P) that provides updates to the fiscal year (FY) 2025 Skilled Nursing Facility Quality Reporting Program (SNF QRP). In this proposed rule, CMS is proposing to require SNF’s to collect and submit through the Minimum Data Set (MDS) four new assessment items in the Social Determinants of Health (SDOH) category: one item for Living Situation, two items for Food, and one item for Utilities. CMS is also proposing to modify the current Transportation item. Additionally, CMS is proposing to adopt a similar validation process for the SNF QRP that was adopted for the SNF VBP. Finally, CMS is seeking feedback with a Request for Information (RFI) on quality measure concepts under consideration for future SNF QRP years.

The proposed rule went on display at the Federal Register and will be available at: https://www.federalregister.gov/public-inspection

SNF Provider Preview Reports – Now Available

The Skilled Nursing Facility (SNF) Provider Preview Reports have been updated and are now available. These reports contain provider performance scores for quality measures, which will be published on Care Compare and Provider Data Catalog (PDC) during the July 2024 refresh.

For more information, please visit the CMS SNF QRP Public Reporting website.

Free Training for Nursing Facility Staff

The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) was established by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Medicare and Medicaid Services (CMS). It provides mental health and substance use training, customized technical assistance and resources to certified Medicare and Medicaid nursing facility staff who care for residents with a variety of behavioral health conditions at absolutely no cost.

Check out resources today!

www.nursinghomebehavioralhealth.org

CMS Developed Global Public Health Emergency (PHE)

Grants Funds Still Available

CMS developed three applications to facilitate visitation and prevent the spread of COVID-19 infection. These one-time grants will continue beyond the PHE to allow all certified nursing facilities access to the products. CNFs can apply for all three programs for up to a total of $9,000.

Communicative Technology: Up to $3,000 for tablets and accessories to allow residents to communicate remotely with family and friends

Visitation I: Up to $3,000 for in-person visitation aids such as outdoor shelters and clear dividers

Visitation II: Up to $3,000 for portable fans and/or room air cleaners with HEPA filters (H-13, -14)

Want the funds but too busy for paperwork? We can help!

Contact Lena Mullins-Datko, CMP Grants Administrator, for assistance with applications at: Lena.mullinsdatko@ky.gov, CMPapplication_OIG@ky.gov, or (502) 564-5771.

For more details on the Kentucky CMP Reinvestment Fund and applications visit the Civil Money Penalty Funds - Cabinet for Health and Family Services website or contact Lena Mullins-Datko.

Division of Health Care Contact Information

Central Office

Carrie Storms, Director

Marissia Izlar, Assistant Director

Andrea Willhite, Assistant Director

275 E. Main St., 5E-A Frankfort, KY 40621

Phone: 502-564-7963

Fax: 502-564-6546

Western Enforcement Branch

Terri Gipson, Regional Program Manager

Shelley Singleton, Human Services Program Branch Manager

901 B South Main Street, Hopkinsville, KY 42240

Phone: 270-889-6052

Fax: 270-889-6089

Northern Enforcement Branch

VACANT, Regional Program Manager

Carmen Ferguson, Human Services Program Branch Manager

L & N Building 10-W, 908 W. Broadway, Louisville, KY 40203

Phone: 502-595-4958

Fax: 502-595-4540

Southern Enforcement Branch

Tammy Ricks, Regional Program Manager

Casey Shelley, Human Services Program Branch Manager

116 Commerce Ave., London, KY 40744

Phone: 606-330-2030

Fax: 606-330-2054

Eastern Enforcement Branch

Gae Vanlandingham, Regional Program Manager

Will Hendrickson, Human Services Program Branch Manager

455 Park Place, Suite 120A, Lexington, KY 40511

Phone: 859-246-2301

Fax: 859-246-2307

Kentucky's Top 10 Citations

for Nursing Homes

Health Care

Life Safety Code

Emergency Preparedness

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 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.

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

All certified nursing facilities are required to 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.

Click here for the CMS security rules.

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 or contact Zakary Carter, ASPEN Coordinator, at Zakary.Carter@ky.gov.

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.

Regional Map

Contact Information

LTC Facility Self-Reported

Incidents & Complaints

Email addresses were 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. 

Cabinet for Health and Family Services

Office of Inspector General

Division of Health Care 

DHC Leadership Team:

David T. Lovely

Acting Inspector General

Tricia Steward

Executive Advisor

Carrie Storms

Director

Marissia Izlar

Assistant Director

Andrea Willhite

Assistant Director