KHCA/KCAL is committed to providing our members with important updates. Below is a list of the most recent information. Please visit our website for a list of complete updates. www.khca.org/covid-19-resources
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In observance of Independence Day, we will not publish on Monday, July 4th. Our daily message will resume on Tuesday, July 5th. We wish you a safe and happy holiday.
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More from CMS via their Daily Digest Bulletin last night
CMS Issues Significant Updates to Improve the Safety and Quality Care for Long-Term Care Residents and Calls for Reducing Room Crowding
Today, as part of the Biden-Harris Administration’s initiative to promote the safety and quality of nursing home care across the country, the Centers for Medicare & Medicaid Services (CMS) issued updates to guidance on minimum health and safety standards that Long-Term Care (LTC) facilities (often called “nursing homes”) must meet to participate in Medicare and Medicaid. CMS also updated and developed new guidance in the State Operations Manual (SOM) to address issues that significantly affect residents of LTC facilities. The surveyors who use these resources to perform both routine and complaint-based inspections of nursing homes are responsible for determining whether facilities are complying with CMS’ requirements.
“As the COVID-19 pandemic highlighted, we have a pressing moral responsibility to ensure that residents of long-term care facilities are treated with the respect and dignity they deserve,” said CMS Administrator Chiquita Brooks-LaSure. “CMS is proud to be leading President Biden’s initiative to improve the safety and quality of care in the nation’s nursing homes, and this set of improvements is our next step toward that goal.”
The updates to the guidance make progress on President Joe Biden’s vision to protect seniors by improving the safety and quality of our nation’s nursing homes, as outlined in a fact sheet released prior to his first State of the Union Address in March 2022. A key part of reaching this goal is addressing staffing levels in nursing homes, which have a substantial impact on the quality of care and outcomes for the resident experience. Today’s guidance furthers this goal but is just one piece of the implementation of the action plan announced in the State of the Union, which includes, among other things, new rulemaking to require minimum staffing levels in nursing homes.
To begin helping address the staffing issue while the rulemaking process is underway, CMS added new requirements for surveyors to incorporate the use of Payroll Based Journal staffing data for their inspections. This will help better identify potential noncompliance with CMS’s nurse staffing requirements, such as lack of a registered nurse for eight hours each day, or lack of licensed nursing for 24 hours a day. This guidance will help to uncover instances of insufficient staffing and yield higher quality care.
With emerging infectious diseases such as COVID-19, CMS believes that the role of the Infection Preventionist (IP) is critical in the facility’s efforts to mitigate the onset and spread of infections. Using lessons learned from the pandemic, CMS is providing further guidance requiring each facility to have an IP who has specialized training to effectively oversee the facility’s infection prevention and control program—in accord with President Biden’s campaign commitment to ensure facilities have sufficient on-site IPs.
The updated guidance clarifies CMS’s expectations for ensuring timely investigations. This will help address findings from the Government Accountability Office which noted variation among states in reporting, tracking and processing reports of abuse and neglect.
The updates also contain improvements to CMS guidance for mental health and substance use disorder, and builds upon the agency’s Behavioral Health Strategy to better meet the unique needs of LTC facility residents with mental health and substance use challenges. CMS also clarified the minimum level of knowledge and skills of facility staff to ensure that the policies and practices do not conflict with resident rights or other participation requirements.
As part of the Biden-Harris Administration call to reduce resident room crowding, CMS has highlighted the benefits of reducing the number of residents in each room for preventing infections and the importance of residents’ rights to privacy and homelike environment. The pandemic has further proven the risk of contracting infection diseases in rooms with several residents. CMS is urging providers to consider making changes to their settings to allow for a maximum of double occupancy in each room and encouraging facilities to explore ways to allow for more single occupancy rooms for nursing home residents.
CMS believes all people deserve to have access to quality health care and will continue working to improve the safety and quality of nursing home care. CMS will hold nursing homes accountable and make the quality of care and facility ownership more transparent so that potential residents and their loved ones can make informed decisions about care.
LTC facilities and state survey agencies can review each change in the advance copies attached to the CMS QSO-22-19-NH memorandum. The online SOM will be updated on or after October 24, 2022, when these changes go into effect. Surveyors will begin using the guidance and changes, which will be incorporated into the survey process on October 24, 2022.
For a fact sheet on the new and updated guidance for nursing home resident health and safety, please visit.
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CMS To Incorporate Payroll Based Journal Staffing Figures Into Staff Compliance Investigations
"Nursing home operators should be on high alert about the questions surveyors will ask employees about sufficient staffing after heavy emphasis was placed on the matter in updated guidance released this week by the Centers for Medicare & Medicaid Services." The agency "now plans to incorporate Payroll Based Journal staffing figures into investigations about potential noncompliance with nurse staffing requirements." American Association of Post-Acute Care Nursing Education and Certification Strategy Vice President Amy Stewart said, "While [the] administration may feel the facility is adequately staffed, direct care staff may not. READ MORE
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ATTENTION ALL HCBS PROVIDERS WHO HAVE NOT COME INTO COMPLIANCE WITH THE SETTINGS FINAL RULE
Providers who are new to the HCBS program, have had a change in ownership since beginning final rule compliance or missed the opportunity to submit a self-assessment of their setting will now be able to register on the new compliance portal. For providers who are working through the community connect portal, please continue to do so. As a reminder, provider settings must be deemed compliant by March 2023 or lose their ability to bill for HCBS services. Click here for information on upcoming technical assistance sessions with the new portal.
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KDADS to hold public comment period for proposed amendments to several HCBS Waivers
KDADS is proposing to amend several HCBS waivers and is seeking public comments. Waivers affected include PD, FE, BI, IDD, and TA waivers. Changes to the PD waiver will affect the delivery of services in Assisted Living and Home Plus settings. Click here to view the public comment invitation. There are virtual options and one in person option to have your voice heard. July 18 (Virtual) July 19 (In Person) and July 20 (Virtual).
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Clinical Update from KHCA Consultant Linda Farrar. Includes Linda's comments and summary so far on Phase 3 ROP
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KMAP Publishes 2023 HCBS Rates
After much anticipation, KMAP has released the new rates and codes for HCBS waiver programs. Of special note, we anticipated that the FE waive for assisted living/Home Plus would move from $4.49 to $4.94. In fact, the new rate is $5.04. READ MORE
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CMS Releases Revised Nursing Home Surveyor Guidance
CMS has issued QSO-22-19-NH, which includes new and updated surveyor guidance for the following areas:
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Phase 2 and 3 Requirements: Clarifications and technical corrections of Phase 2 guidance issued in 2017; and new guidance for Phase 3 requirements, which became effective November 28, 2019.
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Arbitration Requirements: Guidance on the new requirements, which became effective September 16, 2019.
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Complaint and Facility Reported Incidents (FRIs): CMS revised the guidance in Chapter 5 and related exhibits of the State Operations Manual (SOM) to strengthen the oversight of nursing home complaints and FRIs. CMS also revised its guidance for all Medicare-certified provider/supplier types to improve consistency across the State agencies in their communication to complainants.
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Psychosocial Outcome Severity Guide: CMS revised guidance to clarify the reasonable person concept and examples across the different severity levels.
Surveyors will begin using this guidance to identify non-compliance on October 24, 2022. AHCA has advocated to CMS to give facilities time to review and update existing systems and processes where needed when new guidance is released.
AHCA will review this new and updated guidance in detail over the coming weeks and will share resources to assist members. READ MORE
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Important Information regarding the use of GenBody Tests
Attached is a document with links to training and tips for using GenBody tests that may be helpful for your facility. Also included is the correspondence we received regarding the FDA authorized shelf life extension for the tests delivered to these facilities. The earliest expiration date for the tests shipped to facilities is now July 9, 2023. Facilities should check the lot numbers on the tests they’ve received and update the expiration dates accordingly.
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2022-23 PEAK Advisory Group Members
PEAK is excited to announce the 2022-23 PEAK Advisory Group members. Their appointment officially starts July 1, 2022.
Congratulations to the highlighted KHCA members that will serve the 2022-23 PEAK Advisory Group.
Here is a list of the full team members:
Returning Members:
Renee Porter, Dooley Center
Sue Brenner, Leonardville Nursing Home
Melinda Keever, Anew Healthcare
New Members:
Camille Russell, State Ombudsman
Chris Osborn, Evergreen Retirement Community
Jeana Poulter, The Nicol Home
Chelsie Helberg, High Plains Retirement Village
Daphne McTaugue, Cheyenne County Village
Jared Holroyd, Topeka Center for Rehabilitation and Healthcare
Katie Ross, Region 5 Ombudsman
Kristen Mattox-Graham, Elmhaven East
Lori Palmer, Medicalodges, Inc.
Teresa Woods, Attica Long Term Care
Leadership:
Trescia Power, KDADS
Laci Cornelison, KSU- PEAK Coordinator
Support Members:
Judy Miller, PEAK consultant
Jackie Sump, PEAK consultant
We are excited about the new mix of providers and Ombudsmen joining the team. The leaving group has made a huge impact on the program including the revisions, which will release in 2023 and a PCC conference in October (detail released soon). This new group gets to carry out the work the leaving group started and make new goals. A big congratulations to the oncoming members.
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A reminder that 2023 AHCA/NCAL National Quality Award applications are available. The program year has opened early to give providers the extra time to prepare and complete applications. If you have not already done so, take the first step and download and review materials. The program provides a pathway to improved outcomes in areas including care, workforce, leadership and operations. Learn more and start today. Click here to learn more.
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This 8-week webinar series runs August-September 2022 and focuses on skill
building for serving effectively as the Director of Nursing with emphasis on
effective leadership and staff engagement, nursing operations and systems
of care for common conditions treated in the LTC setting.
Discussion will include:
• Survey readiness & avoiding frequently cited deficiencies
• HR management
• Staff training/competency
• Risk Management
• QAPI activities targeting QM areas
• Fundamentals of reimbursement
• MDS oversight
• Promoting 5-Star quality.
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Webinar: How Are You Feeling? Mastering Emotional Intelligence
7/13/22 2:00PM-3:30PM
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Joint Provider Fire Marshal Training - Topeka
7/13/22 8:00AM-5:00PM
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Joint Provider Fire Marshal Training - Wichita/Livestream
7/14/22 8:00AM-5:00PM
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Assisted Living FCS, NSA and HSP Lunch and Learn
3 spots remain!
Topeka, KS
7/15/2022 12:00PM-4:00PM
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Webinar: The Proficient Infection Preventionist Series: Adept Antibiotic Stewardship for the Infection Preventionist
Topeka, KS
7/19/2022 1:30PM-2:30PM
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Webinar: Documentation for Social Services
Topeka, KS
7/26/2022 2:00PM-3:15PM
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Kansas Health Care Association and the Kansas Center for Assisted Living
1100 SW Gage Blvd. | PO Box 4770 | Topeka, KS 66604
PH: 785-267-6003 FAX: 785-267-0833
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