Sprinkler Requirement Update from AHCA

Karen Morris and Nancy Leveille in Clinical & Quality

We have received the following memo from AHCA related to the “fully sprinklered requirement” which goes into effect for all nursing homes next Tuesday.  Per AHCA, CMS will be issuing guidance after the August 13 deadline related to “special circumstances” under which they will grant extentions.  We have received inquiries related to how surveyors will handle the issue and we are aware that regional office survey staff have been calling administrators this week to inquire if their sprinkler projects are on track to finish by the deadline.

Per AHCA’s memo below under #2. “There will NOT be an “army of surveyors” that will descend on nursing centers on August 13 to inspect for full sprinklering.    Surveyors will determine full sprinklering on the date of the next standard survey for a center or if a complaint has been filed related to a center being not fully sprinklered.” (See #3 related to survey citations.)  The associations are meeting with DOH staff for our regular monthly meeting tomorrow and this issue is on our agenda for discussion. We will issue the minutes from that meeting in our next member mailing.

To:   Affiliate Policy Task Force
        Life Safety Committee
        Survey/Regulatory Committee
 
As you know, all nursing centers must be fully sprinklered by August 13, 2013.  During an in-person meeting of the Life Safety Committee during which the committee met with Jim Merrill, Life Safety Specialist with CMS, numerous questions were posed related to full sprinklering  which require clarification from CMS.
 
As well, on February 7, 2013, CMS issued a Notice of Proposed Rulemaking (NPRM) related to providing extensions for the date of full sprinklering under very specific criteria.  The final rule related to the extension will not be published until after August 13.  According to Thomas Hamilton:  CMS is doing its utmost to make sure the final rule is issued prior to a center incurring a very serious remedy imposition that is required by statute or regulations.  CMS is not wanting to close nursing centers due to their inability to be fully sprinklered [if the center meets the criteria included in the proposed rule].  Mr. Hamilton’s recommendation to centers that believe they meet the extension criteria contained in the NPRM:  “Be concerned but don’t panic.”
 
Today CMS provided AHCA with the following information related to both of the topics above:

  1. According to CMS records, about 1300 centers are either not sprinklered or are partially sprinklered.  Of that number, fewer than 200 centers are not sprinklered at all.

  2.  There will NOT be an “army of surveyors” that will descend on nursing centers on August 13 to inspect for full sprinklering.    Surveyors will determine full sprinklering on the date of the next standard survey for a center or if a complaint has been filed related to a center being not fully sprinklered.

  3. If a center is not fully sprinklered on the date of the standard or sprinkler-related complaint survey that occurs after August 13, the center will receive a citation (at a level of F or higher, depending on the circumstances) and will be found to be not in substantial compliance.  Such a citation will start the regulatory clock – that is, if the center is not in substantial compliance at 3 months, there will be a Denial of Payment on New Admissions and if not in substantial compliance at 6 months, de-certification. 

  4. A Survey & Certification Memorandum (S&C Memo) that includes a Q&A section is expected to be released in the next several weeks.  This memo and the Q&A section will include information that was discussed during today’s call as well as additional information related to the questions that AHCA posed to CMS during our meeting with Mr. Merrill in June.

  5. Mr. Hamilton requested that nursing centers who believe they meet the extension criteria contained in the NPRM should contact their State Survey Agency and their Regional Office: CMS Central Office may attempt to collect PRIOR to publication of the final rule to assist in processing such extensions requests as quickly as possible.

We appreciate that CMS has provided this information and we look forward to receiving the promised S&C Memo.  If I can answer any questions, please let me know.  Lyn
 
Lyn Bentley, MSW
Sr.Director of Regulatory Services
AHCA
1201 L St., NW
Washington, DC 20005
202-898-6304

NYSHFA contacts: 

Nancy Leveille
Sr. Director, Member Operational Support Services
518-462-4800 ext 20 

 

Karen Morris
Director, Clinical & Quality Services
518-462-4800 ext 15