DOH/Provider March 6, 2014 Meeting Summary

Nancy Leveille in Clinical & Quality

Below is the summary of the March 6, 2014 meeting:

  1. Proposed Emergency Preparedness Regulations and HCS:  DOH staff reviewed comments they will be sending to CMS in response to the proposed CMS rule on emergency preparedness. DOH is concerned that the timeframe to roll out the new requirements is too aggressive and that CMS has underestimated the time and effort involved in the changes.  They also expressed concern that the references used in the document are outdated.  NYSHFA staff and members submitted their comments related to the rule through AHCA and we have many of the same concerns as DOH.  We also had a discussion related to the HCS system and EFINDS. Several facilities across the state have not completed the eFINDS Administrator and/or the eFINDS Data Reporter role in the HCS communications directory.  You must have a designated role in the communications directory in order to access the eFINDS system. DOH will be contacting these facilities directly to insure they comply with this requirement and DOH is planning to conducts drills to insure every provider can use the eFINDS system.  Training webinars and reference materials are available on the HCS, see attached reference guide.

  2. Mental Health Hospitals Discharges to SNF: Debbie Zetterstrom and Cathy Mayton-Collins ,NYS OMH, came to discuss issues related to patients they are trying to discharge from  NYS Acute Psychiatric hospitals to SNF. Some of these patients need end of life care. The group discussed a variety of issues related to relationships with mental health providers and the lack of services in some areas of NYS that create barriers to provide quality of care. Specific regions that are difficult to discharge patients to are in the capital district and north country. These areas we know have had problems with support when a resident has mental health issues and also a lack of providers to assist with services needed. WE recommended that the hospital reach out to create a relationship with homes in those areas and to identify how the hospital can also support needs of the SNF to make it a two way partnership.

  3. Hepatitis C Screening Follow Up: DOH provided a FAQ on this new law for screening which clarifies the new rule. See attached. The main question our members have had were answered. All new residents being admitted from the hospital should have this screening offered and any action taken by the hospital. Residents being admitted from home or community services with a primary physician should have had screening offered and documented outcomes by their primary physician, nurse practitioner or physician’s assistance. In both of those situations the practitioner is required to have documented the offer of screening and any action taken. Therefore this documentation should be requested as part of the admission process. Any resident born between the years 1945-1965, that you had before January 1, 2014 should now be offered the screening by your physician, nurse practitioner or physician assistant at the facility and document the outcome as well.

  4. Survey Entrance Form: DOH shared the form they have developed for surveyors to use when they are conducting a traditional survey in SNF. They have added a couple elements that are on the QIS survey entrance list to keep both entrance conference documents consistent.  For example: They added a document that lists of residents who received a psychoactive medications within the last 30 days as a new element. See attached form to help you prepare for either type of survey.

  5. QIS Survey Status: NYSHFA noted that many of the capital district SNFs are reporting having only traditional surveys vs QIS in this area. DOH noted the causes of this is the number of new surveyors and the CMS requirement that still remains to have all new surveyors attain the SMQT training   (traditional survey competency) before they can be trained in QIS. However, she noted that QIS training is currently going forward in the Central region and then will be back to the Capital district region. CMS is now moving ahead with continuing the spread of QIS in other states. In NYS, the unexpected turnover of surveyors has slowed the process dramatically over the last 1 ½ years. But NYSDOH’s goal is to continue to move forward with QIS.

  6. Quality Pool: DOH noted that they have met with the Quality pool staff to discuss the AG list of ineligible SNF due to abuse cases. NYSHFA restated our concern over those facilities that did not receive any deficiency for this type of a case and were placed on the ineligible list. Note: NYSHFA and the Clinical and Quality Committee have had discussions with both the quality pool staff and the DOH staff separately on concerns over elements of the quality pool and have also documented concerns and recommendations.

  7.  LNHA Registration backlog: The LNHA’s re-licensure letters are out in the mail this week. We discussed the backlog  is not going to change as long as the system remains the same with all the LNHA documents due on Dec 31st every two years. NYSHFA recommended they examine how they could provide a list of all that are completed during the period while they are producing all the letters to reduce a variety of phone call, emails and worries. SED had the same issue a few years back and took steps that resolved this type of issue from repeating.

  8. Medication Administration Workgroup: DOH held the first meeting of this task force to initiate problem solving of the high level deficiencies (IJs) in this clinical area. Karen Morris is NYSHFA’s lead on this group.

  9. CHRC: NYSHFA discussed the backlog of CHRC resolutions on individuals who are on hold while their cases are being researched to see if they can be allowed to work in SNF. Some of these are going on for several months without conclusion. This is causing the SNF to continue close supervision of them and not being able to make them permanent employees or removing them if needed. It also affects CNA trainees and SNF are wondering if they should even test those whose results are not in. DOH noted they can and should continue with their training and can be tested. We requested data to be reviewed by region and across NYS on the amount of this backlog.

  10. UAS: There have been proposed changes to the regulations related to completion of the UAS as it relates to Managed Care Plans. Currently, ADHCs are still required to complete the UAS.

      NYSHFA CONTACT: Nancy Leveille, RN, MS
    Sr. Director, Member Operational Support
    518-462-4800 x20