DOH/Nursing Home Provider Association Meeting Summary - July 24, 2014

Nancy Leveille in Clinical & Quality

Below is the summary of the July 24, 2014 meeting:

Updates on Death Certificate Requirements – Guy Warner, Director Vital Records, NYSDOH, presented information on the current and upcoming status of recording death certificates. SNF have been highly compliant with completing the death certificate within the 72 hour requirement process thus allowing families an early accessibility to these documents for multiple needs. Last September, Public Health Law (PHL) #4148 was passed enabling the ability to develop an electronic system to record death certificates for all of NYS. Currently, only NYC has a platform to accomplish this and has been successful with implementing this electronic system. PHL 4148 enables the rest of NYS to be online. DOH is establishing the mechanics of the new process and will most likely pilot it in a couple upstate regions to test it out before full implementation. This workgroup will begin in September, 2014 with the pilot beginning at the beginning of 2015.

Update on CMS Dementia Pilot Program:  DOH reported that NYS was selected by CMS to become a pilot state to have focused surveys on dementia care starting in August and running through September.  Five SNF have been selected by DOH to have this two day survey process. The five SNF were not named, but are spread out across the state.  They will be medium sized facilities. Some were identified for having potentially strong dementia programs and others for having lower scores on some of the Quality measures associated with dementia. These will be unannounced surveys; they will be two days in length; and have three surveyors on the team, one of which will be a CMS representative. SNF will not have to prepare anything for the survey and the team should not be giving out deficiencies during this process, unless there is a blatant issue that they must report. This is a pilot to collect information for CMS as they decide how to better assess care elements for residents with dementia who reside in SNF across the country.

Use of Digital Display Boards for Required Posting:  DOH researched whether Digital Display Boards were allowable to meet the intent of publically displaying the materials that are required to be posted in a SNF. DOH noted that activities schedules and meals posting may be the most adaptable materials that are required to be posted for this type of display as they are easier to see, get updated on a daily/weekly/monthly basis and can move the information as the day progresses and activities/meals change. But for SOD, POC, and reporting of abuse or complaints etc., this may not meet the intent of the display boards if they continually scroll, are not in an area where someone could discretely take their time to read them and be able to read the full document easily. DOH recommends providers look back at the intent of the requirement to ensure if they utilize these boards, the residents and families can easily read and digest the information without undo difficulty. They did not recommend them for the second group of required postings listed above.

HIV Testing:  There has been an update to the HIV testing requirements in May 2014 and they are listed on the attached chart. Individuals now can provide oral vs. written consent for testing and authorized state and local health departments are now permitted to use information obtained by the state HIV/AIDS case reporting system to follow up with medical providers and work directly with the medical providers if they see a patient who may have fallen out of care.   HIV/AIDS information in medical records remains confidential and is subject to both HIPAA and Article 27-F protection.

Electronic Prescribing – Terry O’Leary, Director, Bureau of Narcotics Enforcement and his staff presented information on the upcoming E-prescription process. See separate member mailing on this date entitled E-Prescribing for full information.

IPRO:  the 11th scope of work has been established and IPRO will continue to be the Quality Innovation Network (QIN-QIO) for NYS. However, they will no longer be the contractor for Medicare beneficiary issues requiring case review and complaint exploration. CMS has decided to have separate contractors for these two different parts of their work. One of their new goals is to have at least 75% of NYS SNF utilize their services. NYSHFA has been collaborating with IPRO on many projects over the years. Most recently in our grant funded Quality Series and our INTERACT project. IPRO will have a booth at NYSHFA’s Fall Conference and IPRO staff will be available to discuss their current resources/projects. More information will be forthcoming from IPRO over the next few weeks.

Routine Blood Glucose Monitoring:  DOH reviewed the 2012 CMS S&C letters related to the use and proper cleaning of glucometers. This memo noted that each individual must have their own glucometer to prevent the spread of hepatitis between residents/patients and the providers must clean the equipment based on the manufacturer’s recommendations. They recently have seen SNF using their own cleaning procedures which were not compliant with the manufacturer’s recommendations.


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