You're receiving this email because of your relationship with the Office of Inspector General, Division of Health Care. Thank you for your continued commitment to serving the citizens of our Commonwealth!
Cabinet for Health & Family Services
Office of Inspector General
Division of Health Care
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Long Term Care Provider Newsletter
October 2020
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The Kentucky Office of Inspector General is committed to the protection of patients and residents of healthcare facilities from the spread of infectious disease. Regarding any coronavirus (COVID-19) concerns, you may refer to the following website for the most up-to-date news and information:
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From the Immunization Branch and the
KY COVID-19 Vaccine Planning Committee
Facilities have until November 2, 2020, to either opt-in or opt-out of the federal government's vaccination plan through CVS and Walgreens. This covers vaccination of the residents and includes end-to-end service for the vaccination; distribution, storage, delivery/administration, record keeping; and reporting for the vaccine. If the facility decides to opt-out, they will have to arrange all of the logistical and reporting concerns on their own!
See attached for additional information and the link to enroll in the CVS and Walgreens program.
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FREE Minimum Data Set Training Available Now!
Minimum Data Set training, hosted annually by the Kentucky Office of Inspector General and presented by Myers and Stauffer LC, is now available on TRAIN. This free course has been split into six webinars that review the new MDS and Resident Assessment Instrument manual updates and revisions from the Centers for Medicare and Medicaid Services (CMS), effective October 1, 2020:
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OIG DHC MDS Updates Effective October 1 2020 Session 1 (Search for course 1093110)
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OIG DHC MDS Updates Effective October 1 2020 Session 2 (Search for course 1093111)
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OIG DHC MDS Updates Effective October 1 2020 Session 3 (Search for course 1093112)
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OIG DHC MDS Updates Effective October 1 2020 Session 4 (Search for course 1093113)
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OIG DHC MDS Updates Effective October 1 2020 Session 5 (Search for course 1093114)
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OIG DHC MDS Updates Effective October 1 2020 Session 6 (Search for course 1093115)
The Kentucky Board of Nursing has approved contact hours for sessions 2, 4, 5, and 6. Kentucky RNs, LPNs, and LTC Administrators will receive CEs upon completion, assessment, and evaluation of each session. (Please note that you must have an individual TRAIN account in order to receive credit.)
Disclaimer Statement: The Kentucky Board of Nursing approval of an individual continuing education provider does not constitute endorsement of program content.
Please contact Melissa Richard with any questions by email or at 502-564-7963 x.3310.
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New Requirements for the Calculation of
PDPM Codes on OBRA Assessments
Effective 10/01/2020 Kentucky will require the calculation of Patient Driven Payment Model (PDPM) payment codes on Omnibus Budget Reconciliation Act (OBRA) assessments when not combined with a 5-day Prospective Payment System (PPS) assessment, specifically the Nursing Home Comprehensive (NC) and Nursing Home Quarterly (NQ) assessment item sets.
This now includes item sets:
- GG0130: Self-Care
- GG0170: Mobility
- I0020: Indicate the resident’s primary medical condition category
- J2100: Recent Surgery Requiring Active SNF Care
- J2300-J5000: Surgical Procedures
Providers should follow the RAI User’s Manual guidance for coding these items.
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Two New Emergency Preparedness Resources For LTC Facilities
The Earthquake Preparedness Guide for LTC Facilities
A Supplement to the Kentucky LTC Emergency Preparedness Manual
In October 2020, the LTC2Prepare Initiative of the Kent School of Social Work University of Louisville and the Central U.S. Earthquake Consortium published a comprehensive guide to earthquake preparedness for Kentucky long-term care facilities.
It is the first and only Earthquake Preparedness Guide for LTC in the nation! The guide includes detailed steps for facilities to take before, during, and after an earthquake along with five annexes with additional resources.
This guide provides information to: assist LTCs in understanding and addressing vulnerabilities to earthquake impact; take actions prior to an earthquake to help reduce facility damage; identifies enhancements for all-hazards plans earthquake response; recommends measures to protect life-safety during an earthquake event; and provides information on recovery issues specific to earthquakes.
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The Kentucky LTC Emergency Preparedness Initiative Family Council Manual
Developed by LTC2Prepare and the Nursing Home Ombudsman Agency of the Bluegrass, this manual is a step-by-step guide to starting and/or reactivating a Family Council using Emergency Preparedness as a driving topic.
Family members and representatives can learn about the facility emergency plans and an opportunity to create their own Personal Emergency Preparedness Plan.
The manual provides a how-to to get started, sample invitations, bylaws, agenda, minutes and ideas for other activities and topics are also included.
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For username and password assistance, contact
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Grant Opportunity for Visitation Aid Assistance
On September 17, 2020, CMS announced a Civil Money Penalty Nursing Home Visitation Aid Grant opportunity which is now available for all certified nursing facilities. This grant allows up to $3,000 per facility to purchase plexiglass or similar dividers and/or purchase or rent tents to aid in visitation for residents as a result of the state of emergency due to COVID-19. Detailed information about this grant and the application form can be found on our webpage.
If you any questions, or need additional information regarding the Nursing Home Visitation Aid Grant, please contact Gina Riddell, Grants Administrator, at gina.riddell@ky.gov or 502-564-2888 Ext. 3341.
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Centers for Medicare & Medicaid Services Region IV
Long Term Care Quality Improvement Initiative
Resource Center
CMS Region IV LTC Quality Improvement Initiative ends December 31, 2020
Less than 90 Days Left to Obtain Free CE/CPEs
- Nurses: up to 42 CE credits
- Social Workers: up to 29 CE credits
- Dietitians/Nutritionists: up to 20.5 CE credits
The CMP grant that has funded this Quality Improvement Initiative is ending. Starting January 1, 2021, the password-protected website will no longer be accessible.
All Clinical Practical Guidelines (CPGs) and other resources will be taken down and the CE program will end.
Take advantage of these resources, especially the FREE Continuing Education Credits, through December 31, 2020.
The Archive of awarded CEs and Certificates of Completion will remain available during this time.
All Facilities have been assigned a unique username and password. For assistance, please contact the Help Desk at help@www.cpgltc.org.
CMS Region IV LTC Quality Improvement Initiative is a collaboration between CMS Region IV, State Survey Agencies, and the University of Louisville Kent School of Social Work. CMS Region IV Partner States: Alabama, Florida, Georgia, Kentucky, Mississippi, South Carolina
Materials were produced pursuant to the Long Term Care (LTC) Quality Improvement Initiative/ AMDA Clinical Practice Guidelines and CMS Region IV Website: Sponsored by University of Louisville Research Foundation, Inc., Alabama Medicaid Agency; State of Florida, Agency for Health Care Administration; Georgia Department of Community Health, Grant #16051G; Kentucky Cabinet for Health and Family Services, Office of the Inspector General, Grant #PO2 723 1600004042 1; Mississippi State Department of Health, Mississippi Division of Medicaid in the Office of the Governor; and South Carolina Department of Health and Human Services. CMS Project Numbers: 2015-04-AL-UOL-0303; 2015-04-FL-UOL-0303; 2015-04-GA-UOL-0303; 2015-04-KY-UOL-0303; 2015-04-MS-UOL-0303; 2015-04-SC-UOL-0303.
Copyright by University of Louisville Kent School of Social Work 2019. All rights reserved.
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MDS 3.0 QM User’s Manual Version 14.0 Now Available
The MDS 3.0 QM User’s Manual V14.0 has been posted. The MDS 3.0 QM User’s Manual V14.0 contains detailed specifications for the MDS 3.0 quality measures and includes a Notable Changes section that summarizes the major changes from MDS 3.0 QM User’s Manual V13.0. The MDS 3.0 QM User’s Manual V14.0 can be found in the Downloads section of the Quality Measures webpage, grouped with other Skilled Nursing Facility (SNF) and Nursing Home user’s manuals in a zip file titled Users-Manuals-Updated-10-19-2020. The zip file titled User Manuals - Updated 01-21-2020 (ZIP) containing the MDS 3.0 QM User’s Manual V13.0 has been moved to the Quality Measures Archive webpage.
Five files have been posted:
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MDS 3.0 QM User’s Manual V14.0 (MDS-3_0-QM-USERS-MANUAL-v14_0.pdf) contains detailed specifications for the MDS 3.0 quality measures, as well as the Quality Measure Reporting Module Table that documents CMS quality measures calculated using MDS 3.0 data and reported in a CMS reporting module. MDS 3.0 QM User’s Manual V14.0 is available under the Downloads section of this webpage.
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Nursing Home Compare Claims-based Quality Measure Technical Specifications (Nursing Home Compare Claims-based Measures Tech Specs.pdf) contains detailed technical specifications for all nursing home quality measures.
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Nursing Home Compare Quality Measures Technical Specifications Appendix (APPENDIX - Claims-based measures Technical Specifications.pdf) contains tables and appendices related to the Nursing Home Compare Claims-based Quality Measures.
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Skilled Nursing Facility Quality Reporting Program Measure Calculations and Reporting User’s Manual V3.0 (SNF Measure Calculations and Reporting User's Manual V3.0_FINAL_508C_081419.pdf) contains detailed specifications for all SNF QRP Quality Measures.
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SNF QRP Measure Calculations and Reporting User’s Manual Version 3.0.1 (SNF-QRP-QM-Users-Manual-V3_0_1-Addendum-Change-Table.pdf) contains appendices for the SNF QRP Measure Calculations and Reporting Manual V3.0, including a risk adjustment appendix and Hierarchical Condition Category (HCC) crosswalks.
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PDPM Grouper DLL Version, V1.0008
An update to the PDPM Grouper DLL has been posted, along with its source code and test cases on the MDS 3.0 Technical Information webpage. This version, V1.0008, corrects an issue with a dynamic array that was not consistently reinitialized when processing multiple assessments within a short time frame. This occasionally caused incorrect PDPM recalculation results when processing pre- and post- 10/01/2020 assessments.
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CMS Confidential Dry Run Reports
The Centers for Medicare & Medicaid Services (CMS) would like to announce the Confidential Dry Run Reports containing FY 2018 and FY 2019 performance scores for the Skilled Nursing Facility Healthcare-Associated Infections Requiring Hospitalizations measure (SNF HAI measure) are now available. Performance scores are based on the draft measure specifications posted on CMS Measure Management Public Comment page. Providers can view these reports in their Certification and Survey Provider Enhanced Reports (CASPER) provider shared folders. These reports are accompanied by a Data Dictionary defining key measure terms.
The purpose of these Confidential Dry Run Reports is to allow SNFs to become familiar with this measure and to inform them of their performance in comparison to their peers. It is important to recognize that HAIs in SNFs are not considered “never-events.” The goal of this risk-adjusted measure is to identify SNFs that have notably higher rates of HAIs and to statistically distinguish between SNFs that are either better than or worse than their peers in infection prevention and in infection management. SNFs may choose to incorporate this measure into their internal quality assurance activities to improve patient outcomes. Review and use of this measure information is strictly voluntary.
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Skilled Nursing Facility (SNF) Quality Reporting Program (QRP)
Measure Calculations and Reporting User’s Manual V3.0.1
This document serves as an addendum that communicates quality measure updates to the SNF QRP Measure Calculations and Reporting User’s Manual Version 3.0. The SNF QRP Measure Calculations and Reporting User’s Manual V3.0.1 is effective on October 1, 2020 and provides information on measure-related changes in a change table format in lieu of a complete update to the overall manual. Additionally, we have included the updated Risk Adjustment Appendix File for the SNF Quality Reporting Program Measures Calculations and Reporting User’s Manual V3.0.1, which contains the risk-adjustment values used to calculate the risk-adjusted quality measures, and Crosswalks of ICD-10 codes to HCC categories used in the risk models for the Change in Self-Care, Change in Mobility, Discharge Self-Care, and Discharge Mobility measures (NQF #2633, NQF #2634, NQF #2635, and NQF #2636, respectively).
We would like to describe several changes to the quality measure specifications, including updates to the exclusion criteria for the SNF Functional Outcome and Discharge to Community measures.
Specification updates for all four SNF Functional Outcome Measures:
- Exclusion criteria: The age exclusion criterion for these measures has been updated from 21 years to 18 years, such that any resident younger than 18 years of age will be excluded from measure calculations.
Specification update for the SNF Discharge to Community Measure:
- Exclusion criteria: This measure has been updated to exclude residents who had a long-term nursing facility (NF) stay in the 180 days preceding their qualifying hospitalization and SNF stay, with no intervening community discharge between the long-term NF stay and qualifying hospitalization.
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Updated SNF QRP COVID-19 PR Tip Sheet is Available
An updated version of the SNF COVID-19 PR Tip Sheet that was posted on September 8, 2020, is now available. The purpose of this Tip Sheet is to help providers understand CMS’ public reporting strategy for the PAC QRP in the midst of the COVID-19 public health emergency (PHE). This Tip Sheet explains the CMS strategy to account for CMS quality data which were exempted from public reporting due to COVID-19, and the impact on CMS’ Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) data on the Nursing Home Compare website refreshes. The updated Tip sheet is available in the Downloads section of this Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Training webpage.
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Kentucky's Top 10 Citations
for Nursing Homes
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Informal Appeal of Survey Findings
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.
Chrystal Daugherty, IDR/IIDR Coordinator
Office of Inspector General
116 Commerce Ave.
London, KY 40744
Fax: (606) 330-2054
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MDS/RAI CONTACT INFORMATION
Chrystal Daugherty
MDS Assessment/Coding Issues
Rhonda Littleton-Roe
Transmission or Technical
Please do not send any identifiable patient information through e-mail. This includes patient names, SSNs, dates of birth, or any other data items considered identifiers or Protected Health Information (PHI) under HIPAA. Please redact any PHI prior to sending.
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Is your certified nursing facility signed up for ePOC? If so, 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.
If your facility is not 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 call Rhonda Littleton-Roe at 502-564-7963 x.3300.
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Have you notified your residents?
Click the link below to download and/or print the contact list for various agencies.
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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.
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CMS Survey and Certification memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices.
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Transfer/Discharge Hearing Appeals
Please submit your requests for transfer/discharge hearing appeals to Secretary Eric C. Friedlander, Cabinet for Health and Family Services, by emailing:
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LTC Facility Self-Reported
Incidents & Complaints
New email addresses have been 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.
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Quality, Safety & Education Portal
CMS's QSEP provides the full curriculum of surveyor training and guidance on health care facility regulations. All training is available on-demand on a top-notch self-service portal. 24/7 access means you have the freedom to learn what you want, where you want, when you want.
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Employment Opportunities
To search and apply for positions within the Office of Inspector General, please visit the Kentucky Personnel Cabinet's web page by clicking below.
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DHC Leadership Team:
Inspector General
Deputy Inspector General
Director
Assistant Director
Assistant Director
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Want to Sign Up for This Newsletter?
If you have received a copy of this newsletter from a friend or co-worker, you can click here and enter your information to join our mailing list, or contact MelissaD.Richard@ky.gov.
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Commonwealth of Kentucky | Office of Inspector General | 275 East Main St., Frankfort, KY 40621 |
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The Office of Inspector General is the regulatory and licensing agency for all health care, day care and long-term care facilities and child adoption/child-placing agencies in the commonwealth.
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