CMS Region V Updates

by Zach Cattell, IHCA General Counsel

IHCA recently had the opportunity, along with several other states’ long term care associations, to meet with the survey and certification staff of CMS Region V. The following information was discussed:

• Citation patterns by state and by region. See attached charts that summarize the top ten citations for Region V as well as a total deficiencies cited by severity level. F441, F371, F323 and F279 were in the top ten for all states in Region V.

• QIS will continue to be implemented in the states where training has started, but no new states will begin QIS training until further funding is identified. In addition, QIS will continue to only apply to annual surveys and there is no word at the current time as to if or when QIS will apply to complaint surveys.

• Elder Justice Act – Crimes Reporting

     1. Unfortunately, no new guidance or insights were discussed by CMS as to the rollout of the      reporting requirement. CMS stands by its last issued guidance

     2. The Region V staff was unsure as to when CMS Central Office would be issuing any additional guidance or promulgating regulation to implement the CMP and excluded individual provisions of the law

     3. Facilities should continue to follow the guidance issued by CMS and the ISDH to implement the crimes reporting requirement

• Independent Informal Dispute Resolution (IIDR)

     1. A new CMS S&C Memorandum was published on December 2, 2011 that superseded the October 14, 2011 memorandum on the implementation of IIDR. The new Memorandum is attached and includes the Interim Advance Guidelines that will be placed in the State Operations Manual regarding the IIDR process.

     2. The ISDH is working on its own guidance regarding IIDR since it is required by CMS to implement the IIDR program for Indiana. The ISDH is expected to release guidance when the new IIDR process goes into effect on January 1, 2012.

     3. The new IIDR process will only apply to all standard or complaint surveys begun on or after January 1, 2012 and include enforcement action on a G-level deficiency or higher for which Civil Money Penalty may be assessed and escrowed.

     4. IHCA is analyzing the CMS and ISDH guidance.

• Life Safety Code citation history for 2011. See attached charts regarding Life Safety Code citations for Region V states, comparisons of the top ten citations from 2010 to 2011, as well as CMS’s tips on how to avoid the top ten deficiencies. Indiana’s #1 Life Safety Code deficiency was K144 – Emergency Generators for the second year in a row.
 
Please contact Zach Cattell at zcattell@ihca.org or 317-616-9001 with any questions.