NYSDOH Provider Association Call Update
NYSHFA participated in a meeting with the NYSDOH and LTC Associations. Highlights from the meeting are noted below:
Due to a number of inquiries, an FAQ document is currently being assembled regarding the NH Testing, Visitation, and Cohorting Health Advisory that was distributed on 10-13-2022.
NH Staffing Law: currently under review within the NYSDOH, no timeline has been given for its release.
Incident Reporting: an FAQ is currently being developed. The NYSDOH took the online State Reporting Manual down and are following CMS guidance. Facilities are reminded to complete their investigations thoroughly and to take all incidents seriously.
Phase 3: Surveyors have been training for the past three months on the changes to the survey process. Both Chapter 5 and Appendix PP have been updated as well as the tools. Two new Critical Element Pathways have been added: Arbitration and Mental Health. There has been a recent uptick in the number of IJ’s related to smoking. The NYSDOH advised facilities to look at clinical pathways and facility policies and procedures as it relates to smoking. All Critical Element Pathways may be viewed here under survey resources: https://www.cms.gov/medicare/provider-enrollment-and-certification/guidanceforlawsandregulations/nursing-homes.
TNAs to CNA Program: NYSDOH remains in contact with Prometric regarding the number of TNA’s that have not been tested, and any issues identified with testing sites and/or applications. NYSDOH is encouraging facilities to get TNA’s tested prior to the end of the Public Health Emergency. Facilities are encouraged to review sample test questions and skills with the test candidates prior to testing to ensure good pass rates. The number of TNA’s waiting to be tested has decreased this month; progress is being made.
Top Citations: (in no particular order) – Accidents, Reporting (late), Care Plan Development, Freedom of Abuse, Food Procurement, Infection Prevention, Quality of Life, and Advance Directives.
CMS Pilot Schizophrenia Surveys: Facilities are being asked for records and audits are being conducted off site. Areas of concern include diagnosis of Schizophrenia after admission to the nursing home, lack of psych assessment or notes, and GDR recommended by the pharmacist but not followed through by the facility.
HERDS: No reduction in frequency at this time, as there has been an uptick in transmission rates in certain areas of the state. Some facilities are working with epidemiology, in which paused visitations have been implemented to mitigate the spread of COVID-19.
Involuntary Transfers & Discharges: Discussed DAL NH 19-07 (10/11/22), COVID Cohorting Guidance and Minimum Staffing Mitigation as it relates to transfer and discharge. A risk/benefit analysis should be conducted when making decisions regarding any transfer – how did the facility arrive at the decision, and were the resident and resident’s representative provided notice? All decisions must be well documented.
NYSDOH Epidemiology is reviewing the CDC’s Updated Guidance on Return to Work after COVID-19.
CMS Staffing Study: No updates at this time.
Life Safety Code Waiver Delays: Due to delays in obtaining an approvable waiver after a Life Safety Code Survey, at times facilities have been issued Denial of Payment of New Admissions (DOPNA) notices, which directly affect facility revenue. The NYSDOH presented a timeline of where issues were identified delaying the process to CMS and are working on solutions to help ease some of the barriers. This included the discussion of hiring an engineer to expedite review under the Office for the Aging and Long-Term Care.
NYSHFA/NYSCAL CONTACTS:
Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15
Tarrah Quinlan, RN, BSN
Director of Education Program Development and Member Operations
518-462-4800 x20
