LeadingAge Washington

8/28/13

New CMS Survey & Certification Letter: Discharge Assessments


          This memo clarifies the steps facilities must take to address MDS 3.0 discharge assessments that have not been completed and/or submitted as required under 42 CFR §483.20(g) and 42 CFR §483.20(f)(1).

o   42 CFR §483.20(g)-Accuracy of Assessment, requires that assessments “accurately reflect the resident’s status.”

o   42 CFR §483.20 (f)-Automated Data Processing, requires facilities to encode the following information for each resident in the facility within 7 days from completion of a resident’s assessment: (i) Admission assessment. (ii) Annual assessment updates. (iii) Significant change in status assessments. (iv) Quarterly review assessments. (v) A subset of items upon a resident’s transfer, reentry, discharge, and death. “A ‘subset of items upon…discharge…’ means discharge assessment.”

8/27/13

HUD Extends Service Coordinator NOFA

For more information, read here.

Assisted Living Regulations To Be Amended: Caregiver Training

A Dear Assisted Living Provider letter was just released outlining plans to 
add and amend sections to Chapter 388-78A WAC to comply and be consistent with new laws passed by the 2013 Legislature:

Dear Nursing Home/Assisted Living Administrator Letters Posted

DSHS/ALTSA has notified providers of its intent to amend background check regulations.  

Highlights of the changes under consideration to the consolidated Secretary's List of disqualifying crimes may include:
  • The addition of new disqualifying crimes;
  • Clarification of disqualifying negative actions; and
  • The addition of the category of "Pending Crimes" that would disqualify a caregiver from having unsupervised access to a resident(s) pending the final outcome of a criminal matter on the Secretary's List. 
Read the letter here.

Free Distribution of CMS' Hand in Hand Training

Nursing homes across the country are being reminded that the CMS training tool entitled Hand in Hand is FREE to nursing homes for their use in preventing abuse and enhancing their skills in working with residents suffering from dementia.

For more information, read here.

8/5/13

National Rules Proposed for State LTC Ombudsman Program

The Administration on Aging (AoA) has issued preliminary rules to regulate the functions and authority of LTC Ombudsman across the states in furtherance of the Older Americans Act.  States would have 1 year from final rule adoption to comply with the regulations.  The AoA expects no financial impact to either states or long term care providers.

Housing Needs Study to Be Undertaken by Department of Commerce

In collaboration with the Washington State Housing Finance Commission, the state's Affordable Housing Advisory Board and the Department of Commerce, a project is to commence in September of this year to develop a statewide housing inventory and needs data using a replicable model that can be updated every three to five years. 

Final Rules Published for Nurse Delegation

To implement 2012 legislation, the Washington State Department of Health recently issued its final rules regarding the allowance of the use of nurse delegation to certified home care aides in certain settings, including assisted living. 

The term 'boarding home' has also been replaced by the term 'assisted living' throughout nurse delegation WAC. 

Contact Julie Martin, jmartin@leadingagewa.org, for assistance.  

Assisted Living Regulations Open for Amendments

To comply with legislative mandates from the recently-ended 2013 legislative session, ALTSA has begun rulemaking to accommodate WAC 388-78A changes in the following areas: gender neutral terminology; caregiver training and certification deadlines and RN/LPN exemption from certain continuing education requirements; and the definition of 'neglect'.  Read the Dear Assisted Living Provider letter here. 

Shortage of PPD for Washington State TB Screening

The Department of Health and ALTSA recognize that there is a current shortage of PPD for required TB testing in community based and state licensed facilities. 

Please remember that licensing requirements include both the PPD and blood test options.  Providers should work closely with their licensing staff and/or field managers in the event questions arise about any delays in testing.

Please contact Bonnie Blachly at bblachly@leadingagewa with questions.   
 
 

Developing a Philanthropy Program for Adult Day Providers

Join LeadingAge for a free webinar designed to help you raise valuable operating dollars through fundraising:  Friday, August 9, 11-12 Pacific. 
 

Consolidation of HUD Offices: An Update

From Ross Business Development, an update on the latest happenings with HUD's Hub offices.

7/29/13

Important Updates on Home Care Aide Certification/Training

The Department of Health recently issued an update regarding home care aides/long term care workers, applicable to assisted living, adult family home and home care employees.  Note the effective date of some of the changes was Sunday, July 28.

During the 2013 legislative session, the Washington State Legislature enacted Substitute House Bill 1381, which extends the time a long-term care worker can work without having the home care aide certification and allows a provisional home care aide certification for long-term care workers who are limited English proficient.  This law goes into effect on July 28, 2013.

Extension of Time:
Currently, long-term care workers have 150 days from their date of hire to obtain a home care aide certification.  Beginning July 28, 2013, long-term care workers will have 200 days from the date of hire to obtain the home care aide certification.  This means that if 7/28/13 is a long-term care worker’s 150th day or if the long-term care worker is within your 150 days of their first day of hire, they are automatically extended to 200 days.  If the long-term care worker has already been instructed to stop providing care because their hire date was prior to March 1, 2013- this extension to 200 days does not apply.

Provisional Home Care Aide Certification:
1)    The new law defines limited English proficient as an individual who is limited in his or her ability to read, write, or speak English.  A new application is available on the Department of Health web-site.  This application allows a new applicant to also apply for the provisional certification by checking the box.  All applicants need to use the new application even if they are not applying for the provisional certification.  The new application is at the following web-site:
http://www.doh.wa.gov/Portals/1/Documents/Pubs/675002.pdf

The provisional certification is only good for 60 days after the expiration of the 200 day deadline, there is no fee required, it is not renewable and can be issued only once. It will be a separate credential on provider credential search and once issued they will receive a separate license in the mail with a different license number than their home care aide certification.

 
2)    If a long-term care worker who is limited English proficient has already submitted an application and would like the provisional certification, they need to complete and submit a one page supplemental form for the provisional certification.  The form is at the following web-site:
http://www.doh.wa.gov/Portals/1/Documents/Pubs/675008.pdf

If you have questions regarding the application process, please contact the credentialing section at (360) 236-2700.


EXAMINATION APPLICATION:

1)    The Department of Health is aware that applicants, employers and trainers, who are trying to reach our examination vendor, Prometric, are currently experiencing longer-than-normal wait times.  This is due to moving their customer service center from Minnesota to Maryland, as there were some unexpected fallouts.

·       Prometric is working to bring the wait times back to normal as soon as possible.  If you find you are waiting a very long time on the phone, please either call back at a later time or e-mail Prometric at WAHCA@prometric.com.     

·       You can help by assuring that you, your employees or your students are submitting the current examination application form and that you are sending it to the correct address in Maryland.  Applications sent to the incorrect address are rerouted and take more time to reach the Customer Service Center.  More calls are received as a result of this time-lag.  The correct address is Prometric, Attn: Washington Home Care Aide Program, 7941 Corporate Dr., Nottingham, MD  21236.  Current applications are available at the Prometric web-site:

2)    Be sure long-term care workers are submitting their applications as soon as possible.  At this time, long-term care workers are allowed to submit an examination application as soon as they know the end date for their training program.   We are aware of applications that are received by Prometric 60 days after the long-term care worker has finished their training.  Applying early will mean that the worker will have an earlier examination date, the information they received during training will be fresh and they will have an easier time meeting their deadline.

3)    Be sure long-term care workers are looking at the list of available testing sites.  A new testing location opened in Yakima on June 1, 2013 and there is now a new testing site available in Tacoma.  A list of testing locations are available at the following web-site:

Grant Funding Allows Bundled Services for Aging at Home

A project made possible through grant funding is finding that through a tripod of services including nursing care, occupational therapy and home improvement assistance, seniors can save thousands in dollars spent on more costly alternatives to aging in their homes.

The Baltimore-based project, coined “Capable,” or Community Aging in Place – Advancing Better Living for Elders is modeled after a Philadelphia study, “ABLE,” that was tested in the early 2000s. Those who are 65 and older who qualify for the program by proving difficulty in at least one activity of daily living receive the services of the visiting nurse, occupational therapist and handyman over four months for a cost of about $4,000. About $1,100 of the spending goes to home improvements such as banisters, hand rails and lighting.

Read more here.

7/23/13

ALTSA Offers 4 Caregiver CEUs for Natural Disaster Awareness

The 4 hour course seeks to address the all-hazards comprehensive emergency management needs of senior citizens – inclusive of all economic, medical, cognitive, and mobility determinants – specifically as they address the actions of the individuals who care for them. This course will offer participants the knowledge and skills required to assess vulnerability emphasizing the unique characteristics of the senior citizen population. Hazard identification and risk assessment is focused on the senior citizen home and the senior care facility, although community-wide risk assessment will also be addressed within the larger geographic area.


 

4 Locations 10 AM – 3 PM 
To register click on the link next to the location:

 
Aug. 19, 2013 Lacey https://www.123signup.com/register?id=brcfj Aug. 20, 2013 Renton https://www.123signup.com/register?id=brcyx Aug. 22, 2013 Yakima https://www.123signup.com/register?id=brytd Aug. 23, 2013 Spokane https://www.123signup.com/register?id=brytf
 
Each offering has a Train the Trainer component available (a 5-10 min assigned "teach-back" of course material for a limited number of trainers).

Focus on QAPI: The Second Element


QAPI (Quality Assurance Performance Improvement) has 5 elements that you must include in your program.  The second aspect of QAPI is Governance and Leadership.   This aspect deals with who is going to take responsibility for the QAPI process and how are they going to do it?  Those of you in Administration need to take the lead in QAPI.  Use your staff, residents and families to get input that will help you to decide how to proceed.  You need to provide the necessary training and equipment for the staff as you select projects to work on.  When you think about establishing policies around QAPI, you need to make sure they will stand up in the face of changes in personnel and turnover.    Set your priorities for improvement.  Your QAPI program must have at least one person accountable with adequate resources to ensure the success.  It is important to set expectations from the start.  As you set these expectations, keep in mind safety, quality, rights, choice and respect.  Finally, create an organizational culture and climate that holds staff accountable, where systems are evaluated through root cause analysis rather than punishing individuals and creating fear of retaliation.  Very often identified problems are due to a system failure rather than an individual making a mistake. 
 
For assistance, contact Bonnie Blachly at bblachly@leadingagewa.org.
 

Fair Housing: HUD Posts New Rule for Comment

On July 19, the U.S. Department of Housing and Urban Development (HUD) issued for comment a proposed rule on Affirmatively Furthering Fair Housing (AFFH) to help program participants take more informed steps to overcoming historic patterns of segregation, to promoting fair-housing choice, and to fostering inclusive communities for all. Comments are due Sept. 17.

Fair Housing: HUD Posts New Rule for Comment - LeadingAge

7/16/13

HUD Service Coordinator Grant Update


All Service Coordinator and CHSP extension requests for Federal Fiscal Year 2013 are due to HUD field staff by August 1, 2013.

You can find this year’s guidance on HUD's website at http://portal.hud.gov/hudportal/HUD?src=/program_offices/housing/mfh/scp/resources.

If both your grant term expires and you will completely run out of money by December 31, 2013, you should submit an extension request by August 1.

QAPI (Quality Assurance Performance Improvement) Update


QAPI (Quality Assurance Performance Improvement) has 5 elements that you must include in your program.  The first aspect of QAPI is Design and Scope.  Your QAPI process must measure how you are doing in every department and against every part of the regulation.  It is more than a one- time look but is on-going.  It should include your clinical care, quality of life, resident choice and care transitions.  When looking at design and scope, you need to make sure you are using the best available evidence to define and measure your goals.  Nursing Homes must have a written QAPI plan.  As you consider how you will craft design and scope, use your quality indicators and quality measures.  They can give you a retrospective look at how you did which is the QA part of QAPI.  Then use that data to determine what changes you will implement, monitor and measure in the coming months.  That is the PI part of QAPI.  Be sure you are monitoring your outcomes related to the newly implemented changes you make.
Stay tuned for next week's QAPI update.  Contact Bonnie Blachly with questions or for assistance.
 

Updated Fees for Copying Health Care Records


The Washington State Department of Health has officially adopted an updated rule on allowable fees health care providers may charge for searching and duplicating health care records under WAC 246-08-400. 
 
The updated fees are as follows:

·         No more than $1.09 per page for the first 30 pages

·         No more than .82 per page for all additional pages

·         A $24 clerical fee may be charged for searching and handling records
 

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