Current and Future Regulatory and Financial Environment

10/6/2014
Division of Health Service Regulation
Adult Care Licensure
DHSR Staff
Drexdal Pratt, Division Director
Cheryl Ouimet, Chief Operating Officer
Jan Brickley, Interim Section Chief,
Adult Care Licensure
Steve Lewis, Section Chief, Construction
DHSR
• Division Initiatives
• Legislative Activity 2014
• ACLS Update
1
10/6/2014
DHSR Initiatives
•
•
•
•
•
The Cloud – Virtual Desktop Computing
QI Initiative – Customer Service Survey
Regionalization of Survey Staff
Home Based Survey Staff
Posting Statement of Deficiencies (SODs)
on DHSR website - November 2014
• LTC facilities use of NCEM’s Automated
Disaster Plan – amending rules 2015
Legislative Update 2014
The GA’s Joint Oversight Committee for
HHS will hire a contractor to study:
• Moratorium on special care unit licenses
• Quality of resident care within ACHs
• Adequacy of State oversight of ACHs,
including inspections, procedures, and
processes
Legislative Study =
Opportunities for Improvement
• Star Rating System
• Penalty Review Committee (PRC)
• Role of DHSR & County DSSs with ACHs
- inspections
- county oversight
2
10/6/2014
SCU Moratorium
SB 744 - continues 3-year moratorium on SCU licenses
(7/1/13-6/30/16)
SB 744 Added: DHHS can issue a SCU license to a facility
that had a CON as of 7/31/13
DHHS Secretary can grant an exception to the moratorium
(1 ACH and 3 NHs granted exceptions in the past year)
Guidance on exception request process on DHSR website
http://www.ncdhhs.gov/dhsr/scumoratorium.html
Periodic Review of Existing Rules
G.S. 150B-21.3A
Mandates that all rules will sunset after 10 years
unless reviewed.
DHHS will review all rules within 5 years based on
the schedule set by Rules Review Commission.
ACH & FCH rules to be reviewed in 2017-2018
NC DHHS Rules Review website & Interested
Parties listserv.
http://www.ncdhhs.gov/dhsr/rules/index.html
Other Regulatory Updates
• DHSR has a full-time Rules Review
Manager as of May 2014
• Drug Testing (2013- SB 542) of ACH
employees effective 10/1/13
• Revisions of ACH medication rules to the
Medical Care Commission 9/12/14
3
10/6/2014
Adult Care Licensure Update
Annual Survey Process – Person vs. Paper
Medication Aide Testing Results via DHSR web
Awake staff in small FCHs/ACHs with
cognitively impaired residents
Environmental Conditions – ACLS & Construction
Annual Surveys
• Resident-centered survey process
• Increased focus on observations and
interviews with minimal record reviews
• If compliance concerns are being
identified, the survey will be expanded to
clarify concerns and to determine if the
facility is in compliance
Top 10 Deficiencies
(07/01/2013-06/30/2014)
1. Health Care
2. Medication
Administration
3. Housekeeping and
Furnishings
4. Personal Care and
Supervision
5. Nutrition and Food
Service
6. Infection Prevention
Requirements
7. HCPR Checks
8. Resident Rights
9. Tuberculosis (TB)
Testing
10. Hot Water
Temperatures
4
10/6/2014
Medication Aide Testing
• Effective May 1, 2014, verification for any
medication exam results is ONLY available via the
NC Adult Care Medication Aide Testing Website:
https://mats.dhhs.state.nc.us:8598/searchVerifications.aspx
• Questions or request for information for any testing
by Adult Care Licensure Section
– Via email: [email protected] or
– Via phone (919-855-3793) M-F 8:30 am- 4:00 pm
Awake Staff
• A family care or adult care home with 12 or fewer
residents with residents who are not cognitively
oriented, present with wandering or elopement
behaviors, or are not able to utilize a call system or
do not have the ability to know where and how to reenter the facility, must ensure the resident’s needs
are met and supervision provided with awake staff.
• Additional staff employed as needed for supervision
and care of residents - 10A NCAC 13G .0601(d)
• Supervision of residents in accordance with
resident’s assessed needs, care plan and current
symptoms - 10A NCAC 13F/G .0901 (b)
Locked Closets
• 10A NCAC 13F .0306(a)(5) &
10A NCAC 13G .0315(a)(5)
• If a resident’s wardrobe closet is large
enough for an individual to be in the
closet, then the lock must allow for anyone
in the closet to independently open the
door and walk out of the closet
5
10/6/2014
Environmental Conditions
• ACLS & Construction staff take photos as part of
their survey protocol
• ACLS - baseline photos of the common living
room and a common bath and environmental
conditions when noncompliance exists or when
there is a complaint with specific allegations
regarding the environment
• No individuals, residents or staff, will be included
in any photos
Environmental Conditions
CONSTRUCTION SECTION
10A NCAC 13F.0311 – Other Requirements
(a)The building & all the fire safety,
electrical, mechanical, and plumbing
equipment in an ACH shall be maintained
in a safe and operating condition
Construction recommends licensure action if there are
egregious conditions or after follow-up visits have been
conducted & compliance has not been achieved by the
facility.
6

Download Report