Health Facility Services A presentation for the HomeCare Association of Arkansas, April 2017

Content 2017 New Conditions of Participation Deficiency Patterns Providing Personal Care Emergency Preparedness Surveyor Round Table Questions and Answers about the survey process

2017 Conditions of Participation WHEN!! Effective July 13, 2017 Effective January 13, 2018 as published in the Federal Register

To tell the age of any horse!

2017 Conditions of Participation Continuous & Integrated Patient-centered assessment Care Planning Service delivery Interdisciplinary Contributions

2017 conditions of Participation Interactions & Communication Outcomes & QAPI Pt Rights Infection Control Emergency Planning

Survey DATA Top condition Top standard 156 Acceptance of Patients , Plan of Care, Medical Supervision Top standard 158 Written Plan of Care

Average # of Deficiencies/Survey 2009 AR 1.7 and Nation 3.2 2010 AR 1.4 and Nation 3.3 2011 AR 2.3 and Nation 3.0 2012 AR 1.2 and Nation 2.7

Average # of Deficiencies/Survey 2013 AR 1.3 and Nation 3.2 2014 AR 1.2 and Nation 2.9 2015 AR 1.1 and Nation 3.2 2016 AR 1.4 and Nation 2.9

Private Care Agencies Private Care Agencies 9 new Private Care Agencies in 2012 27 new Private Care Agencies in 2016 Currently we have over 100 Private Care Agencies

Providing Personal Care Home Health / Private Care Agencies to assist in accomplishing activities of daily living

Initial Licensure Receive pre-certification from ARChoices Application Qualify for provisional license as a Private Care Agency. Application & CBC Review of Policy and Procedures Onsite inspection Obtain Provider number from Medicaid

Community Resources Community Paramedics Community Health Workers Arkansas Community Health Workers http://www.archwa.org/

Emergency Preparedness Headed to a home visit

Goals

Four Provisions for All Provider Types

Risk Assessment and Planning Develop an emergency plan based on a risk assessment Perform risk assessment using an “all hazards” approach, focusing on capacities and capabilities Update emergency plan at least annually

Policies and Procedures Develop and implement policies and procedures (Ps&Ps) based on the emergency plan and risk assessment Ps&Ps must address a range of issues including evacuation plans, procedures for sheltering in place, tracking patients and staff during an emergency Review and update Ps&Ps at least annually

Communication Plan Develop a communication plan that complies with both Federal and State laws Coordinate patient care across health care providers and with state and local public health departments and emergency management systems Review and update plan annually

Training and Testing Program Develop and maintain training and testing programs, including initial training in Ps&Ps Demonstrate knowledge of emergency procedures and provide training at least annually Conduct drills and exercises to test the emergency plan

Requirements Vary by Provider Type Home health agencies and hospices are required to inform state and local officials of patients in need of evacuation

Link to the Final Rule View the final rule at: https://www.regulations.gov/document?D=CMS-2013-0269-0377

Survey & Certification Agencies are expected to be in compliance with the CoPs and requirements 1 year following the publication of the final rule In the event the provider is non-compliant, the same general process will occur as is currently in place for any other conditions and could lead to termination of the provider agreement

Survey Process

HHA Survey Process Pre survey Preparation Entrance Interview Information Gathering Information Analysis Exit conference Formulation of the Statement of Deficiencies

Surveyors Lynn Wooley, RN – OASIS Education Coordinator Kirk Gardner, RN Naomi Armstrong, RN Carolyn Guth, RN 5. Tim Simpson, RN

1-800-223-0340 Home Health Hotline Email – Liz.Davis @ arkansas.gov CONTACT Information (501)661-2201 – office phone 1-800-223-0340 Home Health Hotline Email – Liz.Davis @ arkansas.gov