CMS Update October 6, 2013 Steven Chickering Associate Regional Administrator, WDSC October 6, 2013
Objectives Review ICF/IID Demographics Learn about what’s new with the ICF/IID Program Identify the top 10 W Tags/Citations
CMS Central Office ICF/IID Team Peggye Wilkerson – Deputy Director, Division of Continuing Care Providers Adrienne Rogers – Team Lead Melissa Rice Vacant
ICF/IID Demographics Total number of individuals served: 420,613 Under 22 years of age: 31,992 22-45 years of age: 160,993 46-65 years of age: 191,013 Over 65 years of age: 36,615
ICF/IID Demographics Total number of ICF/IIDs: 5723
Where Individuals Reside Large (>100 beds) 43% Medium (17-99 beds) 16% Small (4-16 beds) 41%
What’s Happening
Interpretive Guidance ICF/IID Interpretive Guidelines Updated Internal review of draft revisions Public comment of draft revisions Final clearance hopefully by end of 2013
Survey & Certification Letters S&C: 13-11-ICF/IID – Intermediate Care Facilities for the Intellectually Disabled (ICF/IID) No Longer Certified Under Time-Limited Agreements, Published: February 8, 2013
S&C: 13-11-ICF/IID (cont) The Burden Reduction Rule I removed the time limited agreement for certification of ICF/IID’s – The regulation at §442.15 was changed to provide that provider agreements for ICF/IID’s would remain in effect as long as the facility remains in compliance with the Conditions Of Participation (COP’s). Regulations at §442.109 through §442.111 are also changed to reflect this change.
Survey & Certification Letters (cont) S&C: 13-28-ICF/IID-QIDP – Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) – Nomenclature Change (Qualified Intellectual Disabilities Professional (QIDP), Published: May 3, 2013
S&C 13-28-ICF/IID-QIDP (cont) Rosa’s Law: The enactment of Rosa’s Law on October 5, 2010 changed all references to “mental retardation” in Federal law to “intellectual disability” and changed all references to a “mentally retarded individual” to “an individual with an intellectual disability.” These changes were codified in regulation by the Centers for Medicare & Medicaid Services (CMS) on May 16, 2012.
S&C Letters - Future Locked Areas Prone Restraints Undergoing clearance process Prone Restraints Reviewing literature and data
ICF/IID Nomenclature Continue to update forms with correct nomenclature Form CMS-3070 G will be revised in 2013 Updating State Operations Manual (SOM) as well Training materials have been updated Reviewing website references
Elderly Individuals Guidelines to assist surveyors in evaluating IPPs for elderly individuals under development
Survey Process No Changes at this time Anticipate a review within next 12-18 months
Top 10 Deficient Practice Citations
Top 10 W-Tags W249 – IPP Program Implementation W104 – Governing Body Oversight W331 – Nursing Services W369 – Medication Administration W149 – Prevention of Abuse, Neglect and Mistreatment
Top 10 W-Tags (continued) W189 – Staff Training Program W322 – Preventive and General Health Care W159 – QIDP W120 – Outside Services W154 – Thorough Investigations
Other Frequently Cited W-Tags W368 – Medications administered in accordance with physician orders W263 – Restrictive programs implemented only with informed consent W153 – All allegations of abuse, neglect, mistreatment & injuries of unknown origin are reported immediately to administrator and/or others according to state law W436 – Furnish adaptive equipment
Other Frequently Cited W-Tags (cont) W227 – IPP states specific objectives W262 – Specially constituted committee reviews, approves and monitors all restrictive programs W312 – Medications used to manage inappropriate behavior may be used only when its an integral part of IPP
Training Basic Surveyor Training Web-based Basic Courses – pilot Two courses per year Includes onsite experience Web-based Basic Courses – pilot Post-training evaluations
CMS ICF/IID Surveyor Contract Augment Regional Offices and State Survey Agencies Will complete 77 surveys during FY 2013 Assist with CMS training activities
Questions ?
Thank You for the Opportunity Contact Information: Peggye.Wilkerson@cms.hhs.gov 410-786-4857 Steven.Chickering@cms.hhs.gov 415-744-3682