1. Health Facilities & Emergency Medical Services Division
Colorado Medical Directors Association
April 26, 2019

2. Our Mission
Protect the health, safety and welfare of all health care system users Ensure access to quality health care for all Coloradans

3. eliable to all stakeholders, citizens and visitors
HFEMSD’s Philosophy of Regulation
eliable to all stakeholders, citizens and visitors
fficient, effective and elegant in all service interactions
ccountable, transparent and collaborative interactions
ompliant through balanced sanctions and fair practices
elpful whenever possible

4. Nursing Facilities 230 currently licensed nursing facilities.
3 recent closures – Courtyard Care Center in Fruita and Brookdale Mountain View in Denver, Welbrook Senior Living in Grand Junction.
194 recertification surveys were conducted in FFY 18 – better than last year but still not making federal workload.
Complaint volume continues to outpace investigations completed complaints were closed in FFY 18 but 858 were opened.
Surveyor staffing has greatly improved. 13 of the 15 vacancies from last year have been filled.
In order to operate certain health facilities in Colorado, a license to operate has to be issued and active at all times.
Obviously there are more licensed health care facilities in Colorado, there are the ones in my branch where Radiology Services are either provided at the facility or may be provided under contract with another facility.
Not all health entities are licensed by the department. Urgent Care, physician practices

5. Nursing Facilities Federal Updates
Phase 3 of the revised survey process goes into effect November 28, An Infection Preventionist must be designated by facilities by then. An online IP training course has been developed by CMS.
CMS revised the guidance for identifying Immediate Jeopardy. Surveyor training completed in March.
CMS now requires 50% of the weekend or off hour recertification survey to be conducted at facilities with low RN or weekend staffing.

6. Nursing Facilities Nursing Home Compare
CMS is ending the freeze on the health inspection domain of the Five Star Quality Rating System. They are resuming the methodology of using three cycles of inspections to determine the facility’s star rating.
Short and long stay measures will now be part of the Quality measure.
The threshold for “number of days without an RN onsite” that triggers an automatic downgrade to one star has been reduced from 7 to 4 days.

7. Occurrences Investigations
Initial Inspections
State Fiscal Year 17-18: 349
Re-Inspections
State Fiscal Year 17-18: 834
Occurrences Investigations
State Fiscal Year 16-17: 5,270 State Fiscal Year 17-18: 6,315
We have fewer inspections in SFY 2018 than SFY 2017 due to some of our significant vacancy numbers in some of the survey units.
Complaint Intakes
State Fiscal Year 16-17: 1,605
State Fiscal Year 17-18: 1,668

8. Recent Projects Home & Community Facilities
New ALR rules effective June, 2018 with an expanded roll out through 2020
Community Integrated Health Care Service Agencies (CIHCS) effective January, 2018 with two agencies licensed thus far
Education & Technical Assistance
Colorado Health Facilities Interactive (COHFI) systems rebuild
Health Facility Quality
BHE proposal
HFD Reports/data rebuild project

9. Recent Projects (cont.)
Emergency Medical & Trauma Services
SB Allow EMS Providers, under physician medical direction, to practice within their full scope in clinical settings, and authorizes supervision of EMS providers in clinical settings by mid-level providers (APNs and PAs) and from RNs
SB would create a peer health assistance program for EMS Providers, funded through fees and gifts, grants, donations
Certification Licensing Enforcement & Records
Development of the fingerprint background check process
Hospital affiliation project

10. Some Leadership Changes!
Elaine McManis has been promoted to our HFEMS Deputy Division Director!!
Kara Johnson-Hufford has been promoted to our HFEMS Associate Division Director!!
Shelly Sanderman is our Interim Chief of our Certification, Licensing, Enforcement and Records Branch!!

11. UPDATE
---UPDATE---

12. Questions? Randy Kuykendall Division Director 303-692-2945