DCH- Healthcare Facility Regulation Division

Transcription

1 Georgia Department of Human Services (DHS) Division of Aging Services (DAS) Community Care Services Program (CCSP) AAA Network Meeting Waiver Contact Information: Department of Community Health (DCH) - CCSP - Tom Underwood (tunderwood@dch.ga.gov) at SOURCE - Lorrie Stewart (lstewart@dch.ga.gov) at ICWP - Barbara Means-Cheeley (bcheeley@dch.ga.gov) at GAPP-Sharon Collins (scollins@dch.ga.gov) at NOW/COMP - Marilyn Ellis (mellis@dch.ga.gov) at o Host Homes ADH Updates: DCH- Healthcare Facility Regulation Division ADH licensure application (new) deadline 4/7/15 click on licensure forms & applications on the right side click on adult day center initial licensure application packet call for more information or questions o Proof of licensure due to DAS provider specialists by Client attending ADH will need. 1- Evidence that the participant is free of active tuberculosis based upon the results of a negative tuberculin skin test or chest x-ray within 12 months prior to admission 2- A medical examination report signed by a physician, nurse practitioner or physician assistant, completed within six months prior to admission that includes recommendations for care, diet, and medical, nursing, health or supportive services which may be needed Personal Care Home Licensing Private Home Care Licensing

2 Page 2 HCBS final rule- (mandatory survey by providers) Revalidation- revalidationenrollment2@dch.ga.gov- deadline was 4/1/15 failure to not do= suspension Provider reactivation- on dch website- enrollment@dch.ga.gov Web navigation manual- If you have an audit and it is discovered an employee is on the exclusion list the monies can/will be recouped for the period of time the person was employed by your agency during the exclusion period. GMCF 10/1/14: CCSP began using GMCF (Georgia Medical Care Foundation) for INITIAL client level of care certifications. As of May 1, 2015, all 12 areas have begun submitting some levels of care, whether initial or annual. All levels of care will be submitted to GMCF starting 7/1/15. As providers receive the referrals from Care Coordination they will find that the levels of care will only be 365 days in length. Example. GMCF approves the LOC on The next due loc will then be Currently, the LOC extends to the last day of the month of the approved LOC.

3 Page 3 CCSP Updates: As of April 1, there will be 1 admission per AAA until otherwise notified. The CCSP LOC PA is valid for up to 365 days. Only initial and annual LOCs will be sent to GMCF. Modified RN/LPN visits will be completed for client/careplan changes with no new LOC or completion of the MDS as of 4/20/15, this includes those clients discharging from NH/rehab/swing bed facilities and returning to CCSP. Network Meeting attendance records can be accessed through AIMS. This system tracks and trends provider attendance for policy compliance of providers for attendance of two (2) network meetings per FISCAL (July 1 June 30) year in the Planning and Service Areas (PSA) in which services are being rendered. Due to the changing content of information provided at the meetings, providers must attend the meetings in different quarters (July-September, October-December, January-March, and April-June)/Gen Services Manual Pg. VI-14. Corrective action can be applied for those providers who are not in compliance. Providers who serve more than one PSA region must meet their network meeting attendance requirement by attending meetings in different regions in different calendar quarters. The minimum network meeting attendance requirement can consist of participation via Webinar, when available, for one meeting, and attendance in person at another meeting. ***Please be sure to add DAS web addresses to your safe sites on your agency s. Go to tools, junk mail handling, trust list and make sure dhr.state.ga.us is added so any received s from DAS will not be blocked. Do this also for your Care Coordination sites as well as your AAA sites addresses.*** Find It in the Manual CCSP Medicaid Provider Manuals Click on Provider Information and choose Provider Manuals from the drop down option. The provider manuals will be listed in alphabetical order on the left side of the screen. Click on the manual you need. (All the CCSP policy manuals are found on the page 1 of the list.) The Part I Medicaid Policy & Procedure Manual is found on page 3. *Medicaid Manuals are revised/updated quarterly: January / April / July / October CCSP Care Coordination Manual Click on Manuals/Index/Div of Aging Medicaid Eligibility/DFCS Click on Manuals/Index/Div of Family Children Services Private home Care Regulations/Personal Care Home Regulations/Proxy Caregiver Rules

4 Page 4 CCSP STAFF CHANGES/UPDATES Area Agency on Aging Care Coordination Specialist Provider Specialist Atlanta Regional Jill Crump Nancy Dubas () Jill.Crump@dhs.ga.gov Nancy.Dubas@dhs.ga.gov Coastal Regional Central Savannah River Area () Regional Carolyn.Porter@dhs.ga.gov Jill Crump*/ Heather Johnson Sherryl.Sledge@dhs.ga.gov Legacy Link Jill Crump Nancy Dubas Heart of Georgia Altamaha Regional Middle Georgia Regional Northeast Georgia Regional Northwest Georgia Regional River Valley Regional Three Rivers/Southern Crescent Area Agency on Aging Southern Georgia Regional Southwest Georgia Council on Aging (SOWEGA) Jill Crump Jill Crump*/Heather Johnson Carolyn Porter*/Heather Johnson Jill Crump Carolyn Porter*/Heather Johnson Charlene.Bailey@dhs.ga.gov Pam Buckmaster Pam.Buckmaster@dhs.ga.gov CCSP Section Manager ( ) Janet Roorbach Janet.Roorbach@dhs.ga.gov Operations Analyst/AIMS Specialist ( ) Ashley Mitchell Ashley.Mitchell@dhs.ga.gov CCSP Executive Secretary ( ) *Heather Johnson-Heather.Johnson@dhs.ga.gov- CC Specialist on leave at present ( ) DHS-Division of Aging Services, CCSP electronic mailbox: CCSP_messages@dhr.state.ga.us

5 Page 5 ALS F Management Agency Assignments Sherryl Nancy Charlene Altrus- Coastal Statewide Health Care- Coastal No homes/clients Haven of Hope- Another Alternative- Love and Hope- Jesus Is Lord Health Services- Samaritan Care- Auspice Alternative- Concerned Care- Averett Healthcare- River Valley- New 11/14 Friendly Neighbors- Three Rivers Care Plus- Cherokee Angel -no homes/clients Faith Health Services- Core Care- Alegna- Truecare- SOWEGA Regency Health- River Valley Caring Together- Alternative Family- Middle Georgia Health Service- NE PRN Nursing- Middle Vision PCH- Middle Heavenly Sunshine- NE

6 Page 6 SFY 2015 Schedule for DAS Program Integrity CCSP Satisfaction by Service & Compliance Monitoring Q1: ALS G (July 2014-Sept 2014) -COMPLETED Q2: ALS F / HDM Customer Satisfaction (Oct 2014-Dec 2014)-COMPLETED Q3: Provider Agency Satisfaction with CCSP Care Coordination and DAS CCSP (Jan 2015-Mar 2015) COMPLETED- awaiting results Q4: ADH and Consumer Satisfaction with Care Coordination/PSS Cust Sat.(April 2015-June 2015) IN PROCESS PART A Policy Compliance: Reference the CCSP ALS-F Statewide Compliance Review Report - SFY 2015 for all questions and results of the compliance review. Q1-75% of the homes had an up-to-date hard copy of the CCSP ALS manual or demonstrated the ability to view the manual on the internet. Q2-93% of the homes had instructions and evacuation notices with the routing clearly defined from the specific area posted in common areas throughout the homes. Q3-89% of the homes presented documentation supporting that fire/evacuation drills are occurring at least every other month. Q4 - Based on documentation provided, at least one of the direct care staff present at the time of the review was certified in CPR in 91% of the homes. Q5 - Based on documentation provided, at least one of the direct care staff present at the time of the review was certified in First Aid in 85% of the homes. Q6 - The designee-in-charge at 98% of the homes had access to and was familiar with the materials required to complete the review. Q8 and Q9 98% of the homes had a process in place for reporting serious and unusual/unexpected incidents/emergencies and 100% identified/located the ALC/CLA/PCH Incident Reporting Form. PART B Clinical Records Review: Reference the CCSP ALS-F Statewide Clinical Records Review Report - SFY 2015 for all questions and results of the clinical records review. It is noted that due to Providers efforts to keep the clinical record manageable for home staffs, some of the documentation required to complete the records review had been removed from individual client records. This documentation is reported to be on file at Provider offices. Q1 - Supervisory visits are conducted at least twice a month with at least 14 days between the first and second visits in 89% of the records in the review.

7 Page 7 Q2 - The Registered Nurse (RN) had conducted at least one of the supervisory visits in each of the months under review in 93% of the records in the review. Q3 If a LPN conducted Supervisory Visits, the RN had signed and dated the LPN s documentation in 33 (65%) of the records; and in 18 (35%) records, the RN had not documented her/his review appropriately. In the records review, documented Supervisory Visits: Q4-93% included an assessment of each client s general condition. Q5-93% included a review of each client s progress towards individual care goals. Q6-89% included the appropriateness of the current level of services. Q7-93% included follow-up from the previous supervisory notes. Q8 For clients taking medications, the homes were maintaining medication administration records current to the month of the RCs visits for 99% of these clients included in the records review. Q9 64% of the review records had medication administration records signed and dated by the supervising RN. Q11 - Monthly RN reviews of each client s Care Plan was documented by his/her signature/initials and dated in 49% of the review records. The chart below is the comparison of the percentages of positive responses indicating overall satisfaction with CCSP Home Delivered Meals Services. Overall satisfaction increased from 86% in SFY 2013 to 89% in SFY CCSP Home Delivered Meals Services Overall Annual Consumer Satisfaction 100% 75% 79% 88% 87% 86% 89% 50% 25% 0% SFY 2008 SFY 2009 SFY 2011 SFY 2013 SFY 2015