General Interest

News from CDPH Quarterly Meeting

Below are highlights from the February 21, 2020 Quarterly Stakeholders Meeting for Long-Term Care Providers provided by Brenda Klütz, LeadingAge California’s Senior Policy Advisor.

Court Decision for CANHR v. Smith [Re. H&S 1418.8 – Epple bill]

  • LeadingAge California asked if the department was planning to train surveyors and notify providers of the court decision.  For the short-term, no All Facility Letter will be published.  At this point in time, any AFL would just restate the court decision.
  • At this point, next steps by CDPH responding to complaints.  District Managers will be notified of the court decision and will be required to notify headquarters of the receipt of a complaint.  In this way, the department will be aware of the nature of the complaint and identify the extent to which surveyor training is necessary.
  • Meetings will be schedule with the California Health and Human Services Agency to discuss the most challenging court directive: that an individual who is unaffiliate with the facility be on the IDT when making care decisions for an individual who both lacks capacity and does not have a legal representative.
  • LeadingAge California is releasing a new Technical brief on this subject.  We are always available to discuss this issue and help.

Dialysis in Skilled Nursing Facilities

  • LeadingAge California asked if the department was planning to update the AFL on dialysis services in SNFs.  The most recent guidance was released in 2007.  Since then the federal requirements for both SNFs and ESRDs have been updated.  We will be providing the department information on those changes and work with them to update guidance to our communities.

Remember to Update your E-POC Users!

  • A bit over 500 skilled nursing facilities have set up E-POC accounts.   However, CDPH has noted that not all those accounts are being used.  Evidently with staff turnover, facilities may not be registering new staffs to be able to submit Plans of Correction to the District Office.  Make sure you update staff access to the portal!

Remote Monitoring of Residents after SNF Discharge

  • LeadingAge California has asked CDPH about their guidance on providing remote monitoring of residents after they are discharged from a SNF.  This is of interest to SNF that are a part of a Life Plan Community or community that provides multiple levels of care.   CDPH has committed to working with us to clarify their expectations and those of CMS.

Phase 3 Surveyor Training

  • CDPH started training new surveyors on the Phase 3 requirements on January 1, 2020 as part of the new surveyor academy.  More seasoned surveyors have been given bits & pieces of information.  The department’s Central Training Unit will be recording videos so that all surveyors are familiar with Phase 3 requirements.
  • As a side note, CMS has not yet released the Interpretive Guidelines for Appendix PP.  They were originally scheduled to be released last summer.  LeadingAge California will notify members as soon as the IGs are available.

Submit your Workforce Shortage and Patient Needs Waivers ASAP!

  • The deadline for submitting waivers is April 1, 2020!
  • Thus far CDPH has received 123 patient needs waiver requests and only 8 workforce shortage requests.
  • Please don’t wait until the last minute to submit your waiver requests!  If you submit the waiver request earlier and CDPH has questions you are able to provide additional information prior to April 1st.

CMS Areas of Emphasis on Surveys

  • CMS has notified CDPH that they will be providing additional scrutiny to surveys that contain deficiencies related to the use of antipsychotics as well as transfer and discharge.  Don’t be surprised if additional focus is given on these two requirements areas.