2005 Survey & Certification’s LTC Policy “Year-in-Review”

Centers for Medicare and Medicaid Services (CMS)

Satellite Broadcast and Webcast

Friday, October 21, 2005

1:00 PM –2:00 PM EDT

PLEASE ADJUST TIMES FOR YOUR TIMEZONE

This live satellite broadcast and Webcast will focus on reviewingpoliciesand guidelinesissued during FY2005 for the survey and certification of long-term care (LTC) facilities across the nation. In addition, various projects that CMS’ Division of Nursing Homes (DNH) in the Survey & Certification Group (S&C) are involved with will be presented.

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Goals

The goal is to provide LTCsurveyors with a review of the LTC survey and certification policies and guidelines issued during FY 2005,highlighting the impact(s)upon the long term care survey process.

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Objectives

After viewing this program, participants will be able to:

  • Identify the communication methods that the S&C group uses to issue new and clarifying policies and guidance.
  • Identify some of the S&C memoranda that CMS issued during FY 2005 that impact the survey and certification process of LTC facilities.
  • Identify some of the interpretive guidance that CMS’ S&C DNH team issued during FY 2005; and
  • Identify some of the projects that CMS’ S&C DNH team was working on during FY 2005.
Target Audience

CMS Regional Office and State Agency Long-term Caresurvey staff

Faculty

Beverly Cullen, Nurse Consultant, CMS

Rosemary Dunn, Nurse Consultant, CMS

Fred Gladden, Technical Director, CMS

Cynthia Graunke, Director, CMS

Elaine Lew, Health Insurance Specialist, CMS

Katherine Lochary, Health Insurance Specialist, CMS

James Merrill, Life Safety Code Specialist, CMS

Jeane Nitsch, Social Worker, CMS

Linda O’Hara, Nurse Consultant, CMS

Karen Schoeneman, Health Insurance Specialist, CMS

Christina Stillwell-Deaner, Nurse Consultant, CMS

Registration and Viewing Instructions

Individual and Site registration is available today. To obtain CEUs for viewing the training program you must go to the CMS website. For individual and site registration and viewing instructions go to:

Webcast Information
This program will have a live Webcast and will be available for viewing up to 12-months following October 21 at

Satellite Technical Specifications
This broadcast will be available on C and Ku Digicipher bands. Specific satellite technical specifications will are available at or can be obtained by calling 1-800-401-9387.

Handouts

Handouts for this broadcast will be available at the following website after October17, 2005:

Videotapes:

Videotaped copies of this program can be obtained from the National Technical Information Services (NTIS) 2 weeks following the transmission of this broadcast: and address: 5285 Port Royal Road, Room 1008, Sills Building, SpringfieldVA, 22161 - 1-703-605-6186.

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JOIN THE CMS LIVE WEBCAST AND SATELLITE CONFERENCE!

2005 Survey & Certification’s LTC Policy “Year-in-Review”

Webcast and Satellite Broadcast

Friday, October 21, 2005

1:00 PM –2:00 PM EDT

On Friday, October 21, 2005 at 1:00-2:00 p.m. EDT, the Center for Medicaid and State Operations/ Survey and Certification Group/Division of Nursing Homes will sponsor a liveWebcast and satellite broadcast entitled “2005 Survey & Certification’s LTC Policy “Year-in-Review”.”This broadcast is designed to provide a review of the policies and guidelines issued, as well as projects the division was involved with,during FY2005 regarding the survey and certification of LTC facilities across the nation.

Presenters and Topics

Time (EDT) / Topic / Presenter
1:00 – 1:05 p.m. / Welcome Introduction
  1. S&C letters
  2. S&C guidance
  3. S&C communication methodologies
/ Thomas Hamilton, Group Director, CMS
Beverly Cullen, CMS
Karen Schoeneman, CMS
1:05 – 1:10 p.m. / Life Safety Code Guidance
  1. Fire Safety Requirements for LTC facilities
  2. Use of Alcohol-Based Hand Rubs
  3. Life Safety Code Survey Issues in LTC facilities
/ James Merrill, CMS
1:10 – 1:20 p.m. / Interpretive Guidelines & Severity Guidance
  1. Interpretive Guidelines & Severity Guidance Revisions Project
  2. Pressure Ulcers Guidance
  3. Urinary Incontinence, Urinary Tract Infections, & Catheters Guidance
  4. Quality Assessment & Assurance Guidance
/ Beverly Cullen, CMS
Karen Schoeneman, CMS
1:20 – 1:25 p.m. / Medical Director Guidance
  1. S&C 05-29
  2. Guidance Training
/ Linda O’Hara, CMS
1:25 – 1:35 p.m. / Interpretive Guidelines & Severity Guidance
  1. Activities & Activities Director Guidance
  2. PsychoSocial Outcomes Guidance
  3. Pain Management & Palliative Care Guidance
  4. Accidents & Supervision Guidance
  5. Unnecessary Drugs Guidance
  6. Pharmacy & Medication Guidance
  7. Nutrition & Food Sanitation Guidance
  8. Abuse, Neglect, & Mistreatment Guidance
  9. Guidance Training
/ Beverly Cullen, CMS
Karen Schoeneman, CMS
1:35 – 1:40 p.m. / Electronic Signature Guidance
  1. S&C 05-14
  2. S&C 04-46
/ Rosemary Dunn, CMS
1:40 – 1:42 p.m. / QIS Demonstration Commercial / Fred Gladden, CMS
1:42 – 1:50 p.m. / Complaint Management Guidance
  1. S&C 05-12
  2. ACTS
  3. S&C 05-27
  4. CASPER
  5. S&C 05-31
/ Elaine Lew, CMS
Katherine Lochary, CMS
1:50 – 1:53 p.m. / Abuse & Neglect Guidance
  1. Reporting of Alleged Violations of Mistreatment, Neglect, Abuse, & Misappropriation of Resident Property
  2. Defining “Injuries of Unknown Source”
/ Jeane Nitsch, CMS
1:53 – 1:59 p.m. / FY 2006 Forecast
  1. Influenza & Pneumonia Immunization Regulation
  2. Prescription Drug Coverage Satellite Broadcast
  3. Past NonCompliance Guidance
  4. Civil Money Penalty Grid
  5. GPRA Goals: Pressure Ulcers & Physical Restraints
/ Cynthia Graunke, CMS
1:59 – 2:00 p.m. / Closing / Beverly Cullen, CMS
Karen Schoeneman, CMS

Faculty Biographical Information

Beverly Cullen, RN

Beverly is a Nurse Consultant for the Division of Nursing Homes in the Survey & Certification Group in the Center for Medicaid & State Operations at the Centers for Medicare and Medicaid Services (CMS). She is a registered nurse who joined CMS over seven years ago, and who has previous experiences as a director of nurses in nursing homes and as a surveyor and supervisor with the Minnesota Department of Health for over seventeen years. At CMS, Beverly works on survey issues related to quality of care. She is also the project officer on a contract involved with enhancing the guidance to surveyors in key regulatory areas including pressure ulcers, incontinence, and others. Beverly has been involved in the development of the QIS survey as well.

Rosemary Dunn, RN

Rosemary is a Nurse Consultant for the Division of Nursing Homes in the Survey & Certification Group in the Center for Medicaid & State Operations at the Centers for Medicare and Medicaid Services (CMS). Prior to joining CMS in 1990, she has many years of clinical and administrative experience in the health services industry, acquiring substantial practical expertise in the acute, post-acute, and long-term care arenas within the public and private sector in the states of Rhode Island, Vermont, and Maryland. As a Public Health Surveyor in the past, she specialized in the establishment, development and oversight of programs such as Nursing Homes, Assisted Living Settings, Rural Health Clinic, Rehabilitation and Psychiatric Units and TreatmentCenters, and group homes for those with Developmental Disabilities. Rosemary has been involved with Resident Assessment Instrument and Minimum Data Set issues since their implementation in 1990, and continues to work with various state and national associations regarding the MDS, including providing guidance through the development of national policies and educational materials for use in training.

Cindy Graunke

Cindy Graunke is the Director of the Division of Nursing Homes in the Center for Medicaid and State Operations at the Centers for Medicare and Medicaid Services (CMS) where she is responsible for survey, certification, and enforcement issues in nursing homes. During her 31 years of Federal service, Ms. Graunke has worked in the Office of the Assistant Secretary for Health, the Veterans Administration, the Consumer Product Safety Commission, and for the past 24 years, the Centers for Medicare and Medicaid Services. Ms. Graunke has been with the Survey and Certification Group since 1989, and has been involved with nursing home reform enforcement issues since. She also serves as a Senior Fellow in the Council for Excellence in Government.

Fred Gladden

Fred is the Technical Director with the Division of Nursing Homes in the Center for Medicaid and State Operations at the Centers for Medicare and Medicaid Services (CMS). Prior to joining CMS, Fred was a Director of a State Survey Agency involved with the regulation of health care providers for over eighteen years. He also has over eight years experience as a Hospital Administrator, and has earned a Bachelor of Science and Master of Science degrees, as well as a Master of Hospital Administration degree. Currently, Fred is the CMS Lead for the Quality Indicator Survey (QIS) Demonstration and works with the Medicare/Medicaid Nursing Home certification program.

Elaine Lew

Elaine is a Health Insurance Specialist for the Division of Nursing Homes in the Survey & Certification Group in the Center for Medicaid & State Operations at the Centers for Medicare and Medicaid Services (CMS). She joined CMS over six years ago, and has been involved with conducting evaluations of various aspects of the nursing home enforcement process, and the development and implementation of policies related to the management of nursing home complaints. One of Elaine’s current roles includes administration of a national administrative database for complaints that assists in tracking state survey agency processes.

Katherine Lochary

Kathy is a Health Insurance Specialist for the Division of Nursing Homes in the Survey & Certification Group in the Center for Medicaid & State Operations at the Centers for Medicare and Medicaid Services (CMS). She joined CMS over 13 years, and has experience working on the development of the final nursing home enforcement regulations with the accompanying policy and procedural instructions. Also, she has previous experience with the instruction of new surveyors at CMS sponsored training courses, and the coordination of national listening sessions, training activities, and conferences for CMS. One of Kathy’s current roles includes assisting in the refinement of the CMS national automated complaint tracking system and the policies and procedures related to complaints about the care and services received by nursing home residents.

James Merrill, BS

Jim is the Life Safety Specialist for the Division of Nursing Homes and the Division of Continuing Care Services in the Survey & Certification Group in the Center for Medicaid & State Operations at the Centers for Medicare and Medicaid Services (CMS). Prior to joining CMS’ Central Office, Jim was a Facility Engineer at the PineRidgeIndianHospital in Pine Ridge, South Dakota for the Indian Health Services, and served as the Life Safety Specialist with the CMS Philadelphia Regional Office. Jim has earned his Bachelor of Science degree in Civil Engineering and is a registered Professional Engineer. He is also a member of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and is a member of the American Institute of Architects revision committee involved with the revision of the Guidelines for Design and Construction of Healthcare Facilities. His work covers the areas of nursing homes and Intermediate Care Facilities for the Mentally Retarded. Jim also has experience in the area of accrediting organizations for various provider types.

Jeane Nitsch, MS, MSW, LCSW-C

Jeane Nitsch is a Social Worker Consultant for the Division of Nursing Homes in the Survey & Certification Group in the Center for Medicaid & State Operations at the Centers for Medicare and Medicaid Services (CMS). She has experience as a Director of Admissions and Social Work in a hospital-based sub-acute unit, as well as experience in long-term care facilities, continuing care retirement communities, and assisted living facilities. Since joining CMS in 1998, her primary role has been in the development and implementation of national policies for nursing homes in areas such as physical and chemical restraints use, abuse and neglect, and other quality of life issues pertaining to the survey and certification of long-term care facilities. Ms. Nitsch holds a Master of Social Work degree specializing in Aging from the Maryland School of Social Work, and a Master of Science degree in Health Care Management from the University of Maryland University College.

Linda O’Hara, MS, BSN, RN

Linda O’Hara is a Nurse Consultant for the Division of Nursing Homes in the Survey & Certification Group in the Center for Medicaid & State Operations at the Centers for Medicare and Medicaid Services (CMS). She has experience as a research analyst in a long-term care unit with the Center for Health Program Development and Management at the University of Maryland, Baltimore County (UMBC), as well as a number of years experience working with adults and children with developmental disabilities. Linda is a graduate of the University of Marylandwhere she received a Bachelor of Science degree in nursing, a master of science degree in Nursing Health Policy, and an advanced certificate in Health and Public Policy. She is also a member of the Sigma Theta Tau International Honor Society of Nursing.

Karen Schoeneman

Karen is a Health Insurance Specialist for the Division of Nursing Homes in the Survey & Certification Group in the Center for Medicaid & State Operations at the Centers for Medicare and Medicaid Services (CMS). She is involved with the survey process and specializes in the quality of life requirements. She has executive produced several CMS live satellite broadcasts including shows on activities, the Pioneer Network, a 2-part show on person-centered dementia care, and on pressure ulcer care. Karen co-leads current CMS contracts involved with the modernization of the survey process, the development of an internet repository of clinical standards for the nursing home setting, and the convening of expert panels to rewrite the interpretive guidelines for several key regulatory Tags.

Christina Stillwell-Deaner, BS, BSN, RN

Chrissy is a Nurse Consultant for the Division of Nursing Homes in the Survey & Certification Group in the Center for Medicaid & State Operations at the Centers for Medicare and Medicaid Services (CMS). She joined CMS over three years ago, and has been involved with national provider outreach and education campaigns, as well as Medicare fiscal intermediary, carrier, and durable medical equipment regional contractor issues. She is a clinical nurse with past experience in surgery and continued experience in pediatric and adolescent disability nursing. Chrissy is a graduate of VillaJulieCollege’s School of Nursing, and TowsonUniversity where she attained her Bachelor of Science degree in Biology.She is expecting to complete her Master’s of Science degree inPublic Health with a concentration on health education and public health practice in May of 2006.

2005 Survey & Ceritification’s LTC Policy “Year-in-Review” Satellite Broadcast

TECHNICAL FACT SHEET
DATE: / October 21, 2005
TEST TIME: / 12:30 – 1:00 p.m. EDT
11:30 – 12:00 p.m. CDT
10:30 – 11:00 a.m. MDT
9:30 – 10:00 a.m. PDT
PROGRAM TIME: / 1:00 – 2:00 p.m. EDT
12:00 – 1:00 p.m. CDT
11:00 – 12:00 p.m. MDT
10:00 - 11:00 p.m. PDT
WEBCAST TROUBLESHOOTING NUMBER:
SATELLITE TROUBLE
NUMBER: / 703-812-8816
410-786-3618
CMS Digital Network: / Channel 712

Individuals and Sites outside of the CMS satellite network who wish to set up a site for this program or view this broadcast via webcast should go to

cms.internetstreaming.com to register. Handouts can also be found atthat website

Guidance for Locating Downlink Sites

In general, there are 2 major formats for satellite transmission - digital and analog. CMS uses both analog and digital formats, CMS’s Digital network is a closed network which can only be viewed by its ten regional offices and several State survey agencies in regions VIII, IX, and X. The Digital format that CMS uses is called Digicipher. CMS is also capable of transmitting and receiving programs in KU-band and C-band analog. Ku-band and C-band have been in use for many years, can be received by thousands of ‘steerable’ analog dishes nationwide. C-band is the oldest transmission signal and the most widely used. NOTE: This is NOT ‘video conferencing,’ which is carried by telephone lines.

Locating an Analog Downlink Site

Potential Analog Downlink Sites: There are thousands of steerable analog downlink dishes nationwide at public schools, colleges, libraries, hotels, television stations, restaurants, private residences, etc. A few calls should locate one near you.

Here are some places to start calling:

  • Your Local Cable and Satellite Television Provider: Contact your local cable/satellite television distributor, which is probably listed under “Television -- Cable & Satellite.” Ask to speak with the programming staff and inquire about their willingness to simulcast the broadcast on your area's public access channel. Advise them that this broadcast is free of charge. Satellite television distributors may be able to provide you with a list of public institutions such as libraries, community centers, health care centers, and public schools that subscribe to their services. You may also wish to contact your local public TV station and ask that they download and air the program on their station.
  • Public Libraries: Larger public libraries are a good place to check for satellite downlink facilities. Check library listings in the local government section of the blue pages of your local telephone directory.
  • Educational Institutions: Universities, community colleges, and large public high schools often have satellite downlink capabilities.
  • Hotels and Business Centers: Large hotels that frequently host conventions in business districts, may be able to receive satellite broadcasts. These hotels may charge a fee for viewing.
  • Health Care Facilities: Many hospitals and health maintenance organization (HMO)

offices have satellite reception capabilities.

  • Copy Centers: Commercial office supply centers may also have satellite capabilities.

What Information Do I Need to Give the Site Contact Person?

When you contact an analog site, you will need to give the contact person the satellite coordinate information. The coordinates for the broadcast should be made available from the Central Office contact approximately 30 days prior to the broadcast.

Here is the information you will need to provide:

  • Transmission Type:
  • Satellite:
  • Orbital Location:
  • Transponder:
  • Polarity:
  • Downlink Frequency:
  • Satellite Help Hotline:
  • Broadcast Schedule:
  • Test Signal:
  • Broadcast Title:

Reserving a Downlink Site

You will need to know what to ask the person who answers the phone, who may or may not be the best person at that organization to help.