Health Facilities & Emergency Medical Services Division

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. 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. 650 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.

5. Nursing Facilities • Federal Updates • Phase 3 of the revised survey process goes into effect November 28, 2019. 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. Initial Inspections Occurrences Investigations StateFiscalYear 17-18: 349 Re-Inspections StateFiscalYear 17-18:834 Complaint Intakes StateFiscalYear 16-17: 1,605 StateFiscalYear17-18: 1,668 StateFiscalYear 16-17: 5,270StateFiscalYear 17-18:6,315

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 19-052 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 19-065 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 Sandermanis our Interim Chief of our Certification, Licensing, Enforcement and Records Branch!!

11. UPDATE ---UPDATE---

12. Questions? Randy Kuykendall Division Director 303-692-2945 Randy.Kuykendall@state.co.us