A2 CDC will summarize recent outbreaks and patient notifications in outpatient settings, which highlight the importance of the elements being assessed on the ICWS. CDC will also describe recently released infection prevention materials targeting outpatient settings that will be helpful to surveyors during their assessments.  The Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) collaborated to develop an infection control worksheet (ICWS) to assess infection control practices within ambulatory surgical centers (ASCs). CMS will discuss FY2010 data obtained from the ICWS. The focus will be on similarities/differences among the State Survey Agencies in their ASC worksheets and citation practices, as well as consistency between 2567 citations and the worksheets for a given survey. In addition, we will make state-specific results available.

A4  Washington State has expanded its abuse, neglect, and exploitation findings program beyond nursing facilities. The program is now operating in several other types of settings, including adult family homes (which provide care to fewer than seven residents), supported living settings, and state-operated institutions for individuals with intellectual disabilities.  This expansion has created a number of new hearing issues, including:   administrative law judges choosing to consolidate appeals of the finding against the individual with the facility’s appeal of a licensing action; greater need to rely  solely on the testimony of the vulnerable adult; appellants who may be fellow state agency employees; increased reliance on physical evidence; and more frequent interactions with prosecutors who are pressing criminal charges, based upon the same case facts.   This session will provide discussion around lessons learned, and will also identify legal implementation issues.

A5 Settled Case Law Concerning Immediate Jeopardy.  Does your agency sometimes struggle with what constitutes immediate jeopardy? This session will explore more than 15 years of Departmental Appeals Board decisions concerning Immediate Jeopardy and will focus on specific scenarios that have been found to constitute immediate jeopardy.

B5 This session will discuss State Experiences with QIS and tricks and talents to having a smooth transition for your state into QIS implementation. The session will focus on how different states have implemented QIS and some strategies that they have utilized for this successfully transition.

C1  This fall prevention program is the combination of nationally recognized evidence-based fall prevention practices and practical applications from numerous research studies. Having recently completed this 3 year program, the 16 skilled nursing facilities within the consortium of Empira, collectively achieved over 25% reduction in the occurrence of resident falls and reduced repeated falls from an individual resident to single digits. This program implemented actions and interventions that tested and challenged current and commonly held “best practices.” Through the in-depth analysis of the root causes of falls and specifically through the elimination of all personal alarms, low beds and protective mats on the floor, the Empira fall prevention program significantly improved both the quality of life and the quality of health of their residents. This program was supported through a 3 year grant from the MN Department of Human Services.

Presenter: Sue Ann Guildermann

C3 This session will examine state experience in developing and providing a package of specialized dementia care services in a contracted boarding home setting, sometimes referred to as” Assisted Living”. The service began as a pilot project and a positive outcome evaluation led to expansion of the program. The presentation will include outcomes of the original pilot project, client eligibility criteria, requirements for contracting providers, current program data and quality improvement efforts. The package of services include: care and supervision based upon the specific needs, interests, abilities, and preferences of the person; intermittent nursing services, help with medications, personal care, and other support services; coordination with the person’s family, dementia-specific training for staff, tailored activities and environmental features that enhance safety while allowing access to a secure outdoor area. Staff representing both the contracting and regulatory divisions will share insights and challenges over a decade of program implementation.

C4 This session will explain criminal neglect, the evidence required to prove a criminal neglect case, the obstacles experienced by law enforcement and prosecutors in investigating and proving a case of neglect in a long-term care facility, and ways in which facility administrators, state investigators and law enforcement can assist each other in responding to a case of possible criminal neglect. It will also describe King County’s efforts at establishing a successful Elder Fatality Review Team, and the ways such a team can benefit our systemic response to elder neglect. The session will be led by a prosecutor for the Medicaid Fraud Control Unit, a criminal prosecutor, and the Chief Medical Examiner for King County

D4  The Coordination of Investigations in a Licensed Care Facility - a Sexual Assault Case Study

 This presentation will use a   real-life sexual assault case  that occurred in a facility to highlight the roles of  the different investigators  involved  (facility, State, and law enforcement) and the benefits to coordinating their investigations.  

Presenter:  Detective Steve Kelly, Mary Moran, Kathy Van Olst

D5  This session will provide an overview of the uses of new Quality Measures derived from MDS 3.0, including an update on Nursing Home Compare and the 5 Star Nursing Home Quality Rating System, a review of the use of new QM reports in the survey process, and the relationship between QMs and the QIS survey. Implications for SAs and facilities will be discussed.