Rachel Monger and Debra Zehr met on Thursday with KDADS Commissioner of Survey, Certification and Credentialing Codi Thurness to discuss growing concerns related to long-term care survey and enforcement. Specific issues included:
- The growing number of IJ citations throughout the state. (Of the 6500 complaint calls to the hotline so far this year, 144 were coded at intake as “immediate jeopardy” requiring an onsite visit within 48 hours.)
- The significant delays that some providers have experienced in getting notification from KDADS when their survey resulted in an IJ citation, and all of the negative fallout from such unreasonable delays. Commissioner Thurness provided an overview of the internal steps involved in assigning an IJ. First, deficiencies are reviewed by the Regional Manager and Regional Quality Improvement Manager. If it appears that an IJ may need to be cited, the tag is reviewed by staff in the Topeka office for determination. In rare instances, when uncertainty remains after the first two review points, Topeka asks CMS Region 7 to weigh in on whether the tag should be cited at IJ level. She also noted that KDADS preference is that surveyors remain onsite until an IJ is abated, although that is not always possible.
- Monger and Zehr requested that the Agency stop imposing Denials of Payment for New Admissions (DPNA) when also issuing fines on Substandard Care F and above citations (as required by CMS as of September 1st.) Commissioner Thurness noted that the Agency is awaiting clarification from CMS about whether they have discretion on the DPNA in such instances.
