From our recent meeting with DQA – Important things to know

As previously reported, WHCA/WiCAL staff meets quarterly with Division of Quality Assurance (DQA) leadership to discuss questions from stakeholders and observations from the Department. These meetings have been very helpful to hear what the Department is seeing and to address issues raised by providers. Last week we heard important feedback from DQA on Self-Reports, Director of Nursing/Administrator Turnover, and Facility Initiated Discharges.

Providers are seeing more surveyor visits following Self-Reports:

• DQA indicated each self report is reviewed and surveyors may be sent out, most are sent out due to missing information.
• What you can do to provide adequate information?
  • Perform staff and resident interviews – provide summary statement in self-report, helps provide scope of the issue.
  • If there is suspicion of a crime, provide police report.
  • In instance of neglect or abuse, provide information on what you did ie. education of staff; removal of staff; transition of 1-1 for resident.
  • A note that in some cases, DHS has 3 days to complete the investigation following the initial report, while the facility has 5 days to complete their report, so visit will occur before you submitted additional information.

Director of Nursing (DON) and Administrator Turnover 2024 YTD:

• 558 DON changes
• 549 Administrator Changes

Importantly these changes include individuals who went on leave and returned, and do not reflect a 100% accurate depiction of the turnover in these critical roles. That said, 2023 turnover numbers were in the 300’s, so 2024 marks a significant increase.

The Department recommended working with Association members to facilitate an exit interview best practice, so that as an organization we can better understand if these turnover numbers are a result of individuals leaving the long-term care field, or if these are transitions to other organizations in our community.

Facility Initiated Discharges:

Recently a number of providers have received rejections of facility initiated discharges. We asked what level of detail the Department expects on the location that they are being discharged to. The State Operations Manual (SOM) requires the name or description of the facility accepting the resident. DQA as well as the Board on Aging and Long Term Care Ombudsmen agree that a description satisfies this requirement. Meaning that if the resident will need to be discharged to a Skilled Nursing Facility, that description is sufficient. Additionally, you would not need to file a 2^nd 30 day notice unless the placement type is different than described in the initial notice. For example, the notice indicated discharge to a skilled nursing facility but since the initial notice it is determined that an assisted living facility would be a more appropriate placement.

The BOALTC Ombudsmen recommended a conference with the resident and stakeholders as soon as it seems that a discharge may need to be made. The 30 day discharge should not be the first notice to the resident in order to ensure a smooth transition.

We hope that this information is helpful to you.

Questions or comments?  Please contact Eric Koch, ekoch@whca.wical.org or Rick Abrams, rick@whcawical.org.