My memory's not as sharp as it used to be. Also, my memory's not as sharp as it used to be. And in clsoing I would like to say my memory is not as sharp as it use to be.

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November 30, 2010
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Transition and Appointments in Kansas Agencies

• Interim Secretary of KDHE
• Acting Secretary John Mitchell

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Bureau of Child Care Health Facilities

• Consists of three primary sections with
  director(s) for each
• Child Care (Corrie Edwards Rachel Berroth)
• Health Occupations Credentialing (Marla Rhoden)
• Health Facilities (Charles Moore)

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Our Bureau Chief is Joseph Kroll
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BCCHF Org. Chart
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We are just one of many Bureaus.
This is us! So you see, we are just one part of
a very large system .
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and still there is more!
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Child Care consist of 2 sections

• CHILD CARE
• The Department administers the licensing law as a
  preventive program to assure that out-of-home
  care for children and maternity patients will not
  be exploitive, unsafe, or unhealthy.

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(Child Care continued)

• The main purpose of the law is to protect the
  health, safety, and welfare of children receiving
  care away from their parents and home. It is also
  a consumer protection law assuring parents that
  the care they are paying for meets minimum
  standards of good care.

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Registration or Licensure (depending on the
number of children in care) is required
regardless of the motivation for providing care,
and whether or not there is advertisement of or
payment for services. The essential fact is that
a child or children receive care away from their
own homes.
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Foster Care

• The State Department of Health and Environment
  does not place children in residential care.
  Children are placed by parents or guardian, by a
  public agency such as a social and rehabilitation
  services, or by a private child placing agency
  licensed to perform a placement service.

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Various kinds of homes are

• Family Foster Home
• Twenty-four hour family care for one to four
  children between the ages of infancy to 16 years
  of age.

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Group Boarding Home Twenty-four hour
non-secure care for five to ten children between
the ages of infancy to 16 years of age.

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Residential Center Twenty-four hour non-secure
care for over ten children between the ages of
infancy to 16 years of age.
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Attendant Care Facility Non-secure care not
to exceed 24 hours excluding weekends and
holidays for juveniles taken into custody.
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Detention Center A secure public or private
facility which is used for the lawful custody of
accused or adjudicated juvenile offenders under
16 years of age pending court disposition.
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Secure Care Center A secure youth
residential facility, other than a juvenile
detention facility, used to provide care and
treatment for alleged or adjudicated children in
need of care pursuant to the Kansas code for the
care of children.
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Secure Residential Treatment Facility A secure
facility operated or structured to provide a
therapeutic residential care alternative to
psychiatric hospitalization for five or more
youth with a diagnosis of severe emotional,
behavioral, or psychiatric condition."Treatment"
means comprehensive, individualized,
goal-directed, therapeutic services provided to
youth.
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Special Categories of Service Requiring a License

• Child Placing Agency
• Maternity Care
• Maternity Center or Hospital

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Health Occupations Credentialing

• Kansas law recognizes over 30 health occupational
  groups for which licensing, registration, or
  certification is provided. There are 11
  regulatory bodies that issue credentials to those
  professions. Health Occupations Credentialing
  (HOC) issues licenses to dietitians,
  speech-language pathologists, audiologists, and
  adult care home administrators.

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Health Occupations Credentialing (continued)

• Certification programs administered by HOC
  include nurse aides, home health aides, and
  medication aides. Other related professions or
  para-professions administered through this
  section include operators of assisted living
  facilities or residential care facilities,
  activities directors, and social service
  designees for adult care homes (ACH) in Kansas.
  (ACHs are regulated by the Kansas Department on
  Aging)

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Also administered by HOC and related to the aide
certification program is the Kansas Nurse Aide
Registry, which is federally mandated to assure
that only qualified individuals with no findings
of abuse, neglect or exploitation on their
records are employed to provide direct care
services to residents of adult care facilities.
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Health Facilities consist of both medical
facilities and non-long term care entities.
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Health Facilities staff

• Our section employs 10 RNs that work as health
  facility survey staff that tour the various
  facilities we regulate to assure they are meeting
  the licensing and/or certification for Medicare.
  
• We also have one State Survey Manager and an
  assistant, Risk Management Specialist, 2 Sr.
  Admin Assistants, a Certification Specialists

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The health facilities gang.
Our section regulates approximately 850 entities.
The list of what we regulate follows.
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We regulate/license or certify for Medicare

• Medical Facilities
• (KSA 65-425)
•  
• General Hospitals State Licensed
• Critical Access Hospitals (CAH) State Licensed
• Special HospitalsState Licensed
• Ambulatory Surgery Centers (ASC) State Licensed

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We regulate/license or certify for Medicare

• Non-Long Term Care Entities
• Home Health Agencies (HHA) State Licensed
• Hospice
• End Stage Renal Dialysis Centers (ESRD)
• Rural Health Clinics (RHC)
• Outpatient Physical Therapy (OPPT)
• Mobile X-Ray
• Comprehensive Outpatient Rehabilitation
  Facilities (CORF)
• These are Medicare Certified only. There is no
  state licensing.
•  

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The web site for Child Care and Health Facilities
is
Found at www.kdheks.gov at the Health tab.
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For Health Occupations
Found at www.kdheks.gov/hoc
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What is it?
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Bedbugs Found in Hospital

• A hospital is one of the most recent victims of a
  bedbug infestation that has hit a nursing home,
  assisted living care facility and an elementary
  school, among other facilities, in central Maine.
  

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(continued)

• A hospital is one of the most recent victims of a
  bedbug.
• Bedbug infestations are on the rise nationally.
  The tiny insects, which feed on human blood while
  people are sleeping, are most commonly found in
  hotels and people's homes, but have also made
  their way to retail stores, movie theaters and
  healthcare facilities.
• Infestations have nothing to do with cleanliness,
  and the bugs do not carry or spread diseases.
  However, they are very difficult and expensive to
  eradicate once they've established a presence. ,
  assisted living care facility and an elementary
  school, among other facilities, in central Maine.

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Emergency Response TimeInformationRef
SC-07-27July 13, 2007
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42 CFR 485.16(a) of the CAH emergency services
Conditions of Participation (CoP) require a CAH
to have emergency services available 24 hours a
day, while 485.618(d) sets standards for
emergency services personnel, including response
times for personnel to be available on site.
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On November 24, 2006 CMS published a final rule
(71 FR 68159) amending the CAH CoPs at 42 CFR
485.618(d). The revised final rule allows an RN
with training and experience in emergency care to
conduct some medical screening examinations
(MSE).
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This is permitted only if the RN is on site
and immediately available when an individual
comes to the CAHs emergency department and
requests examination or treatment the RN has
training and experience in emergency care and
the nature of the request for medical care
is within the scope of practice of an RN and
consistent with applicable State laws and the
CAHs bylaws or rules and regulations.
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When must the physician be called ?(When does
the clock start running i.e. the 30 minutes or
60 minutes in frontier areas.)

• When there is no Qualified Medical Person (QMP)
  on site to complete the MSE
• when it is beyond the scope and practice of the
  RN present or
• once the QMP is able to determine the
  severity/scope of the emergent situation and
  calls the physician.

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What are our surveyors looking for in their
investigation

• Determine whether or not the CAH uses RNs to
  conduct medical screening examinations (MSEs) of
  individuals coming to the CAHs emergency
  department.
• Surveyors are to confirm that the CAHs bylaws or
  rules and regulations provide for RNs to
  screening examinations within their scope of
  practice, consistent with State law, and that the
  RNs performing such examinations have documented
  training and experience in emergency care.

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(continued)

• Surveyor must review at least one medical record
  of an emergency department patient whose
  screening examination was conducted by an RN, to
  confirm that the examination was within the scope
  of practice permitted by an RN, consistent with
  State law and the CAHs bylaws or rules and
  regulations.

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We can meet your information needs with one stop
shopping at.
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If there is anything you have questions that you
do not believe are being responded to
appropriately, please feel free to call Charles
Moore. The letter of introduction you should be
receiving on each and every survey gives my phone
number and e-mail address.

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Needing more information?

• Contact
• Charles Moore, Director Medical ServicesBureau
  of Child Care Health Facilities1000 SW
  Jackson, Suite 200Topeka, KS 66612e-mail
  cmoore_at_kdhe.state.ks.usDesk Phone [phone]F
  AX 785-291-3419

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Other contacts in our BureauAnita Hodge RN,
State Survey Manager 296-0127Lynn Searles RN,
Risk Mgmt Specialist 291-3552Tamara Wilkerson,
Licensure Certi. 296-1263 Lois Wilkins,
Sr. Admin Assist-Licensure 296-1258Theresa
Carter, Sr. Admin Assist-Cert. 296-1249(all
are Area code 785)
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Web site for Critical Access Hospital (CAH)
Federal Regulations and
Guidelines Appendix Whttp//www.kdheks.gov/bc
chf/index.htmlClick on Bureau of Health
Facilities and then forms to get to the above.
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Thought for the dayThe only real mistake is
the one from which we learn nothing
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Questions?
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(No Transcript)