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Home Care Matters

Stay up-to-date with the latest updates and reminders from the Home Care and Assisted Living Program. Topics include license renewal, correction orders, and prevention of multidrug-resistant organisms.

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Home Care Matters

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  1. Home Care Matters Home Care and Assisted Living Program November 28, 2018

  2. Agenda

  3. Home Care and Assisted Living Program (HCALP) Staff • Jonathan Hill, Survey Supervisor • Lari Anne Mazzitello, Operations Coordinator • Neng Vang, Licensing Specialist • Cindy Vargas, Organizational Coordinator • Collaborative Healthcare Association Infection Network (CHAIN) • Sean O’Malley, Epidemiologist • Healthcare-Associated Infections and Antimicrobial Resistance Unit Welcome

  4. Housekeeping Lari Anne Mazzitello

  5. title Optional Tagline Goes Here | mn.gov/websiteurl

  6. Image of website

  7. Image of website continued Optional Tagline Goes Here | mn.gov/websiteurl

  8. General Updates Cindy Vargas

  9. Communication When Contacting Us • Emailing scanned documents is better than faxing • When leaving voicemail messages, speak slowly and include your • HFID • Name • Agency name • Telephone number

  10. Reminder for Temporary Licensees Home care law requires that temporary licensees • Notify the Department of Health when you get your first client • Within five days of starting services By notifying MDH • You are complying with the law • We can put you on the survey schedule • We can determine if we can grant you a license

  11. License Renewal Fees License fees increased by 10% in July 2018. Use the Revenue Worksheet to calculate revenue from licensed home care services.

  12. Fines for uncorrected orders Invoices for fines are now issued by Financial Management at MDH. Send your payments of fines to the address on the invoice. Interest charges will accrue if not paid in 30 days. Past due fines are sent to the Minnesota Department of Revenue for collection.

  13. New Survey Forms Coming Soon! • New forms are being piloted by HCALP surveyors now. • Forms were designed to help • Surveyors be more efficient • Providers conduct self-audits • Watch for them in early January 2019! • We will notify providers via Home Care Updates.

  14. Licensing Neng Vang

  15. License Renewal Reminders: Time Submit early • At least 60 days before expiration of license

  16. License Renewal Reminders: Revenue $289592 Revenue • Do notuse decimals • Round to nearest dollar • Do not use commas Include revenue from licensed home care services • Home Care Revenue Worksheet

  17. License Renewal Reminders: Payment Pay by e-check • Convenient • No fee • Faster to process • More secure If you send a check include • Copy of confirmation page • HFID # on check

  18. License Renewal Reminders: Application To ensure your license renewal is not delayed • Complete all required fields • Be accurate and thorough You only need to return the confirmation page if • Paying by check • Mailing your certificate of insurance • Your agency is Medicare certified (HHA)

  19. License Renewal Responsibilities Licensees • Renew at least 30 days before current license expires • It is illegal to operate without a license MDH will • Notify licensee if application appears complete OR • Inform licensee if items are missing • Process renewal applications within 60 days of receiving complete application

  20. Survey Jonathan Hill

  21. Correction Orders • Top 5 Correction Orders • Common Home Care Correction Orders (http://www.health.state.mn.us/divs/fpc/homecare/providers/commonviolations.html) • Comprehensive • Basic • Quality Management • Minn Stat 144A.479 Subd. 3

  22. Home Care Matters Statewide CallNovember 28, 2018 Sean O’Malley, Epidemiologist Healthcare-Associated Infections & Antimicrobial Resistance Unit sean.omalley@state.mn.us

  23. Objectives • Overview of multidrug-resistant organisms (MDROs) • Overview of carbapenem-resistant Enterobacteriaceae (CRE) • What is CRE? What is carbapenemase-producing CRE (CP-CRE)? • What can we do to prevent spread of MDROs, specifically CRE? • Risk factors for colonization and infection • Prevention efforts • Coordinated approach • Resources

  24. Overview of Multidrug-Resistant Organisms Overview of Multidrug-Resistant Organisms

  25. How do bacteria develop resistance?

  26. CDC Hazard Levels

  27. Overview of Carbapenem-Resistant Enterobacteriaceae Overview of Carbapenem-ResistantEnterobacteriaceae

  28. The Enterobacteriaceae • Family of over 70 species of bacteria • Most common: Klebsiella spp., Escherichia coli, Enterobacter spp. • Enteric organisms • Common cause of healthcare-associated infections • Urinary tract infections • Bacteremia • Pneumonia • Wound infections • Carbapenem antibiotics (e.g., meropenem)

  29. Carbapenem-Resistant Enterobacteriaceae (CRE) • Infections associated with high mortality rates • Prolonged colonization • Difficult to treat • Pan-resistant strains • New antibiotic development is slow • Resistance can spread

  30. Carbapenemase-Producing CRE (CP-CRE) • Carbapenemase: enzyme that breaks down carbapenems and other antibiotics • CP-CRE: CRE that carry genes for carbapenemase production • Can spread the genes to other bacteria, making them resistant • Can cause major outbreaks in health care facilities Susceptible Bacteria KPC Containing Bacteria XX XX XX Resistance Gene Transfer New KPC Containing Bacteria

  31. CP-CRE Cases by Patient Location, 2013-2017

  32. MDRO – CRE – CP-CRE

  33. What can we do to prevent spread of MDROs, specifically CRE? What can we do to prevent spread of MDROs, specifically CRE?

  34. Understand Risk Factors • Indwelling devices • E.g. ventilator, urinary catheter, central venous catheter, gastronomy tube • Immunocompromised status • Surgical procedures • Wound management • Prolonged antibiotic exposure

  35. Practice Prevention • Perform evidence-based infection control practices • Wash hands frequently especially before/after handling indwelling devices, after contact with wounds, and after exposure to blood and bodily fluids • Communicate with healthcare facilities about transfer of patients with MDROs, particularly CRE • When possible, dedicate specific equipment to patients colonized or infected with MDROs • Ask questions! • Sean O’Malley: sean.omalley@state.mn.us • Infectious Disease Epidemiology, Prevention and Control Main Line: (651) 201-5414

  36. Implement Coordinated Approach

  37. Resources MDH Resources: Antimicrobial Resistance and Stewardship (http://www.health.state.mn.us/divs/idepc/dtopics/antibioticresistance/index.html) Infection Prevention and Control Resources (http://www.health.state.mn.us/divs/idepc/dtopics/icar/res/icf.html) CDC Resources: Antibiotic/Antimicrobial Resistance (https://www.cdc.gov/drugresistance) Carbapenem-resistant Enterobacteriaceae in Healthcare Settings (https://www.cdc.gov/HAI/organisms/cre/index.html) Multidrug-resistant organisms (MDRO) Management (https://www.cdc.gov/infectioncontrol/guidelines/mdro/index.html) CRE Toolkit: Facility Guidance for Control of Carbapenem-resistant Enterobacteriaceae (https://www.cdc.gov/hai/organisms/cre/cre-toolkit/index.html)

  38. Thank you! Questions? Sean O’Malley sean.omalley@state.mn.us 651-201-5414 (Main Line)

  39. Q & A Time Home Care and Assisted Living Team

  40. Mark Your Calendars Next Home Care Matters Call Wednesday, February 20, 2019 10:00 – 11:30 am

  41. Thank you for participating in Home Care Matters!

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