New Yrk State Department f Health Divisin f ACF/Assisted Living Surveillance New Administratr/EHP Prgram Crdinatr and/r Operatr Checklist and Infrmatinal Guide As a new Administratr/EHP Prgram Crdinatr and/r Operatr f an Adult Care Facility (ACF) in New Yrk State, there are specific requirements that each Administratr/EHP Prgram Crdinatr and/r Operatr is respnsible fr. Belw is a list f items fr yur reference. This list is nt all inclusive. Please review the list t ensure all items have been cmpleted. If yu have any questins, please cntact yur Reginal Office. Yur facility is required t adhere t all applicable laws and regulatins. 18 NYCRR Part 487 (Adult Hme); 18 NYCRR Part 488 (Enriched Husing Prgram); and 18 NYCRR Part 494 (Assisted Living Prgram). 10 NYCRR Part 1001 (Assisted Living Residence; Enhanced Assisted Living Residence; Special Needs Assisted Living Residence). Department f Health Website: http://www.health.ny.gv Health Cmmerce System (HCS) Obtain an HCS Accunt Ppulate required HCS Cmmunicatins Directry rles Lcate and review all Dear Administratr Letters Review and have knwledge f cmmnly used HCS applicatins Statewide Financial System (SFS) Identify r btain facility s SFS accunt number ACF/Assisted Living Surveillance Mandated Frms Frms btained, shared, and in-service scheduled Emergency Preparedness Disaster and Emergency Respnse Plan reviewed and revised, as needed Cmplete Evacuatin f Facilities in Disasters System (efinds) training Lcate efinds equipment Applicatin fr a Class 3a License New Operatr(s) Only Upn receipt f yur apprval fr a change f peratr, wner, r name change the applicant must ntify and apply fr a new Class 3A licensure thrugh the Bureau f Narctic Enfrcement (BNE). Fr mre infrmatin, please cntact BNE at (866) 811-7957 r narctic@health.ny.gv Residency/Admissin Agreements New Facility: Admissin/Residency Agreements, as apprved by the Department during the licensure prcess, are executed upn admissin f any new resident. Change f Operatr: Admissin/Residency Agreements, as apprved by the Department during the licensure prcess, are executed immediately upn ntice the Change f Operatr has been apprved. Dev. 04/2017 Page 1 f 5
Health Cmmerce System (HCS) Lcatin: https://cmmerce.health.state.ny.us/public/hcs_lgin.html The Health Cmmerce System is a highly secure, internet based, electrnic prtal, extensively used fr cmmunicatins and critical data/infrmatin sharing. Adult Care Facility (ACF) peratrs must btain Health Cmmerce System accunts and access these accunts regularly, and are recmmended t d s at least daily. In additin, peratrs must ensure that there are sufficient and knwledgeable staff designated as HCS users, and that staff are assigned t the varius HCS Cmmunicatins Directry rles, t receive infrmatin and ensure rapid respnse t requests fr infrmatin by the State and/r lcal Department f Health. Each facility must establish and maintain an HCS Directr accunt. This individual has the right t bligate the rganizatin t uphld the requirements f HCS use. Yu must request this HCS Directr accunt by cntacting the Department f Health at (518) 408-1133. The fllwing HCS Cmmunicatins Directry rles are required t be ppulated within the HCS by at least ne persn fr each facility: Operatr Administratr HPN Crdinatr * Financial Submitter Emergency Respnse Crdinatr efinds Reprting Administratr Criminal Histry Recrd Check Authrized Persn (CHRC AP) ** 24 by 7 Facility Cntact * Yu must request an HPN Crdinatr accunt by cntacting the Department f Health at (518) 408-1133. This request will generate dcumentatin which must be cmpleted, ntarized, and mailed back t the Department s Cmmerce Accunt Management Unit (CAMU). As sn as the facility has at least ne HPN Crdinatr designated, that Crdinatr can then place ther users within the rganizatin int the required rles identified abve and thers listed in the Health Cmmerce System. ** Yu must request this Criminal Histry Recrd Authrized Persn (CHRC AP) rle accunt by cntacting the Department f Health at (518) 402-5549. Facilities are als required t ensure that up-t-date r current emergency cntact infrmatin is available t the Department thrugh the HCS. Crdinatrs can use the Crdinatr s Update Tl t update the cntact/emergency infrmatin fr their rganizatinal ffices, e.g. 24 by 7 Facility Cntact, and fr individual users. Nte that all infrmatin entered using the Crdinatr s Update Tl must be validated every 90 days. Dear Administratr Letters (DAL s) Lcatin: Health Cmmerce System My Cntent Dcuments by Grup Lng Term Care Dear Administratr Letters (select the year yu wish t review) ACF The psting f Dear Administratr Letters (DAL s) n the Health Cmmerce System is the primary methd f cmmunicatin frm the Department f Health t Adult Care Facilities. Users are strngly encuraged t review this sectin f the Health Cmmerce System at least nce a week t view any new items. Dev. 04/2017 Page 2 f 5
Health Cmmerce System (HCS) Applicatins Lcatin: Health Cmmerce System My Cntent All Applicatins All Applicatins displays a list f applicatins available fr immediate access. Click n the applicatin name t pen the applicatin. Click n the crrespnding applicatin prfile (infrmatin icn) t view the applicatin descriptin, hw t get access, wh t cntact fr assistance, tutrials, r demnstratins. Yu may add applicatins t yur list f My Applicatins n yur hme page. Applicatins available t yu are indicated with add and remve icns. Click the green plus icn t add applicatins t yur list r the red minus buttn t remve applicatins frm yur list. Electrnic Plan f Crrectin (epoc) Lcatin: Health Cmmerce System My Cntent All Applicatins E Electrnic Plan f Crrectin Electrnic Plan f Crrectin (epoc) is an applicatin within the Health Cmmerce System that autmates the distributin f Statements f Deficiency (SODs) and the receipt f Plans f Crrectin (POCs). Prvider access t the applicatin will be gverned by HCS rles: Administratr rle: may read SODs/POCs, edit, save, and submit POCs; POC Editr rle: may read SODs/POCs, edit and save POCs; and Operatr rle: may read SODs/POCs It is strngly suggested DAL 15-09 be reviewed as it cntains a webinar intrducing this applicatin. Evacuatin f Facilities in Disaster Systems (efinds) Lcatin: Health Cmmerce System My Cntent All Applicatins E Evacuatin f Facilities in Disasters Systems All facilities must access and becme prficient in the efinds applicatin. This applicatin is used during evacuatin preparatin t track the residents when they leave the facility, when they arrive at a new lcatin, and repatriatin t their riginal lcatin. The infrmatin is electrnically sent t the Department t assist in emergency activities and versight. Infrmatin abut available webinar and in persn training fr efinds is available n the NYSDOH Learning Management System (LMS) at: https://www.nylearnsph.cm/public/default.aspx, by searching fr efinds r RTC-eFINDS. All facilities will receive an efinds scanner and resident wristbands printed with a bar cde fr scanning. This barcde incrprates yur facility s perating certificate number, and the name f yur facility is als printed n the wristband. Lcate the efinds scanner and wristbands that were sent t yur facility, and if necessary due t change f peratr r facility name, btain updated wristbands by cntacting efinds@health.ny.gv. Fr infrmatin n hw t replace a lst r damaged scanner, please cntact the NYSDOH at efinds@health.ny.gv. Emergency Preparedness Facilities are required t have an Emergency and Disaster Respnse Plan. Operatrs must ensure that the Plan is current, and that staff are trained in its use. Lcate DAL 15-13 Evacuatin Planning n HCS, and use this guidance and the regulatins when reviewing and updating the Emergency and Disaster Plan. Dev. 04/2017 Page 3 f 5
Statewide Financial System (SFS) Number Lcatin: http://www.sfs.ny.gv The Statewide Financial System (SFS) is the New Yrk State gvernment s accunting and financial management system. Operatrs must ensure that they have an established and up-t-date SFS accunt. Any questins r requests fr an SFS accunt shuld be directed t the SFS Help Desk at (855) 233-8363. ACF/Assisted Living Surveillance Mandated Frms Lcatin: http://www.health.ny.gv/facilities/adult_care/frms.htm The Department mandates utilizatin f the fllwing frms: ACF Persnal Data Sheet (DSS-2949) ACF Medical Evaluatin (DSS-3122) Incident Reprt (DOH-5175/DSS-3123) Statement f Offering Persnal Allwance Accunt (DOH-5195/DSS-2853) Persnal Allwance Ledger (DOH-5193/DSS-2854) Persnal Allwance Summary (DOH-5196/DSS-2855) Daily Resident Census Reprt (DOH-5176/DSS-2900) Chrnlgical Admissin and Discharge Register (DOH-5177/DSS-3026) Inventry f Resident s Prperty (DOH-5194/DSS-3027) Statement f Administratr Qualificatins (DSS-3233) Ntice f Change Enriched Husing Apartment Certificatin (DOH-5192/DSS-934) ALR Medical Evaluatin (DOH-3122) ALR Resident Persnal Data (DOH-4397A) ALR Resident Evaluatin (DOH-4397B) ALP Medical Evaluatin (DSS-4449C) ALP Medical Evaluatin Interim (DSS-4568) ALP Interim Assessment (DSS-4569) UAS-NY ALP Nursing Functinal/Scial Assessment (DSS-4449D) (when nt using UAS-NY) Reprtable Incidents t the Department The Department mandates the fllwing incidents be reprted t yur Reginal Office n the DOH-5175/DSS- 3123 Incident Reprt: Resident whereabuts were unknwn fr mre than 24 hurs; Resident assaults r injures, r is assaulted r injured by anther resident, staff, r thers; Resident attempted r cmmitted suicide; Cmplaint r evidence f resident abuse; Resident Death; A felny crime may have been cmmitted by r against a resident; Resident behaved in a manner that directly impaired the well-being, care, r safety f the resident r any ther resident, r which substantially interferes with the rderly peratin f the facility; r Resident was invlved in an accident n r ff the facility grunds which resulted in such resident requiring medical care, medical attentin, r services. Yur facility may be subject t additinal reprting requirements t the New Yrk State Justice Center fr the Prtectin f Peple with Special Needs r anther entity. Please refer t Statute and regulatins fr additinal reprting requirements. Dev. 04/2017 Page 4 f 5
Cntact Infrmatin Central Office New Yrk State Department f Health 875 Central Avenue Albany, New Yrk 12206 Telephne: (518) 408-1133 Prgram and Plicy Telephne: (518) 408-1624 Licensure and Certificatin Capital District Reginal Office New Yrk State Department f Health 875 Central Avenue Albany, New Yrk 12206 Telephne: (518) 408-5287 Central New Yrk Reginal Office New Yrk State Department f Health 217 Suth Salina Street, 4 th Flr Syracuse, New Yrk 13202 Telephne: (315) 477-8472 Metrplitan Area Reginal Office New Yrk City New Yrk State Department f Health 90 Church Street, 15 th Flr New Yrk, New Yrk 10007 Telephne: (212) 417-4440 Metrplitan Area Reginal Office Lng Island New Yrk State Department f Health 320 Carletn Avenue, Suite 5000 Central Islip, New Yrk 11722 Telephne: (631) 851-3098 Western Reginal Office New Yrk State Department f Health 335 East Main Street, 1 st Flr Rchester, New Yrk 14604 Telephne: (585) 423-8185 Adult Care Facility Cmplaint Htline Number: (866) 893-6772 Vulnerable Persns Central Register: (855) 373-2122 Public Health Duty Officer (evening/weekends): (866) 881-2809 Dev. 04/2017 Page 5 f 5