Missouri Long-Term Care Information Update

2025 Older Americans Month

Each May, the Administration for Community Living leads the celebration of Older Americans Month (OAM). The theme for OAM 2025 is Flip the Script on Aging, which focuses on transforming how society perceives, talks about, and approaches aging.

This May, the Department of Health and Senior Services (DHSS) invites everyone to explore the benefits of growing older. No matter the age, it is always possible to honor older adults’ contributions, explore the many opportunities to stay active and engaged as we age, and highlight opportunities for purpose, exploration, and connection that come with aging.

Likewise, DHSS encourages each of you to also take time to celebrate OAM this month. As you make plans to host an event in your local community or become aware of other community events, please share the event information with us so we may add and promote it on our DHSS website, Health.Mo.Gov/oam.

DHSS thanks you for your partnership. Please join us in celebrating OAM as well as recognizing older adults as strong and diverse resources in our local communities!

Supplemental Health Care Service “Staffing” Agencies Regulation

Any registered supplemental health care services agency that contracts with a health care facility participating in Medicare or Medicaid is required to submit quarterly reports to the department that contain the following information:

  • A detailed list of each health care facility participating in Medicare or Medicaid with whom the agency has contracted over the prior quarter;
  • A detailed list of the average “hourly” amount charged by the agency to the health care facility over the prior quarter, broken down by health care facility and each individual health care personnel category within each job classification (including but not limited to nursing, therapy, dietary/nutrition, lab, and radiology); and
  • A detailed list of the average “hourly” amount paid by the agency to health care personnel over the prior quarter, broken down by health care facility and each individual health care personnel category within each job classification, including but not limited to nursing, therapy, dietary/nutrition, lab, and radiology.

Pursuant to section 198.644, RSMo, the department is required to prepare an annual report of aggregate data received from the agencies without including information specific to any one agency. This report summarizes data received by the department in 2024, which was the first full year the department received reports.

The 2024 report can be found here: https://health.mo.gov/safety/shcsa/annual-report.html.

The Resident’s Voice Challenge

Creative writing and artistic expression are meaningful and compelling ways to highlight the importance of residents’ rights and how these rights can be carried out in all long-term care settings. The Resident’s Voice Challenge encourages residents to submit essays, poems, artwork, drawings, or videos related to the theme.

In celebration of Consumer Voice’s 50th Anniversary, we are creating a coffee table book featuring residents’ voices. We’re seeking creative artwork (posters, paintings, drawings) or written entries (essays, poems) of 50 words or less. Individuals whose entries are selected for inclusion in the book will receive a complimentary copy of the book.

Use these questions to inspire you:

  • What makes you feel empowered?
  • Why is it important to stand up for your rights? For quality care?
  • What contributes to your quality of life?
  • What is needed for quality care to be provided in a long-term care facility?
  • How can others (family, community members, etc.) support bringing about quality care and quality of life in long-term care facilities?

How to Submit

  1. Read the full Resident’s Voice Challenge Criteria before submitting.
  2. Email submissions to info@theconsumervoice.org by June 30, 2025.
    • Include a mailing address with your submission for residents to receive certificates of participation.

Submissions featuring photo or videos must include completed release forms for each resident.

Hot Water Temperatures

There has been some recent confusion regarding hot water temperatures in federally certified nursing facilities. CMS released an initial draft of the critical element pathway (CEP) for Accidents that showed shower temperatures should be at 100 degrees; however, that specificity was removed from the final draft of the CEP that went into effect in April 2025. CMS does not require specific water temperatures for showers. Facilities may allow for resident preference as long as temperatures are maintained at safe levels to prevent burns and within the state regulation (19 CSR 30-85.012(97)) parameters of 105 degrees and 120 degrees.

MDS Deadline Reminders

Payroll-Based Journal (PBJ) Submission Deadline Reminder

Nursing homes are required to electronically submit direct care staffing information to the Payroll-Based Journal (PBJ) system. Submissions must be received by the end of the 45th calendar day (11:59 PM Eastern Standard Time) after the last day in each fiscal quarter to be considered timely. PBJ data for 1/1/25 through 3/31/25 is due May 15, 2025. Please submit PBJ data as soon as possible to avoid delays.

 

SNF Quality Reporting Program (QRP) Submission Deadline Reminder

SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. The following data must be submitted no later than 11:59 p.m. on May 15, 2025:

  • MDS data for 10/1/24 through 12/31/24;
  • NHSN data for COVID-19 Vaccination Coverage Among Healthcare Personnel for 10/1/24 through 12/31/24;
  • NHSN data for Influenza Vaccination Coverage Among Healthcare Personnel for 10/1/24 through 3/31/25.

 

Swingtech sends informational messages to SNFs that are not meeting APU thresholds on a quarterly basis ahead of each submission deadlines. If you need to add or change the email addresses to which these messages are sent, please email QRPHelp@swingtech.com and be sure to include your facility name and CMS Certification Number (CCN) along with any requested email updates.

Long-Term Care 2024 Annual Facility Survey

This information is intended for Facility users of the Long-term Care Component (LTC) of NHSN.

Long-term care facilities (LTCF) participating in the Healthcare-Associated Infection (HAI) modules, including those tracking urinary tract infections, laboratory-identified events for C. difficile, multidrug-resistant organisms, and prevention process measures, are required to complete and submit the LTCF Annual Facility Survey in the NHSN application portal.

Although the deadline of March 1st has passed, facilities can still complete the survey to retain full access to all previous HAI data and functionality. While the Annual Facility Survey is not required for facilities only reporting in the Respiratory Pathogens and Vaccination (RPV) module, we highly encourage all LTCFs to complete it. Your participation helps to provide more tailored resources and support for the Long-Term Care community.

Here’s a summary of the key details to assist with completing and submitting the survey:

  • Accessing the Survey: You can find the survey under the “Action Items” section or by clicking the “Surveys” tab on the left navigation panel on the NHSN application home page.
  • Survey Period: The survey covers facility characteristics and practices from January 1, 2024, through December 31, 2024.

Submission Requirements:

  • Only one survey is required per facility, and it must be submitted by the designee with administrator rights.
  • The survey must be completed electronically and submitted within the NHSN application.
  • The survey must be completed in a single session as incomplete surveys cannot be saved.

Important Reminder: Surveys submitted via email will not be accepted.

Alert: Although completing the survey is not mandatory for facilities primarily reporting in the Respiratory Pathogens and Vaccination module, it is encouraged. Consequently, the Alert will remain visible on your dashboard.

Paper Form: A paper version of the survey (for data recording purposes only) and the table of instructions are available at the following links:

Important Note: We encourage users responsible for submitting the annual survey to review the form before accessing it within NHSN. You may need to consult with other members of your organization to complete certain questions.

Additionally, a guidance document on how to complete the annual survey can be found here on the NHSN webpage.

Please use NHSN-ServiceNow to submit questions to the NHSN Help Desk. The portal can be accessed here or through your CDC Secure Access Management Services (SAMS) account. After logging into SAMS, the NHSN-ServiceNow link is located at the bottom of the page.

Thank you for your continued commitment to improving care in long-term care settings.

Ombudsman Annual Report FFY24

The Missouri Office of the State Long-Term Care Ombudsman Program is pleased to present the FFY 2024 Annual Report. The Older Americans Act states the State Ombudsman Office shall independently develop, provide final approval of, and disseminate an annual report as set forth in section 712(h)(1) of the Act (42 U.S.C. 3058g(h)(1).

The annual report contains an analysis of Ombudsman program data, describes problems experience by long-term care residents, recommendations for improvements to quality of care and life, successes of the program and barriers that prevent optimal operation of the program.

Thank you for taking some time to review the annual report and learn more about the important role Ombudsman have in Missouri.

Annual Healthcare Personnel Influenza Vaccination Data Reporting for Long-Term Care Facilities – Due May 15, 2025

Facilities required to report annual healthcare personnel (HCP) influenza vaccination data through NHSN must do so by May 15, 2025 to meet CMS reporting requirements for the 2024-2025 influenza season.

Below is a summary of key information about this requirement.

Which facilities are required to report these data?

  • The Influenza Vaccination Coverage among HCP measure was finalized in the FY 2023 SNF PPS Final Rule which was published in the Federal Register on August 3, 2022. As a result, CMS-certified skilled nursing facilities (SNFs) are required to report annual HCP influenza vaccination summary data through the NHSN Healthcare Personnel Safety (HPS) Component.

What data are submitted?

  • The reporting period for the 2024-2025 influenza season is from October 1, 2024, through March 31, 2025. Facilities are only required to submit one report that covers the entire reporting period by May 15, 2025.

How should facilities submit these data?

  • Facilities must report annual HCP influenza vaccination summary data through the NHSN HPS Component. 

Who can activate the HPS Component?

  • Only the NHSN Facility Administrator (FA) can activate a new component. The FA can then add users including the HPS Component Primary Contact once the component is activated.
  • If the NHSN FA leaves the facility but does not transfer the role of FA to another individual prior to leaving, please complete the NHSN FA Change Request Form: https://www.cdc.gov/nhsn/facadmin/index.html.
  • Please do not deactivate any other NHSN Components, such as the LTCF Component.

How can LTCFs add the HPS Component?

Where can facilities access training materials?

Who do facilities contact with questions?

Please use NHSN-ServiceNow (accessed here) to submit questions to the NHSN Help Desk. Users will be authenticated using CDC’s Secure Access Management Services (SAMS), the same way you access NHSN. If you do not have a SAMS login or are unable to access ServiceNow, you can e-mail the NHSN Help Desk at nhsn@cdc.gov.

Thank you for your efforts with reporting annual HCP influenza vaccination summary data through NHSN.

Skilled Nursing Facilities: Report Expanded Ownership, Management, & Related Party Data

UPDATE: Skilled Nursing Facilities: Revalidation Deadline Extended to August 1

https://www.cms.gov/training-education/medicare-learning-network/newsletter/2025-04-17-mlnc#_Toc195616278

Enrolled skilled nursing facilities should collect data on ownership, managerial, and related party information and submit their revalidation. CMS extended the deadline to August 1, 2025. See the Become a Medicare Provider or Supplier webpage for more information.

CMS sent revalidation notices to enrolled skilled nursing facilities (SNFs) from October – December 2024 to collect data on ownership, managerial, and related party information. You must report this data on the revised Medicare Provider Enrollment Application Form (CMS-855A). Click here (PDF) for detailed information on the parties to be reported and here (PDF) for instructions on completing your application via PECOS. Please note that CMS will not be updating the online Medicare Revalidation List to include the SNF off-cycle revalidation schedule.

COMRU PASRR and Level of Care Orientation Training

The Central Office Medical Review Unit (COMRU) has scheduled monthly orientation training to review the requirements of the Pre-Admission and Resident Review (PASRR) and Nursing Facility Level of Care (LOC) application process. These on-line trainings will be one-hour in length and hosted by Ammanda Ott, RN Supervisor for COMRU. Each training is limited, so register soon!

Please see the registration link here for complete details and ongoing dates.

The Resident Advocate Newsletter – Spring 2025

The Spring 2025 issue of The Resident Advocate is now available. This newsletter provides information on residents’ rights and care issues; news and updates on national policy; and self-advocacy tips for obtaining person-centered, quality care.

This issue includes information on:

  • Nursing home residents right to language assistance
  • Tips for staying safe during outbreaks
  • How to join the Consumer Advisory Council, and
  • Participating in this year’s Residents’ Rights Month.

The Resident Advocate is a great resource to share with long-term care residents. Nursing home staff, long-term care Ombudsman programs, family members, and other advocates are encouraged to forward this newsletter to residents or print and share copies. Download this issue or past issues from the website.

2025 Enhanced Leadership Development Academy for LTC Leaders

Do you…..

❍ need a leadership course that addresses the unique challenges SNF leaders face?

❍ want to feel inspired and passionate about leading your SNF?

❍ want to connect with other SNF leaders and have access to free professional development, tools, and resources?

❍ want free CE credit without sacrificing quality and practical application?

❍ want to have the flexibility to learn at the pace and place the works best for you?

If you answer YES to any of these questions, this course may be for YOU!
Take the survey now to see if you qualify for FREE registration.

For more details, please visit the website.

Course ends: October 31, 2025

Resident Choice of Pharmacy

A reminder that residents may choose the pharmacy of their choice. State regulation that applies to all levels of care states:

19 CSR 30-88.010(40) Each resident shall be allowed the option of purchasing or renting goods or services not included in the per diem or monthly rate from a supplier of his or her own choice, provided the quality of goods or services meets the reasonable standards of the facility. Each resident shall be allowed the option of purchasing his or her medications from a pharmacy of his or her choice, provided the quality of the medications and packaging meets reasonable standards of the facility.

Direct Service Worker Panel – Join Today

The Division of Senior and Disability Services (DSDS) is seeking additional Direct Service Workers to join the existing panel. Last year we received valuable information from our panelist and are excited to continue the work through this year. We are seeking Direct Service Workers currently working in the role with experience and knowledge to share. If you know of someone who would be a great contribution to this panel, please send this application information for consideration. Click the image below to learn more and apply.

Any questions should be directed to the Bureau of Policy and Quality Enhancements at LTSS@health.mo.gov.

 

MDS Deadline Reminders

Payroll-Based Journal (PBJ) Submission Deadline Reminder

Nursing homes are required to electronically submit direct care staffing information to the Payroll-Based Journal (PBJ) system. Submissions must be received by the end of the 45th calendar day (11:59 PM Eastern Standard Time) after the last day in each fiscal quarter to be considered timely. PBJ data for 10/1/24 through 12/31/24 is due February 14, 2025. Please submit PBJ data as soon as possible to avoid delays.

 

SNF Quality Reporting Program (QRP) Submission Deadline Reminder

SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. The following data must be submitted no later than 11:59 p.m. on February 18, 2025:

  • MDS data for 7/1/24 through 9/30/24.
  • NHSN data for COVID-19 Vaccination Coverage Among Healthcare Personnel for 7/1/24 through 9/30/24.

 

Swingtech sends informational messages to SNFs that are not meeting APU thresholds on a quarterly basis ahead of each submission deadlines. If you need to add or change the email addresses to which these messages are sent, please email QRPHelp@swingtech.com and be sure to include your facility name and CMS Certification Number (CCN) along with any requested email updates.

Center of Excellence – Behavioral Health Action Network 2025 Series Opportunities

FREE THREE-PART VIRTUAL SERIES

All staff in CMS-certified nursing facilities across the U.S. are invited to join this three-part learning series to enhance skills in person-centered care, engaging with residents, and de-escalation with expert guidance and peer support.

More information including topics and specific dates for each can be found here.