Sponsored by the Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation

There is no cost to attend any of these meetings. Please see the flyer.

September 4, 2024: Region 2
Location: Drury Plaza Hotel & Convention Center, Cape Girardeau

September 5, 2024: Region 7
Location: Crowne Plaza St. Louis Airport, Bridgeton

September 18, 2024: Region 1
Location: Oasis Hotel & Convention Center, Springfield

September 24, 2024: Region 6
Location: Special Olympics Missouri, Jefferson City

September 26, 2024: Region 5
Location: Moberly Municipal Auditorium, Moberly

October 1, 2024: Region 4
Location: Stoney Creek Hotel, St. Joseph

October 2, 2024: Region 3
Location: Adams Pointe Conference Center, Blue Springs

We are currently testing enhancements to the COMRU online submission system which will result in some newer applications being reviewed ahead of older applications. These enhancements are aimed at reducing the number of returned applications for corrections, resulting in faster processing times. Please do not reach out to COMRU staff if you have a newer application reviewed and have older applications that have not been reviewed – this will only slow down processing times.

Some of the enhancements made to the system include:

  • The “Submit” button will be removed from the online application once COMRU has done a preliminary review to determine if the application is a Level 1 or Level 2.
  • On the Level 1 form, Section D, if one of the diagnoses are marked, an error message will populate if the question is not answered YES.
  • A reminder message will populate if the application has a point count under the mandated 18-point requirement for SNF placement.
  • On the Level of Care form, Section D, the comment area below the “Treatment” section will be required to be answered if 6 points is indicated.

In order to assist COMRU with decreasing the amount of time to process submitted applications, please review the online training posted on the COMRU webpage https://health.mo.gov/seniors/nursinghomes/pasrr.php.

In 2023, 34 Missourians died due to heat-related illnesses. Heat is the number one cause of weather-related deaths in the United States.

The Missouri Department of Health and Senior Services (DHSS) urges Missourians to take precautions as heat and humidity rise to dangerous levels. In 2023, 34 Missouri residents, ranging in age from 11 months to 96 years, died due to heat-related illness.

“Heat and humidity can place a lot of stress on the body,” said DHSS Director Paula F. Nickelson. “Heat exhaustion can come on suddenly, with little warning, and lead to heatstroke which becomes a very dangerous situation.”

This early wave of extended extreme heat may not have given Missourians the time to adjust to higher temperatures. This is especially true for some groups like pregnant women, very young children or older adults.

During excessive heat, Nickelson urges Missourians to check on friends and neighbors, especially those who are elderly and chronically ill. To report a senior citizen or an adult with disabilities who is in need of assistance due to the heat, call the state’s toll-free abuse and neglect hotline at 1-800-392-0210, or make a report online.

People who are working or exercising outside in the heat or have certain chronic health conditions such as heart disease, lung disease or diabetes may need to take extra care in the heat. Medications, as well as those with substance use disorder, can impair a body’s response to heat, making one more vulnerable to the heat. Additionally, those experiencing homelessness are at a greater risk of experiencing heat-related illness.

Never leave a child or pet alone in a vehicle. Even on a cooler day, the temperature inside a vehicle can rise by 20 degrees in 10 minutes and is life threating to anyone left inside.

Heat-related illness can affect anyone. Take steps to stay cool in the hottest hours of the day:

  • Prepare your home—Use air conditioning and change air conditioner filters; cover windows that receive morning or afternoon sun with drapes or shades.
  • Stay indoors—Stay in air-conditioned places as much as possible. At home, take a cool bath or shower, use stoves and ovens less often, and keep window blinds and curtains closed to help maintain cooler temperatures. During prolonged periods of high temperatures, use air conditioning – either at home or by seeking shelter in a local cooling center. Don’t rely on fans to keep you cool. Fans are generally okay for providing comfort in temperatures less than 90° F. But at temperatures over 90° F, a fan can make body temperature rise.
  • Schedule activities carefully—Plan outdoor activities for morning or evening hours when the temperatures are cooler.
  • Wear appropriate clothing—Do not over-dress. Good choices are lightweight, light-colored, loose-fitting clothing.
  • Pace yourself—Reduce exercise or physical activity as much as possible during the hottest part of the day and take frequent breaks in the shade or in an air-conditioned place.

Take steps to stay hydrated:

  • Drink plenty of fluids—Take a drink break every 20-30 minutes regardless of your activity level, and do not wait until you are thirsty. Water or hydrating sports drinks are best. Avoid sugary, caffeinated and alcoholic beverages, which actually cause you to lose body fluids.
  • Wear sunscreen—Sunburn affects your body’s ability to cool down and can cause you to become dehydrated.

Take steps to stay informed:

  • Check on friends and neighbors—Especially older adults and individuals with a disability or chronic health conditions, as heat is more likely to affect their health. If you find an emergency situation – call 911. In a non-emergency situation, if a senior or disabled adult is suspected of being in need of assistance due to warm weather, make a call. Make a difference. Call the toll-free Missouri Adult Abuse and Neglect Hotline at 1-800-392-0210
  • Know the signs and symptoms of heat-related illnessWhat to do matters, depending on type of illness occurring. Signs of heat exhaustion may include heavy sweating; cold, pale and clammy skin; dizziness; headache; muscle cramps; tiredness or weakness; nausea or vomiting; or fainting (passing out). If you think you or others are experiencing heat exhaustion, you should stop physical activity and move to a cool place that is preferably air-conditioned, loosen clothing, and sip cool water.

Seek medical attention immediately if you or others are throwing up, your symptoms get worse or symptoms last longer than one hour. Heat stroke is life-threatening and occurs when the body is unable to control its temperature or cool down. Signs of heat stroke may include extremely high body temperature (103°F or higher); hot, red, dry skin with no sweat; fast, strong pulse; throbbing headache; dizziness; nausea; confusion; or loss of consciousness (passing out). You should call 911 right away, as heat stroke is a medical emergency. Then, if you are able, move to a cool place that is preferably air-conditioned. Help lower the person’s body temperature with cool cloths or a cool bath until medical personnel arrive. Do not give the person anything to drink.

  • Pay attention to weather forecasts and heat advisories- CDC’s HeatRisk map is one tool that provides local heat risk information to keep you and others safe.

For more information regarding heat-related illness and prevention, visit the websites of DHSS or the CDC.

National Nursing Assistants Week was celebrated June 13-19, 2024. Join CDC’s Project Firstline to recognize Certified Nursing Assistants (CNAs) across the nation who show an unwavering commitment to providing quality care to their patients and residents.

CNAs are skilled, vital members of the healthcare team, and we express our gratitude for their commitment to serving on the frontlines each day. CNAs dedicate themselves to infection prevention and control and help maintain safe and healthy environments for all patients and residents.

Show your Support

Support CNAs in your facility by saying “thank you” and acknowledging their contributions, which enhance infection control knowledge and make a significant impact in people’s lives.

Build their Knowledge

Utilize these important resources with CNAs in your facility to continue to build knowledge and strengthen infection control practices:

  • Interactive infection control activities: CNA’s can test their knowledge in real time and learn how to apply infection control solutions to stop the spread of germs.
  • Infection Control training toolkits: View ready-made materials and resources to host facilitated training sessions on a variety of infection control topics.
  • Micro-learn series: Use a series of guided discussions to help your staff recognize common infection risks and stop the spread of germs.
  • Enhanced Barrier Precautions resources: If you work in a nursing home, share these resources to help support your staff in understanding and effectively using Enhanced Barrier Precautions to protect residents and themselves.

Frequently asked questions
Pocket card
Overview video

The SLCR Health Education Unit will be conducting Instructor Information Meet Ups.

July 11, 2024: Online Programs
August 8, 2024: Certified vs. Licensed Facility
September 12, 2024: Scheduling a Test & Students
October 10, 2024: Clarifying 17 hours orientation vs. 16 hours OTJ hours
November 14, 2024: Train the Trainer Info
December 12, 2024: Discuss CMT Process

Please see the CNA Registry webpage for past meetings and more information.

If you have questions, please call our office at 573-526-5686.

Help improve the health of your residents by participating in a dental health pilot program!

The Missouri Department of Health and Senior Services Office of Dental Health (ODH) has developed a pilot program to deliver on-site interventional care to long-term care residents to reduce adverse health risks to residents in a cost-effective manner. Oral infections in older adults significantly increase the risk of pneumonia, acute diabetic problems, cardiovascular events and acute rheumatic arthritis episodes. This highlights the need for good oral health care for long-term care facilities (LTCF) residents.

Please see this flyer for more information.

CNA Training Reimbursement Opportunity for Skilled Facilities

Please join us as the Health Education Units hosts an informative webinar with MO HealthNet on July 10, 2024.

You will not want to miss this!! We welcome Carl Meyer and Lee Gerloff from MO HealthNet to be our guest and provide helpful information on what, when and how to submit for reimbursement. HEU will also be available for information regarding regulatory requirements and information related to the training reimbursement.

July 10, 2024: CNA Reimbursement Webinar

Please stay tuned to our CNA Registry webpage for more info and registration to come.

Please contact the Health Education Unit for any questions at the CNARegistry@health.mo.gov.

The Healthcare-Associated Infections/Antimicrobial Resistance Program is currently packing and shipping the Infection Prevention books to Long Term Care facilities across the state. However, due to the large number of facilities it will take some time for all books to be shipped. These books are being mailed via UPS to each facility and you will be receiving them soon.

Original Message

Missouri currently has 975 CNA’s that have not renewed as of June 1, 2024.

Please check the registry for your status at MO TMU.

All CNAs are required to renew their certification every 24 months. Each renewal requires 8 hours of nursing services to be provided for every 24-month period. Proof of the nursing service can include a W2 or paystub from your employer.

All renewals are now electronic through our online registry (TMU) and a $20.00 fee is required.

If you have never logged into TMU Registry to setup your profile, then you will first need to contact the Health Education Unit at 573-526-5686 or CNARegistry@health.mo.gov for assistance. After your profile is setup, a text message and email will be sent to you 60 days prior to your inactive date, during your renewal period. This notification will prevent any delay in keeping your certification active.

If you already have setup your profile, then please see the renewal instructions at https://health.mo.gov/safety/cnaregistry/pdf/how-renew-cna-certification.pdf.

If you have any questions, please contact the Health Education Unit at 573-526-5686 or CNARegistry@health.mo.gov.

Effective July 1, 2024, the Resource Limit/Spenddown Amount will increase from $5,726.00 to the new amount of $5,909.25. Facilities are required to notify the resident/financial guardian of the need to spend down when the resident reaches $200 less that amount to ensure Medicaid will not be affected.

For more information, please visit https://dssmanuals.mo.gov/wp-content/uploads/2022/07/mhabd-appendix-j.pdf.

Feel free to contact Lynn Gilmore, Lead Auditor, at 573-508-4150 if you have any questions.

Help us make the State of Missouri a great place to live and age with dignity!

On June 13, we will be launching the State of Missouri 2024 Needs Assessment Survey on Polco, our online civic engagement platform. Randomly selected households will receive mailed survey invitations around that time. If you receive an invite and meet the criteria listed, please follow the instructions to participate!

If you aren’t selected for this initial survey effort, stay tuned: in July, the survey will be open to all adults age 50+, adults (age 18+) with disabilities, and unpaid caregivers (adults 18+ who provide care for another adult).

To receive an email notification when this survey is available, click the link below, select “Follow” next to Missouri Association of Area Agencies on Aging, and set up a Polco account.

Thank you for helping to create a better community for all!

Set Up a Polco Account

Thanks to all of our champions who work tirelessly to create communities in Missouri where we can all age well.

Your Voice Matters!

Saturday, June 15th, marks a very special day – World Elder Abuse Awareness Day (WEAAD). This is a global awareness day officially introduced by the International Network for the Prevention of Elder Abuse and the World Health Organization at the United Nations on this day in 2006. This important day is in support of the United Nations International Plan of Action which recognizes the significance of elder abuse as a public health and human rights issue. It is observed every year to provide an opportunity for communities around the world to promote a better understanding and increased awareness of the cultural, social, economic, and demographic processes affecting elder abuse and neglect. We know that no community or country in the world is immune from the mistreatment of older adults. In Missouri, the Department of Health and Senior Services (DHSS) receives and investigates reports of abuse, neglect, bullying and exploitation of the elderly and disabled. Last year, DHSS received and investigated 43,862 reports, an average of about 120 each day. The National Center on Elder Abuse estimates for every case of elder abuse or neglect reported to the authorities, as many as 23 cases go unreported.

Missouri’s Department of Health and Senior Services (DHSS) invites you to wear purple anytime throughout the month of June to commemorate this important event and raise awareness of elder abuse, neglect, bullying, and exploitation in later life. The color purple has been adopted as the symbol to raise awareness of elder abuse and the effects of abuse, neglect, bullying, and exploitation in later life.

For more information, please visit https://health.mo.gov/seniors/weaad.php.

The Section for Long-Term Care Regulation is again seeking input from providers we work with. We are asking for your help in identifying areas in our Section where excellent customer service is provided and areas where we need to focus on improving our customer service experience.

Please take a couple minutes to complete our 2024 Provider Feedback Survey by June 25, 2024 at https://www.surveymonkey.com/r/KZXSKB7.

The Healthcare-Associated Infections/Antimicrobial Resistance Program is providing copies of Infection Prevention Guide to Long-Term Care, 2nd edition, and The Infection Preventionist’s Guide to the Lab free of charge to all Missouri Skilled Nursing Facilities, Intermediate Care Facilities, Assisted Living Facilities and Residential Care Facilities. Please utilize these free resources for Infection Prevention in your facility. These books are being mailed via UPS to each facility and you should be receiving them soon.

If there are any questions please contact the Healthcare-Associated Infections/Antimicrobial Resistance Program at (573) 751-6113.

CNA Testing

Headmaster D & S is now offering the knowledge portion of the CNA exam in Spanish.

This change is effective for those scheduling after 5/22/24. Please stay tuned for the updated Candidate Handbook to be added to the DHSS CNA Registry webpage.

For questions, please reach out to Headmaster D & S at 800-393-8664 or the DHSS Health Education Unit at 573-526-5686.

Attention Missouri Nursing Homes!

Register for a Free In-Person Health Ambassador Training

Sessions Will Be Held in Jackson/Cape Girardeau, Saint Louis and Springfield

Don’t miss this opportunity to register two individuals from your nursing home for a free regional in-person Health Ambassador Training in Missouri being presented by the Health Quality Innovation Network (HQIN) and Johns Hopkins University.

This training uses the Be REAL framework which focuses on building trust by forming relationships, targeting resources responsive to a facility’s population, and always keeping the door open for interactions to improve health outcomes such as immunizations and infection prevention.

Two people may register per facility and a maximum of 40 participants will be allowed for each session. Recommended participants include all staff, such as:

  • Nurses
  • Infection Prevention Nurses
  • Nursing assistants
  • Social services
  • Dietary
  • Environmental services
  • Also, please consider sending a resident, family member or volunteer.

These sessions will be interactive and include group discussion, small-group activities, games, and an opportunity to practice what has been learned. 

MO Health Ambassador Trainings

For questions, please contact us at ltc@hqi.solutions.

These trainings have been made available by the Health Quality Innovation Network (HQIN) and the Institute for Vaccine Safety – Johns Hopkins Bloomberg School of Public Health.

Please note this portal refers to the number of beds available for admission-not the number of licensed beds.

The Long-Term Care Ombudsman Program Bed and Service Availability dashboard can now be accessed. Facilities and the public can now view how many beds facilities have available, and which residents they can serve, i.e., memory care, behavioral health, bariatric, etc. This information is beneficial to facilities, families, hospital discharge planners and the general public to determine bed availability and services throughout the State. The dashboard can be accessed at this link dashboard. For information regarding how to navigate the dashboard, access this link training video.

If you have any questions about the survey, please contact the Long-Term Care Ombudsman Program via email LTCOmbudsman@health.mo.gov or call 800-309-3282.

The Board of Nursing Home Administrators has been notified of administrators receiving spam emails. The subject line contains the name BNHA and the emails are from an AOL email account. Please do not open the emails and notify your IT staff at once.

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 1/1/24 through 3/31/24 is due May 15, 2024. 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, 2024:

  • MDS data for 10/1/23 through 12/31/23;
  • NHSN data for COVID-19 Vaccination Coverage Among Healthcare Personnel for 10/1/23 through 12/31/23;
  • NHSN data for Influenza Vaccination Coverage Among Healthcare Personnel for 10/1/23 through 3/31/24.

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.

The process to submit a change in condition is now online.

DMH will no longer accept the Change in Condition PDF through the PASRR email. Any forms submitted by PDF will receive a message directing them to the online form to complete. This will optimize the process making it more efficient and effective, similar to the online process for the Level I/Level. Please use the following link for the online Change in Condition form: Resident Review of Change in Condition: Nursing Facility Notification to Missouri Department of Mental Health (redcapdd.azurewebsites.net). This will also be at the DMH website at Pre-Admission Screening and Resident Review (PASRR) | http://dmh.mo.gov.

Our team of experts at the Health Quality Innovation Network (HQIN) offers free support to ensure your facility’s emergency preparedness plan meets all the necessary criteria.

Take our online assessment, which guides you through a series of questions that will quickly identify what could be missing in your current emergency preparedness plan. After you submit your responses, an HQIN quality advisor will review your responses and provide you with tools and resources to help support survey readiness.

Ready to get started? Click HERE to Take the Assessment