Please plan now to join us for one of the 2017 Annual Long Term Care Provider Meetings.  
Location Flyer 2017 Provider Meeting Locations Flyer

Region 1 – September 27, 2017 
Region 1 Agenda

Region 2 – October 24, 2017
Region 2 Agenda

Region 3 – October 11, 2017
Region 3 Agenda

Region 4 – October 12, 2017
Region 4 Agenda

Region 5 – October 5, 2017
Region 5 Agenda

Region 6 – October 16, 2017
Region 6 Agenda

Region 7 – October 25, 2017
Region 7 Agenda


The Provider Meetings will continue to be held in two sessions, the first session will be for Residential Care Facilities/Assisted Living Facilities, and the second session will be for Skilled Nursing Facilities/Intermediate Care Facilities. This year in order to avoid repetition in the program we will conduct a combined session for all provider types to cover topics of interest relevant to all levels of care. The combined session will run from 10:15 until noon. Registration is not required. CEU’s will be available for Nursing Home Administrators.


Presentation handouts As in previous years, handouts will not be provided at each meeting.  It is your responsibility to print them and bring them to the meeting if you desire.

Most Frequently Cited Deficiencies

Safe and Effective Medication System

Inspecting the Kitchen

Fire Watch

Regulatory Changes/New Survey Process

Complaints by the Numbers

Emergency Preparedness

Influenza Vaccination Requirements

There has been legislation passed in the last couple years regarding influenza vaccination requirements.  Homes should be implementing these requirements as applicable.

198.053.  Assisted living facilities, notification of posting of latest Vaccine Informational Sheet. — No later than October first of each year, in accordance with the latest recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, each assisted living facility, as such term is defined in section 198.006, shall notify residents and staff where in the facility that the latest edition of the Vaccine Informational Sheet published by the Centers for Disease Control and Prevention has been posted. Nothing in this section shall be construed to require any assisted living facility to provide or pay for any vaccination against influenza, allow the department of health to promulgate any rules to implement this section, or cite any facility for acting in good faith to post the Vaccine Informational Sheet.

198.054.  Influenza vaccination for employees, facilities to assist in obtaining. — Each year between October first and March first, all long-term care facilities licensed under this chapter shall assist their health care workers, volunteers, and other employees who have direct contact with residents in obtaining the vaccination for the influenza virus by either offering the vaccination in the facility or providing information as to how they may independently obtain the vaccination, unless contraindicated, in accordance with the latest recommendations of the Centers for Disease Control and Prevention and subject to availability of the vaccine. Facilities are encouraged to document that each health care worker, volunteer, and employee has been offered assistance in receiving a vaccination against the influenza virus and has either accepted or declined.

S&C Memo: 17-43-ALL: Quality and Certification Oversight Reports (QCOR) Website Launch

New Website Platform and Data System: The Centers for Medicare & Medicaid Services (CMS) is releasing information related to the new QCOR website in an overarching initiative for increased transparency.

Please see the full memo at

New MDS 3.0 RAI Manual Posted

CMS posted the MDS 3.0 RAI Manual v1.15 on their website on 8/31/17, which will be effective October 1, 2017. The new Manual can be found in the Related Links Section at the bottom of the following CMS website

The Related Links section at the bottom of this page contains:

  1. MDS 3.0 RAI Manual v1.15 October 1, 2017
  • A Single PDF file of the entire RAI manual for use as an electronic version with bookmarks that you can click on to take you to each section of the manual.
  1. MDS 3.0 RAI Manual v1.15 and Change Tables October 1, 2017
  • Traditional zip files of the RAI manual and the change tables that crosswalk the changes made to this year’s manual. Note: This is the same material as the first item above, except there are separate files for each chapter or subchapter.
  1. MDS 3.0 RAI Manual v1.15 Replacement Manual Pages and Change Tables October 1, 2017
  • Replacement pages for this year’s manual changes for those that want to just update their existing paper based manual with the pages that have changed. It also includes the change tables that crosswalk the changes made to this year’s manual.
  1. MDS Forms (Item Sets) v1.15.1 October 1, 2017
  • Two folders separate the v1.15.1 MDS forms (MDS item sets) into those used in long term care facilities (SNFs and NFs) and those used in swing bed facilities.

MDS 3.0 Section M in Advances in Skin & Wound Care

Elizabeth Ayello has published an article on the MDS 3.0 Section M in Advances in Skin & Wound Care, September 2017 – Volume 30 – Issue 9. This is a free access article, which means anyone can read the article free of charge. There is also an option for CEUs. Elizabeth’s article is available on the Advances in Skin & Wound Care website at, in the Clinical Management Section, and is titled: CMS MDS 3.0 Section M Skin Conditions in Long-term Care: Pressure Ulcers, Skin Tears, and Moisture-Associated Skin Damage Data Update.

SNF QRP Review and Correct Reports & Confidential Feedback Reports

SNF providers were recently notified of two issues affecting the SNF QRP Review and Correct Reports & Confidential Feedback Reports.

An issue was identified within the SNF Review and Correct Report, if one or more modification records are submitted for a patient stay, the most recent submitted assessment, which was accepted by the ASAP system on or prior to the submission deadline for Q1 and Q2 of CY2017, was not being used in the measure calculation.

All quality measure data has been recalculated and is now available in the SNF Quality Reporting Program report category in the CASPER Reporting application. Providers are encouraged to request the report to view updated measure results. The updated report should replace versions of the report requested prior to the issue notification.

The second issue that was identified in the technical coding, which affected our calculation of one measure contained in the SNF Review and Correct Report related to the measure Application of Percent of LTCH Patients with Admission and Discharge Functional Assessment and a Care Plan that Addresses Function, also affected the SNF QRP Confidential Feedback Report (SNF Quality Reporting Program (QRP) Quality Measure Report) is still being resolved and further guidance is forthcoming.

As a reminder, all data for assessment-based measures required in the SNF QRP in CY2017 will remain open to modifications until May 15, 2018. We anticipate that the data currently “frozen” as of August 15, 2017 to be subject to updates as of mid-September. Another notice will be issued once the Review and Correct Report Q1 2017 SNF QRP data is open again.

Further guidance and timelines has been posted to the SNF Quality Reporting Program Data Submission Deadlines webpage.

All facilities will receive an email blast notifying them of the above. We will continue to send follow-up announcements as further guidance can be given.

If you have any questions concerning this information, please contact the QTSO Help Desk at or 1 (888) 477-7876.

You don’t have to be an MDS Coordinator to attend

Often, the topics discussed are beneficial not only for MDS Coordinators but also for floor nurses, Social Services staff, DONs, ADONS and Administrators. You can find a schedule of meetings and topics by going to the Nursing Home Help website found at Some past topics have included Quality Measures, QRP requirements, Phase 1 and 2 Regulation Implementation, discussions with the State RAI Coordinator and State Surveyors, PPS Scheduling, CAA documentation, Care Plans, MDS Review for Social Workers, Wounds, Section GG Coding, Behavior Documentation and ICD-10 Coding. You are welcome to attend any meeting anywhere in the state, no RSVP needed.

Reducing Incontinence

Urinary incontinence can cause a variety of issues in older adults. Tools are available for identifying and improving incontinence such as assessment techniques and established care plans. Click on the following links to learn more.

Sample Care Plan: Urinary Incontinence (PDF)
Urinary Incontinence Assessment in Older Adults (PDF)
Low-Risk Residents Who Lose Control of Their Bowel or Bladder (Long Stay) Root Cause Analysis Tool (Excel)

MLN Fall Workshops

Cape Girardeau

September 27, 2017: Addressing Psychiatric Crises



October 26, 2017: Addressing Psychiatric Crises



November 17, 2017: Staff Empowerment and Making a Home


Kansas City

September 27, 2017: Staff Empowerment and Making a Home

October 5, 2017: Improv for Caregivers

October 25, 2017: Addressing Psychiatric Crises

November 9, 2017: A Fresh and Nutritious Perspective



November 8, 2017: Addressing Psychiatric Crises


Poplar Bluff

October 5, 2017: A Fresh and Nutritious Perspective



October 4, 2017: Staff Empowerment and Making a Home


St. Louis

September 28, 2017: Addressing Psychiatric Crises

October 26, 2017: Improv for Caregivers

November 2, 2017: A Fresh and Nutritious Perspective

November 16, 2017: Staff Empowerment and Making a Home