An Engaged Medical Director: A Real Asset to a LTCF Webinar Presentation

DHSS Section for Long Term Care would like to say thank you to all that were able to take time out of their busy schedules to attend the webinar, “An Engaged Medical Director: A Real Asset to a LTCF,” on 11/20/2024, presented by Dr. Michael Nash. We would like to extend this thank you to Dr. Nash for sharing his wealth of knowledge and passion with us at DHSS, LTCF staff, educators, and providers. We believe the insights shared will be greatly beneficial for long-term term care facilities and Medical Directors.

This recorded presentation is now available on demand, along with the slides from the presentation.
Recording Link: “An Engaged Medical Director: A Real Asset to a LTCF”
Presentation Slides: Engaged Medical Director Presentation for MO DHSS 11-20-24 v2 MN edits

MDS INFO

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 7/1/24 through 9/30/24 is due November 14, 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 November 18, 2024:

  • MDS data for 4/1/24 through 6/30/24;

  • NHSN data for COVID-19 Vaccination Coverage Among Healthcare Personnel for 4/1/24 through 6/30/24;

 

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.

Residents Have the Right to Vote

Election Day is Tuesday, November 5th.

Individuals receiving long-term services and supports retain their voting rights, no matter where they live or what type of care they receive. Federal regulations guarantee residents’ rights, including their rights as citizens, which includes the right to vote. As local elections approach, now is the time for residents of long-term care to make a plan for voting.

Visit our website for information on preparing to vote, finding voting rules in your area, learning what is on your ballot, and suggestions for ways facilities can support residents’ right to vote.

Reporting Annual Healthcare Personnel Influenza Vaccination Data through NHSN (Long-Term Care Facilities)

Initial Webinar

November 19, 2024: 1:00 PM Eastern Time (US and Canada)

Register in advance for the initial webinar on November 19: https://cdc.zoomgov.com/webinar/register/WN_3AMj__gqSkarSwKquC-T3A

 

Replay Session

December 3, 2024: 1:00 PM Eastern Time (US and Canada)

Register in advance for the webinar replay on December 3: https://cdc.zoomgov.com/webinar/register/WN_84q-qGZ3RHWOxlL7jhnPhQ

 

The content of both webinars is the same. After registering, you will receive a confirmation e-mail containing information about joining the webinar.

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 to 50 individuals, so register soon!

Webinar series registration link: https://stateofmo.webex.com/webappng/sites/stateofmo/webinar/webinarSeries/register/cc01ce6f1d64435db3a716b6c489bf51

Upcoming Training Dates/Times

November 5, 2024: 11:00 am
December 10, 2024: 11:00 am
January 14, 2025: 11:00 am
February 11, 2025: 11:00 am
March 11, 2025: 11:00 am

 

Why We Are Conducting These Trainings?
• The LOC/PASRR process is complex and can be overwhelming if individuals do not receive sufficient training. We want to make it easier for you!

• Approximately 50% of applications are returned for corrections. This results in delays to the review and approval process – which directly impacts Medicaid payment to nursing facilities and can result in prolonged hospital stays.
• COMRU receives an average of 30-40 calls per day – many of the answers to the questions asked are contained in information accessible online. A decrease in phone calls will allow additional time for COMRU to review pending applications.

Training Agenda
• Overview of the PASRR and LOC requirements.
• Review of the application process from application submission to approval, including recent enhancements made to the online application system.
• Review of common errors that result in the application being returned for correction.
• Discussion of critical information needed to determine whether the application triggers for a Level 2 evaluation and the impact to the nursing facility and hospital.

Who Should Attend
• Individuals who are new to completing the LOC/PASRR application.
• Individuals who want a refresher of the requirements.

Benefits of Attending
• Familiarity with the process and information included online to assist with completing the application.
• Decrease in returned applications and reduction of processing times.

Prior to attending, please review both on-line trainings (New LOC Webex Training Oct 2021 and Level One Online Form Training Feb 2024) located on COMRU’s webpage https://health.mo.gov/seniors/nursinghomes/pasrr.php.

Please see the flyer

CMS Memo: QSO-24-21-NH: Compliance with Residents’ Rights Requirement related to Nursing Home Residents’ Right to Vote

Memorandum Summary

  • The Centers for Medicare & Medicaid Services (CMS) is affirming the regulatory expectation that ensures nursing home residents have the unimpeded ability to exercise their right to vote as a citizen of the United States.
  • Nursing homes must ensure residents are able to exercise their Constitutional right to vote without interference, coercion, discrimination, or reprisal from the facility.
  • States, localities, and nursing home owners and administrators should collaborate to support a resident’s right to vote.

Please see the full memo for details located.

Infection Prevention and Control Office Hours

Sessions Begin on September 18 at 12 p.m. ET

Register now to join free virtual Infection Prevention and Control Office Hours, which address topics concerning respiratory virus season.

The focus will be on COVID-19 and strategies to decrease transmission among nursing home residents and staff. This series is tailored specifically for long-term care facilities, providing valuable support in areas such as COVID-19 prevention, immunization strategies and strategies to stay healthy. These sessions will help you discover ways to enhance care for both residents and staff.

Please see this flyer for details and registration

Healthcare Quality and Worker Safety Information from CDC

Exciting News! CORHA Launches Newly Redesigned Website – CORHA, The Council for Outbreak Response: Healthcare-Associated Infections (HAIs) and Antimicrobial-Resistant Pathogens (AR) (CORHA) has recently launched a newly redesigned website. The new site offers enhanced features and expanded information to improve user experience, accessibility, and functionality.

 

Long-Term Care Webinar: 2024-2025 Respiratory Virus Season Updates – Please join CDC’s Division of Healthcare Quality Promotion (DHQP) on Monday, September 16, 2024, at 1 p.m. EDT for an overview of the latest respiratory virus vaccination recommendations, testing and treatment guidance, and infection prevention strategies. Long-term care facility residents are often at high risk of respiratory infections and severe disease due to respiratory viruses. A combination of interventions can protect residents and staff health during respiratory virus season.

Register: https://cdc.zoomgov.com/webinar/register/WN_H4-bbiGEQyOCaP7YUT8Jng

 

ICYMI: CDC and AMA Respiratory Virus Season latest information – During the event, speakers from CDC, including CDC Director Dr. Mandy Cohen, provided important updates on protecting patients and others against influenza, COVID-19, and RSV. Updates included:

  • Emerging immunization issues, as well as recommendations and resources for providers.
  • Reminders about treatments available for patients at increased risk of severe COVID-19 illness.

Preview of new HHS vaccination education campaign – Risk Less. Do More.

Mouthcare Without a Battle ~Free Webinar~

Mouth Care Without a Battle” is an evidence-based program designed to educate healthcare staff on providing effective oral healthcare for residents with dementia and other chronic illnesses. Providing daily oral healthcare is crucial for maintaining overall health and well-being in long-term healthcare facilities. Good oral hygiene can prevent infections, reduce the risk of chronic diseases, and improve the quality of life for residents.

Please join the Section for Long-Term Care Regulation along with the Office of Dental Health, on August 20, 2024 at 10:00 a.m. for this FREE webinar. A link will be sent to the email address given at registration. Please register by 5:00 p.m. August 16, 2024 in order to get your link prior to this webinar.

2024 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!

 

For more information visit our web site, or contact Todd Winterbower at winterbowert@missouri.edu.

Take the survey now to see if you qualify for FREE registration.

Senior Day at the State Fair

August 14, 2024
9:00 a.m. – 3:00 p.m.
Mathewson Building

Join DHSS and the Missouri Area Agencies on Aging on the Missouri State Fairgrounds. Senior Day festivities include FREE BINGO, line dance lessons, and much more! The dance contest, open to those aged 60+, has cash prizes for the top three places in each of the categories of Missouri Waltz, Polka, Jitterbug, Two-Step and Line Dancing.

For more information, please visit our website at health.mo.gov/seniorday.

2024 NHSN Annual Training Platform is now Open

The NHSN Annual Training platform is now open! You can now register, access all pre-recorded videos for viewing and start preparing for our live presentations starting July 23, 2024, at 9:00 am EST.

We are officially 1 week away. Log in today to view videos and download slide decks for live sessions. Please note that the pre-recorded sessions kicked off July 15, 2024 and the live virtual training starts next Tuesday, July 23, 2024, at 9:00AM EST.

You can log in to gain access and review the sessions at your convenience.

Click here https://2024nhsntraining-pac.vfairs.com/ to register and confirm your attendance.

We hope that you are getting excited because we are excited and ready!

“See” you soon!

The NHSN Team

Quality Reporting Program: Non-Compliance Letters for FY 2025 APU

CMS is providing notifications to facilities that were determined to be out of compliance with Quality Reporting Program (QRP) requirements for CY 2023, which will affect their FY 2025 Annual Payment Update (APU). Non-compliance notifications are being distributed by the Medicare Administrative Contractors (MACs) and were placed into facilities’ My Reports folders in the Internet Quality Improvement and Evaluation System (iQIES) for SNFs on July 03, 2024. Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 pm, August 14, 2024.

If you receive a notice of non-compliance and would like to request a reconsideration, see the instructions in your notice of non-compliance and on the SNF Quality Reporting Reconsideration and Exception & Extension webpage.

Staying Healthy and Safe in the Summer’s First Heat Wave

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.

Health Education Unit – Upcoming Trainer Info Meet Ups

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.

Dental Health Pilot Program

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

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.

Infection Prevention Books – Update

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

World Elder Abuse Awareness Day

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.

2024 Provider Feedback Survey

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.

2024 SLCR Annual Provider Meetings

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

Thank you to all that attended one of the 2024 Provider Meetings.

There is no cost to attend any of these meetings.

New this Year – Online Registration!

Earn up to 5 CEUs (2.75 Admin/2.25 PC). 

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

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

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

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

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

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

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

 

Handouts
1. Activities for Special Populations
2. Supporting Well Being A Foundation for Person-Centered Care

3. Missouri Medicaid Case Mix
4. Survey Success Tips and Pearls for Excellence in LTC Compliance
4b. 7 Week Survey Prep

5. Region 2 Section Update
5. Region 7 Section Update
5. Region 1 Section Update
5. Region 6 Section Update
5. Region 5 Section Update
5. Region 4 Section Update
5. Region 3 Section Update
7. Enhanced Barrier Precautions