Category: Events

Show-Me ECHO

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Show-Me ECHO (Extension for Community Healthcare Outcomes) uses videoconferencing to connect interdisciplinary teams of experts with clinicians and other healthcare professionals. Together participants and teams collaborate in interactive, individualized, case-based learning environments to develop skills and discuss best practices. Some ECHOs meet every week, some twice a month, and some have a completely different timeline. We know how challenging it can be to commit time away from your other responsibilities, but by building and supporting a strong community of learners, the ECHO model improves care access, quality, and efficiency. Show-Me ECHO learning sessions offer free continuing education and are provided at no cost to participating sites and individuals. Check out the ECHO schedule to see when you can attend the next session!

PAC/LTC: Post-Acute & Long-Term Care
2nd & 4th Thursdays: 9:30 am – 10:30 am

Topics or Learning and Discussion:

  • Post-Vaccination Practices: Including Visitation Policies and PPE practices
  • Ongoing COVID-19 Identification and Treatment: Plans for Recognizing Patients with COVID, Post-COVID Syndromes, Testing, Treatment and Cohorting
  • Emotional and Organizational Support for Staff
  • Vaccinations: Vaccine Confidence, Testing, Logistics, Ongoing Compliance and Complications
  • Addressing and Supporting Needs of Residents, Families or Care Partners: Isolation and Family Communication
  • Stopping the Spread (Infection Control): Building Sustainable Infection Control Practices
  • Leadership Communication for COVID-19: Huddles, Rounding, Etc.
  • Leadership Behaviors to Support Teams During COVID-19: Teamwork, Roles and Psychological Safety

Administrator License Renewals for 2023 and Forward

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Administrators due to renew in 2023 and forward are required to complete all required continuing education (CE) clock hours in-seat or can complete a maximum of half of the total required hours through online continuing education programs (web-based, teleconference, self-study and webinar).

 Refer to the “License Renewal Checklist” on the website https://health.mo.gov/information/boards/bnha/.

 Please contact the Board of Nursing Home Administrators with any questions or concerns at BNHA@health.mo.gov.

VOYCE’S Upcoming Community Education

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October 11, 2022: Residents’ Rights and the Intersection of State Policy
Presenters: Chien Y. Hung, MSW, MA-G, RYT, Program Director, VOYCE; and Nicole Lynch, Policy and Advocacy Director, VOYCE

October is Residents’ Rights Month, an annual initiative highlighting the legally enshrined rights of long-term care residents throughout the United States. Residents’ Rights Month is an annual event designated by the Consumer Voice and is celebrated to honor residents living in all long-term care facilities and consumers receiving services in their home or community. It is a time for celebration and recognition, offering an opportunity for every facility to focus on and celebrate awareness of dignity, respect, and the value of each resident. Residents’ Rights are guaranteed by the federal 1987 Nursing Home Reform Law.

In this presentation, we will explore Residents’ Rights and examine some of the state laws VOYCE has successfully advocated for, including the Essential Caregivers Program Act and the Authorized Electronic Monitoring in Long-Term Care Facilities Act.

COMRU Online Application

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We are aware that some providers are experiencing issues with the link to the COMRU online application. We apologize for this inconvenience. Please first try the following alternative link to see if this will work to access the online application:  https://redcapdrlltc.azurewebsites.net/redcap/surveys/?s=RNMP48LRWY.

If this link does not work, please contact COMRU at COMRU@health.mo.gov for assistance. 

Resolution of Issues: NHSN Person-Level (Event-Level) COVID-19 Vaccination Forms

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We want to provide an update on the issues related to the Person-Level (Event-Level) COVID-19 Vaccination Forms that occurred following the recent NHSN application update. These issues are now resolved, and users can do all of the following:

  • Users can search and filter their data
  • Users can import .CSV files that contain more than one row per individual (for example, if an individual was discharged and later re-admitted)
  • Users can modify all fields, including ID and name
  • Users can no longer delete staff IDs from the other event-level forms (e.g., from the POC tool) if the staff ID is linked to a staff vaccination record

As a reminder, users cannot delete rows. If you have incorrect data that needs to be removed, please do one of the following:

  1. Edit the row/ repurpose the row with someone else’s data, or
  2. Change the discharge/end date to a date that is before the person-level forms could be used to submit date (i.e., before 3/28/2022). This way, the incorrect row won’t contribute to any data that can be submitted. In addition, you should change the ID so that it is not linked to a real ID. Also, add a note to the Comments column on the far right to document that this entry is incorrect.

In addition, updated CSV materials for the Person-Level (Event-Level) COVID-19 Vaccination Forms are now posted to the website, and links are provided below. Please note that is it optional to use the CSV materials, as users can manage all data within the application without using the CSV files.

Resources:

All resources: https://www.cdc.gov/nhsn/ltc/weekly-covid-vac/index.html

Trainings:

Guidance:

.CSV variable description and file layout:

.CSV template and example – HCP:

.CSV template and example – Residents:

Please contact NHSN@cdc.gov with “COVID-19 Person-level Vaccination Forms” in the subject line with any additional questions or concerns. Thank you for your efforts with submitting data to the Weekly COVID-19 Vaccination Modules.

NHSN Long-term Care Release September 2022

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Below is important information regarding modifications to the Long-term Care Facility COVID-19 Module, and COVID-19 Vaccination Module. The changes described below will take effect after the September 2022 NHSN release. Resources on the NHSN LTCF COVID-19 Module webpage and the COVID-19 Vaccination Module webpage will be updated, where indicated, with revised forms, instructions, FAQs, and .CSV templates.

Point of Care (POC) Test Reporting Tool:

No enhancements

COVID-19 Pathway Data Reporting:

Please refer to the below data reporting pathways to learn about enhancements that will be made within each pathway.

Resident Impact and Facility Capacity Pathway:

The Primary Series Vaccination Status section of the Resident Impact and Facility Capacity Pathway has been revised with simplified language to account for the recent approval of the Novavax Vaccine. The reporting process for this pathway has not changed and users will not need to go back and make any revisions to their data. Please continue using the Table of Instructions, found on the LTCF COVID-19 Webpage, as a guide while reporting data for this pathway.

Staff and Personnel Impact Pathway:

No enhancements

Therapeutics Pathway:

For those that upload data via CSV files, please be sure to use the templates that are posted on the LTCF COVID-19 Module Webpage. The following therapeutics must be listed for each submission date within the CSV file.

Each Therapeutic should have a line within the CSV file:

  • Casirivimab plus Imdevimab (Regeneron)
  • Bamlanivimab plus etesevimab (Lilly)
  • Sotrovimab (GlaxoSmithKline)
  • Evusheld (AstraZeneca)
  • Bebtelovimab (Lilly)
  • Paxlovid (Pfizer)
  • Molnupiravir (Merck)

State Veterans Homes COVID-19 Event Reporting Tool

No enhancements

Weekly NHSN COVID-19 Vaccination Data

Optional NHSN Person-Level (Event-Level) Vaccination Forms

  • Enhanced security for Staff-Person-level (event-level) vaccination data.
  • Action item for users: If a user is not a NHSN facility administrator (FA) and submits person-level vaccination data for healthcare personnel, the user must have the ‘Staff/Visitor- Add, Edit, Delete’ and ‘Staff/Visitor- view’ boxes checked under user rights. A user with administrative rights can grant these additional rights to users. Facility administrators will continue to have access to these person-level vaccination data.

For questions about any of these updates, please send an e-mail to the NHSN Helpdesk at NHSN@cdc.gov with the subject line identifying the topic of the message.

COMRU Update

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Beginning October 3, 2022, the Level 2 determination letters will be sent from Bock Associates instead of COMRU. The Level 2 determination letter will continue to be uploaded to the online application. If you have any questions regarding the change in the determination letter, please contact COMRU at 573-522-3092 (option #4).

Please ensure the processed online application and Level 2 screening has been printed/saved for your records. COMRU will begin purging the online system in October, so all Skilled Nursing Facilities (SNF) will need to have copies of these documents prior to them being deleted.

The Green House Team and Pioneer Network – FREE Fall Webinars

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September 27, 2022: Person-Directed Leadership: Creating a Coaching Culture
October 4, 2022: Invest in Your Workforce for 2023
October 11, 2022: Communicating for Policy Success

Join Amanda Loomis of SWBR for a dynamic exploration of the ways that design can promote vitality and wellbeing for elders – and how small touches can go a long way toward revitalizing a nursing home, assisted living community, or other eldercare setting.

2022 MOADD Summit

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November 9, 2022: Missouri Alliance for the Dually Diagnosed (MOADD) Summit
Location: Holiday Inn Executive Center, Columbia

MOADD (Missouri Alliance for Dual Diagnosis) established in 2018, is a collaborative effort between Department of Mental Health (DMH) staff and DMH providers with interest in developing expertise in supporting individuals with dual intellectual/developmental disabilities (I/DD) and behavioral health diagnosis.

MOADD provides resources to assist providers to:

  • Be current in best practices
  • Develop an integrated system to make agencies more aware of resources for behavioral health and DD available through Regional Professional Learning Communities.
  • Provider better outcomes for individuals

MALA’s 2022 ALF Community Based Assessment Training

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November 29-December 1, 2022: 2022 ALF Community Based Assessment Training

As required by 198.005 RSMo and 19 CSR 30‐86.047, residents of Assisted Living Facilities are required to undergo a community-based assessment performed by an appropriately trained and qualified individual. This individual must complete a DHSS approved 24‐ hour training program prior to performing resident assessments. The MALA ALF Assessment Training satisfies this regulatory requirement.

LTC Survey: Staff Emotional Trauma and Need for Peer Support

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The Center for Patient Safety is working with Dr. Sue Scott from MU Healthcare/University of Missouri to learn more about the experiences of LTC staff (at all levels) that might involve emotional trauma and the need for peer support. Experts from the MU Sullivan School of Nursing have also contributed to its development.

The online Long-Term Care Survey 2022 should take about 5 minutes. All responses are anonymous; Dr. Scott will aggregate them as a single group.

The Center for Patient Safety looks forward to input from the LTC community as they develop peer support/second victim programs.

Please contact the Center for Patient Safety for questions:

Kathy Wire, Executive Director
kwire@centerforpatientsafety.org
(573) 636-1014, ext. 1224

Eunice Halverson, Patient Safety Specialist
ehalverson@centerforpatientsafety.org
(573) 636-1014, ext. 1226

Nursing Home Staffing Study Blog and Stakeholder Listening Session

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CMS published a blog describing the multi-faceted approach the agency is taking to determine a minimum staffing level for nursing homes in order to ensure safe and quality care.

Also included in the blog is a registration link for an upcoming Stakeholder Listening Session that CMS is conducting for the public, scheduled for Monday, August 29, at 12:00-1:30 pm (central).

Online Course for CNA Instructor Required 4-Hour Update

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MANHA and MHCA provided in-seat update training in 6 locations earlier this year. We are now offering the update training online. To access you can go to www.staffdevelopmentsolutions.com click on Course Groups. You will find the “CNA Instructor 4 Hour required update” under Train the Trainer course group. Once you complete you will NOT need to do anything else if course is 100% complete. August 30th we will report all RNs who have completed the training to DHSS, Health Education Unit and you will be updated on the registry.

The objectives of this course will meet the elements of the required training to include:

  1. Instruction on how to complete form DHSS-DRL-111 (08-20), Classroom and On-the-Job Training Record;
  2. Instruction on the fundamentals of adult learning;
  3. Instruction in at least one (1) area regarding standards of practice in long term care such as pressure ulcer prevention, dining practices, or resident rights issues;
  4. Instruction on providing care for cognitively impaired residents;
  5. Review of the Nursing Assistant Training Program regulations contained in 19 CSR 30-84.010; and
  6. Review of the administration and resident care requirements contained in 19 CSR 30-85.042.

Any instructor who has not completed the required four (4) hour update training by August 30, 2022, and every five (5) years thereafter shall be removed from the department-approved list of instructors. If removed from the department’s list, the instructor shall attend and successfully complete the Nursing Assistant Instructor Workshop in order to be reinstated to act as an instructor.

SNF Quality Reporting Program (QRP) Submission

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SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. MDS and NHSN data for 1/1/22 through 3/31/22 must be submitted no later than 11:59 p.m. on August 15, 2022.

The Minimum Data Set (MDS) 3.0 must be transmitted to the Centers for Medicare & Medicaid Services (CMS) through the Assessment Submission and Processing (ASAP) system to the Quality Improvement Evaluation System (QIES). Data for the National Healthcare Safety Network (NHSN) measures must be submitted to the Centers for Disease Control and Prevention (CDC). No additional data submission is required for the claims-based measures.

As a reminder, it is recommended that providers run applicable CASPER reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.

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.

More information about SNF QRP can be found on the following webpages:

Payroll-Based Journal (PBJ) Submission Deadline Reminder

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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 4/1/22 through 6/30/22 is due August 14, 2022.

Please submit PBJ data as soon as possible to avoid delays. CMS recommends running staffing reports in CASPER prior to the submission deadline to ensure the accuracy and completeness of submissions. Please remember, the Final File Validation Report verifies that the submission was successful.

Please note: If you need assistance with the PBJ quarterly submission and the deadline falls on a weekend, you must contact the QIES/iQIES Service Center no later than the Friday before the submission deadline, as the Service Center will be unavailable to assist on the weekend.

More information about PBJ can be found on the following webpages:

RAI Manual Update

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CMS released a PDF file labeled “MDS3.0RAIManualv1.17R.Errata.v2.July.15.2022,” available in the Downloads section of the MDS 3.0 RAI Manual webpage. This file contains revisions to pages in Chapter 3, Section I, of the MDS 3.0 RAI Manual v1.17.1R that clarifies the need for a detailed evaluation and appropriate diagnostic information to support a diagnosis, such as for a mental disorder, prior to coding the diagnosis on the MDS, and the steps that may be necessary when a resident has potentially been misdiagnosed. An example of when a diagnosis should not be coded in Section I due to lack of a detailed evaluation and appropriate diagnostic information to support the diagnosis has also been added to this section. Changed manual pages are I-12 and I-16 and are marked with the footer “October 2019 (R).”

Quality Reporting Program: Non-Compliance Letters for FY 2023 APU

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CMS is providing notifications to facilities that were determined to be out of compliance with Quality Reporting Program (QRP) requirements for CY 2021, which will affect their FY 2023 Annual Payment Update (APU). Non-compliance notifications are being distributed by the Medicare Administrative Contractors (MACs) and were placed into SNFs’ CASPER folders in QIES on July 13, 2022. 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 11, 2022.

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.

2022 Missouri Tiered Supports Summit

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July 16, 2022 & July 27-28, 2022: Nurturing Healthy Communities

Includes presentations from change agents and behavior analysts from across the country.

Family Sessions

Saturday, July 16, 2022: 10:30 – 2:00

Family Sessions are an ideal opportunity for parents, grandparents, caregivers, and the behavioral health professionals who support them to learn more about positive practices and at home implementation of Tiered Supports.

Professional Sessions

July 27-28, 2022: 9:30-12:30

Professional Sessions provide an opportunity for agency administrators, supervisors, agency team members, coaches, DMH team members, family caregivers, and other behavioral health professionals to learn more about positive practices and implementation of Tiered Supports.

FREE CEUs available for RBTs, BCaBAs, and BCBAs – Click to Register

MO Tiered Supports is a state multi-tiered positive behavior support consultation service system. The MMTSS team focuses on teaching and coaching agency teams so they can better serve the individuals in their care. You can click on these underlined links to direct you to more information on Tiered supports: Multi-Tiered Systems of Support and Understanding Missouri Multi-Tiered Supports Webinar

For information on this summit, please visit https://dmh.mo.gov/dev-disabilities/tiered-support-summit/2022.

RAI Process from Start to Finish

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August 2-4, 2022: RAI Process from Start to Finish
December 6-8, 2022: RAI Process from Start to Finish

This virtual workshop will look at the RAI process from beginning to end and at each item of the MDS. The MDS is used for both a clinical and a financial assessment and will discuss the rules on scheduling these assessments and meeting the clinical & financial requirements. This includes a basic understanding of PDPM and how it correlates within the RAI process. This virtual workshop reviews how to gain access to and read the MDS reports from CASPER to self-audit your RAI process and look at your QMs. This workshop is designed for the MDS Coordinator and Care Plan Coordinator, or for the DON or ADM who needs a better understanding of the complexity of the RAI Process.

Medicare from Start to Finish

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September 13-14, 2022: Medicare from Start to Finish
November 8-9, 2022: Medicare from Start to Finish

This virtual workshop will review the SNF QRP reports from CASPER that provides information about the Medicare Part A stays in your SNF. It will also explore factors impacting SNF PPS assessment schedule, PDPM basics, and consolidating billing that can impact the financial facet of the facility. It also explains Medicare eligibility, coverage, and skilling criteria. The completion of the MDS is becoming more difficult and confusing; this workshop will help clear up the confusion surrounding this process. This workshop is geared towards those individuals working in long‐term care who have a leadership role such as ADM, DON, ADON, or MDS Coordinator.

LeadingAge Missouri Annual Meeting & EXPO

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September 26-28, 2022: MOMENTUM
Location: The Chase Park Plaza Royal Sonesta, St. Louis

It’s time to reconnect at LeadingAge Missouri Annual Meeting & EXPO at the beautiful Chase Park Plaza Hotel in Saint Louis.

LeadingAge Missouri’s members are eager to connect with you at our Annual Conference & EXPO! This year’s events will offer a wider variety of marketing opportunities sure to suit your goals and budget. The 2022 conference will provide you with a dynamic opportunity to put your life-changing products and services in front of aging services leaders from across Missouri. We are dedicated to helping you to stand out from your competition.

American Rescue Plan Act (ARPA) Funding Opportunity for RCF and ALF

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The Department of Health and Senior Services (DHSS) is excited to announce an upcoming reimbursement opportunity available to Residential Care Facilities (RCF) and Assisted Living Facilities (ALF). Through Missouri’s State Fiscal Recovery Funds, operators may seek reimbursement for expenses incurred directly related to preparing, preventing, and responding to the COVID-19 pandemic.

DHSS will begin accepting applications for reimbursement on September 1, 2022. In the coming weeks, additional details about the reimbursement process, reimbursement amounts, eligible expenses, and supporting documentation will be provided. Our goal is to simplify this process for facility administrators as much as possible.

In preparation of the launch of the application, you are urged to take steps now to prepare. If you operate an RCF or ALF and are interested in this funding opportunity, please ensure you are registered as a vendor to receive payment from the State of Missouri. Before operators can complete an application for this opportunity, they must register as a vendor with the state’s financial system – SAM II. If the operating entity is already registered as a vendor with the State of Missouri, you do not need to re-register.

The SAM II registration Vendor Input Form can be found at https://oa.mo.gov/sites/default/files/vendor_input_ach_eftd.pdf. The completed Vendor Input Form must be sent directly to the Office of Administration by fax at 573-526-9813 or by mail to Office of Administration/Accounting, PO Box 809, Jefferson City, MO 65102.

Operator Tips in Registering as a Vendor with the State of Missouri:

  • Be sure to register only the legal operating entity and not all individual facilities owned by the same operating entity.
  • Be sure the address used in the State’s financial system is the same address that will be used as the operator’s address on the application and any accounts payable documentation.

We will keep you updated with more information regarding the RCF/ALF funding opportunity via this listserv.

Funding for this initiative has been made available through the American Rescue Plan Act (ARPA). Missouri’s ARPA funding opportunities are located here: https://moarpa.mo.gov/available-funding-opportunities/.