April 8, 2022: Dementia Hacks: Solutions for Every Stage
This all-day virtual education event will guide learners to develop refined observational and analytical skills to recognize hallmarks of early, moderate, and late-stage dementia. Learners will gain skills in matching their own care approaches to the person with dementia’s and care partner’s needs at each stage according to their abilities and strengths.
SLCR has received several questions recently regarding visitation in long-term care facilities. All previous guidance provided by DHSS regarding visitation is no longer in effect. No state waivers are in place regarding regulatory or statutory requirements related to visitation. Section 198.088.6(K), RSMo states, “Each resident admitted to the facility may communicate, associate and meet privately with persons of his choice, unless to do so would infringe upon the rights of other residents.” State regulations also require facilities to follow appropriate infection control procedures. To balance these two requirements, all long-term care facilities (RCF, ALF, ICF and SNF) should follow CDC guidance related to visitors: https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care.html#anchor_1631030962190. The CDC guidance points facilities to CMS’ memo for additional information related to visitation. Certified facilities are required to follow CMS guidelines. Although state licensed only facilities are not required to follow the requirements in QSO 20-39 NH, DHSS highly encourages them to use the memo and FAQs as a standard of practice to ensure safe visitation occurs in their long-term care community.
CMS has developed a Frequently Asked Questions document to address the questions received regarding visitation in Nursing Homes. This additional information is provided to help residents, families and providers ensure that safe visitation can occur. The FAQs can be found on the cms.gov emergencies page here and also in QSO-20-39-NH REVISED.
To all facilities that utilize 3G cellular communicators on a fire alarm system, those cell devices must be upgraded. Please see the link below to plan for the phase out of 3G cell networks and services ahead of the announced date.
https://www.fcc.gov/consumers/guides/plan-ahead-phase-out-3g-cellular-networks-and-service
This year Carmen Bowman will be hosting and presenting the Proactive Practices to Prevent Falls series.
Action Pact has exhausted the same old list of “interventions.” Replace old, institutional “interventions” with individualized approaches and proactive practices. Learn how to create a proactive fall reduction culture by all. Teach everyone they have the SUPERPOWER to help prevent falls.
January 28, 2022: Moving from the same old “interventions” to Proactive Practices to Prevent Falls
February 18, 2022: Proactive Practice to Prevent Falls: Anticipating Needs, particularly bathroom needs, by all
March 18, 2022: Proactive Practice to Prevent Falls: Proactively checking in with residents by all
Missouri has received no new supply from Abbott in the last two weeks and was not notified of a pause from the manufacturer until DHSS inquired this week. All states are experiencing a similar situation, and availability at the state level has been decreasing since the White House announced a federal expansion of at-home testing for Americans. Since then, President Biden announced that hundreds of millions of at-home tests will be made available to Americans in January. With the increase in cases due to high Omicron transmissibility, this issue is being closely monitored as supply and demand changes daily. Missouri is placing a pause on fulfilling re-orders. This pause is due only to the current constrained supply, and we will resume the purchase of antigen tests, once they become available. Our team has identified several options that we are exploring and pursuing now to meet the current testing needs of our existing users as well as the long-term needs.
Effective immediately:
Because the antigen tests are not widely/easily available at this time- you will want to take into consideration creating a testing plan that includes both antigen and PCR testing. The State of Missouri is continuing to reimburse homes for PCR testing related to outbreaks.
Reimbursement for OUTBREAK Testing
A reminder that in order to furnish immediate aid and relief in response to the state of emergency due to the spread of COVID-19, the State of Missouri has made some funds from the Coronavirus Relief Fund available to Missouri Long-Term Care facilities with COVID-19 Outbreaks. These funds are available to Long-Term Care facilities that experience an outbreak (one or more positive cases) and are conducting base-line facility testing and some immediate follow-up testing in order to contain outbreaks. For more information: https://apps.dss.mo.gov/LongTermCareCovid19Invoices/.
If you have difficulty obtaining swabs and media from your laboratory- you can order them from Missouri State Public Health Laboratory (MSPH). Your contracted laboratory would still process the samples- not MSPH.
The healthcare continuum is again becoming strained with the number of positive cases across the state. This portal was originally established in November, 2020 to improve communication across the care continuum to assist in ensuring Missourians have access to the right care in the right setting.
We are renewing our request for long-term care communities to complete a brief survey each day in order to identify available beds for potential admissions. Participation in the bed availability survey is voluntary. The survey may be accessed at https://arcg.is/1rjKy8.
The dashboard was reset at 9:00 today, January 6, so homes will need to submit an initial survey – old update links will no longer work.
Reminder: After submitting the initial survey, a confirmation email will be provided for a link to update your survey each day (instead of submitting an initial survey). Submitting an initial survey results in multiple surveys showing on the map with different bed numbers. This makes it difficult to know which totals are current. Please use the link emailed after the initial submission to edit facility bed availability. Please do not submit an “initial” submission more than once. If information does not change from day to day, the submitter can simply update the date and submit – the prior day’s information will populate.
The survey information will populate an accompanying dashboard that will be available to hospitals to use as a tool in finding placement for those patients who would be best served in a long-term care setting.
This dashboard may be accessed at https://mophep.maps.arcgis.com/apps/opsdashboard/index.html#/f1e0745f93fe46b482d8ff4585f821bf.
To view instructions on utilizing the dashboard, click on ‘Instructions’ under the map for information.
January 12, 2022: Train the Trainer
March 2, 2022: Train the Trainer
May 4, 2022: Train the Trainer
July 6, 2022: Train the Trainer
September 7, 2022: Train the Trainer
November 2, 2022: Train the Trainer
Participants must receive approval in order to attend this workshop. Those wishing to attend must submit the application and all other necessary paperwork to MALA at least two weeks prior to the workshop date.
February 2-4, 2022: Reeling in Change – Get Hooked with MANHA
Location: Oasis Hotel and Convention Center, Springfield
Missouri Association of Nursing Home Administrators is pleased to invite you to attend our Winterfest Convention and Trade Show. The goal of this conference is to provide long-term care administrators and their staff practical and inspirational education hours along with the opportunity to network and socialize with colleagues. It is also the only MANHA sponsored conference that provides you a chance to view the latest technology, products, and services offered by suppliers.
March 2-4, 2022: 31st Annual Nursing Home Administrator Conference
Location: Virtual
The 31st Annual Nursing Home Administrators Conference will be held virtually. During these challenging times when person to person interaction is limited, the goal is to not only provide education but to also maintain connections and facilitate the networking that is part of a live event.
After registration, attendees will be sent a personal link and details regarding how to access and participate through the online event.
March 14-16, 2022: ALF 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.
CMS has issued updated visitation guidance for visitation in nursing homes. The new guidance includes that visitation is now allowed for all residents at all times. DHSS will be updating its guidance as well and it will be consistent with the CMS guidance. Long-term care facilities certified for Medicare and Medicaid are required to follow the CMS memo. All long-term care communities (SNF, ICF, ALF and RCF) may utilize the CMS guidance until the DHSS guidance is updated.
Please see the full memo at https://www.cms.gov/files/document/qso-20-39-nh-revised.pdf.
19 CSR 30-82.010 General Licensure Requirements
The Department of Health and Senior Services, Section for Long-Term Care Regulation has drafted emergency and proposed amendments for regulation set 19 CSR 30-82.010 in order to create a temporary closure procedure for those Medicare and Medicaid federally certified facilities (intermediate care facilities and skilled nursing facilities) licensed in Missouri which experience staffing shortages from the COVID-19 vaccine mandate issued by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services emergency regulation 42 CFR part 483.
The emergency amendment for 19 CSR 30-82.010 was filed on November 10, 2021, with an effective date of November 29, 2021, and expiration of May 27, 2022. The emergency amendment can currently be viewed at: https://www.sos.mo.gov/CMSImages/AdRules/main/EmergenciesforInternet/19c30-82.010IE.pdf. The proposed amendment covering this same material will also be published in the same issue of the Missouri Register. The Register publication date is December 15, 2021 for the emergency and proposed amendments and can be found at: http://www.sos.mo.gov/adrules/moreg/moreg.asp.
NOTE: The public comment period for the proposed amendment will be from December 15, 2021 – January 14, 2022. The Department will be accepting comments during the comment period by mailing the comments to: Carmen Grover-Slattery, Regulation Unit Manager, Section for Long-Term Care Regulation, Division of Regulation and Licensure, PO Box 570, Jefferson City, MO 65102-0570 or by emailing to: RegulationUnit@health.mo.gov.
The proposed amendment can be reviewed on our website at: https://health.mo.gov/about/proposedrules/.
The 2021 Annual Section for Long-Term Care Regulation Provider Meeting was held virtually on November 10, 2021.
The recorded videos are available at https://missouri.qualtrics.com/jfe/form/SV_ehWffJkM2r7WSHk.
Many questions asked during presentation were asked and have been compiled into a document with answers in the attached Provider Meeting Q&A.
In response to some specific questions, please see this medical marijuana presentation that was given by SLCR.
Please see the agenda here.
PowerPoint Handouts
1. Welcome & Section Updates
2. Division Introductions
3. Nursing Home Discharges
4. The New CNA Testing Process
5. Immediate Jeopardy and Past Noncompliance
6. Psychosocial Impact
7. Oral Health
8. ICAR Project
9. Life Safety Code Presentation
A message from CMS
Thank you for your interest in in the COVID-19 Omnibus Vaccine Rule (IFC-6). Last week’s stakeholder call had a limit of 10,000 participants and we exceeded that number. Please accept our apologies.
CMS has posted the presentation slides and a recording of the stakeholder call for your convenience.
To view the slides, visit https://www.cms.gov/files/document/covid-19-health-care-staff-vaccination-ifc-6-national-stakeholder-call-slides.pdf.
To view the video, visit https://www.youtube.com/watch?v=xHA0zY1aC-Y.
In addition to the resources above, CMS has prepared a frequently asked questions document, available here: https://www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.pdf.
Our next stakeholder call will be held on:
Wednesday, November 10, 2021
3:30 – 4:30 PM EST
To register in advance, visit https://cms.zoomgov.com/webinar/register/WN_bCsmBuXfTnOCK0owoQVHvg.
After registering, you will receive a confirmation email containing information about joining the webinar.
*Please note we can only accommodate 10,000 participants so register early to guarantee your participation.*
Again, thank you for your interest in this important topic. We look forward to working with you and, appreciate your commitment to the safety of your staff and patients.
SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. MDS data for 4/1/21 through 6/30/21 must be submitted no later than 11:59 p.m. on November 15, 2021.
The Minimum Data Set (MDS) 3.0 must be transmitted to CMS through the Assessment Submission and Processing (ASAP) system to the Quality Improvement Evaluation System (QIES). No additional reporting is required.
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:
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 7/1/21 through 9/30/21 is due November 14, 2021. 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. Therefore, phone and email support will be concluded as of Friday, November 12, 2021 at 8:00 p.m. (ET).More information about PBJ can be found on the following webpages:
December 8, 2021: Envisioning the Future: More to do in 2022
Pioneer Network is pleased to offer the fourth in its series of four Symposia for 2021, based on the theme, Envisioning the Future, and recognizing that there is More to Do in 2022. As the previous symposia have shared, we have learned a lot, but now the key is to take the lessons we have learned and use them to help us shape the future, one that is grounded on the principles of person-centeredness. The work ahead of us will not be easy, but Pioneer Network is pleased to be able to bring together a group of leaders who not only have the vision to lead the way, but who have begun the work needed to take us into the future.
November 2, 2021: FAQs for NHSN users that report weekly COVID-19 Vaccination Data for Long-term Care Facilities
CDC will host a webinar to review recent updates to the National Healthcare Safety Network (NHSN) weekly COVID-19 vaccination data reporting modules. This webinar will focus on addressing some of the frequently asked questions (FAQs) from facilities, reviewing data entry issues, and highlighting helpful training materials and resources.
Join the listen-only webinar to hear comprehensive responses to your FAQs based on the updates made to these modules. Thank you for submitting data to the NHSN weekly COVID-19 Vaccination Module for long-term care facilities.
Please use the link below to register:
Topic: FAQs for NHSN users that report weekly COVID-19 Vaccination Data for Long-term Care Facilities
Date: Tuesday, November 02, 2021
Time: 2:30 PM EST
Register in advance for this webinar:
https://cdc.zoomgov.com/webinar/register/WN_RI1J5TBRTmu0HiRKMALAtw
After registering, you will receive a confirmation email containing information about joining the webinar.
The Department of Health and Senior Services, Section for Long-Term Care Regulation has drafted emergency and proposed amendments regarding adding the level-of-care evaluation and assessment requirements back that were effective prior to October 31, 2021, in order for those individuals who would have qualified for Title XIX funded services prior to October 31, 2021, to be eligible to receive services funded through the American Rescue Plan Act (temporary enhanced federal medical assistance percentage). Therefore, a second level-of-care determination will be utilized from October 29, 2021, until the funding from the American Rescue Plan Act has been expended.
The emergency amendment for 19 CSR 30-81.030 was filed on October 15, 2021, with an effective date of October 29, 2021, and expiration of April 26, 2022. The emergency amendment can currently be viewed at: https://www.sos.mo.gov/adrules/EmergenciesforInternet/emergency. The proposed amendment covering this same material will also be published in the same issue of the Missouri Register. The Register publication date is November 15, 2021 for the emergency and proposed amendments and can be found at: http://www.sos.mo.gov/adrules/moreg/moreg.asp.
NOTE: The public comment period for the proposed amendment will be from November 15, 2021 – December 15, 2021. The Department will be accepting comments during the comment period by mailing the comments to: Carmen Grover-Slattery, Regulation Unit Manager, Section for Long-Term Care Regulation, Division of Regulation and Licensure, PO Box 570, Jefferson City, MO 65102-0570 or by emailing to: RegulationUnit@health.mo.gov.
The proposed amendment can be reviewed on our website at: https://health.mo.gov/about/proposedrules/.
Exciting transformation is coming for the Level of Care (LOC) process effective 10/31/2021! Our current LOC Process (many of us have referred to as the DA124 A/B forms) is undergoing major changes!
Here are some of the highlights:
The application process will all be ELECTRONIC. You will fill out and submit forms online on the COMRU website at https://health.mo.gov/seniors/nursinghomes/pasrr.php. For example, the forms will be able to be sent from the hospital to the nursing home to COMRU, all in one system. This electronic link will be available starting October 29, 2021. COMRU will not process these application until November 1, 2021.
The process of evaluating Level of Care will also change. New areas will be evaluated and previous areas will be changed in order to provide the best assessment for determining Level of Care. You can read about the new process in the proposed Regulation at 19 CSR 30-81.030, https://health.mo.gov/about/proposedrules/, which will go into effect on 10/31/2021.
To help facilities prepare for these changes, COMRU will be hosting a webinar. Additional trainings to follow.
Thursday, October 28, 2021 at 10:00 a.m.
Join from the meeting link
https://stateofmo.webex.com/stateofmo/j.php?MTID=m37d648b96f1c1d7176099f11c07b6185
Join by meeting number
Meeting number (access code): 2451 311 8637
Meeting password: 3YXgTsdkc37
Tap to join from a mobile device (attendees only)
+1-650-479-3207,,24513118637## Call-in toll number (US/Canada)
+1-312-535-8110,,24513118637## United States Toll (Chicago)
Join by phone
1-650-479-3207 Call-in toll number (US/Canada)
+1-312-535-8110 United States Toll (Chicago)
November 16, 2021: Recharge with a Nature Fix
Speaker: Tammy Marshall, Biophiliac & Longevity Expert and Founder & CEO of Biophilia Pharma
Join Pioneer Network for the last of the 2021 Share the Vision webinars, where speaker, Tammy Marshall, Biophiliac & Longevity Expert and Founder & CEO of Biophilia Pharma, will share with attendees the power of nature in supporting health and well-being – not only the residents you support, but for you!
Tammy will explain the value of nature as a health equity and the science behind nature immersion (Yes, spending all those hours outdoors engaging with nature has value beyond just the fact that you like it and it is fun!) She will share tips on how you can find yourself a nature fix, how it is all about knowing thyself.
In Tammy’s work, she has seen how supporting residents so that they can enjoy the outdoors is often very challenging for care communities, and as we approach the winter months, that challenge can become greater, and so Tammy will also be sharing ways to bring the outdoors in.
November 19, 2021: Creating Connectedness
Presenter and Host: Carmen Bowman
LTC communities face daunting challenges when it comes to the difficulties of staffing right now. Employees have increased expectations of their leaders and managers than in the past. For organizations to thrive during rapid change, they need a mindset shift from traditional problem solving to an increased emphasis on the needs of the employee and the vital roles they hold. Learn to identify the top reasons why employees leave, and ideas for a culture that honors and includes employees like never before.
Sponsored by the Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation in partnership with MU Sinclair School of Nursing, this year’s SLCR Provider Meeting will be held virtually.
Wednesday, November 10, 2021
With the meeting being conducted virtually this year, registration will be required. The link to register along with session information will be coming soon. Please stay tuned to the LTC Information Update for more details.
National Consumer Voice for Quality Long-Term Care has a NEW Enrichment Booklet offers residents a variety of activities to keep them entertained and active. This book includes puzzles, word searches and crosswords; prompts for residents to write about the connections in their lives; trivia questions, which can be done alone or with others; and more!
Download and print the Enrichment Booklet for free or purchase hard copies of the booklet from the online store.
October 1-31, 2021: MHCA Virtual Convention
For those who attended the convention in-person but missed an education session, you now have access to any missed sessions as well. Therefore, all of the facilities that registered for the in-person Convention are automatically enrolled in the Virtual Convention! Please note – each facility registered for the Virtual Convention can allow an unlimited number of attendees from your registered facility to participate in the education sessions offered virtually.
If you could not attend the in-person Convention, you can register now for the Virtual Convention. Once the Virtual Convention begins, the education sessions will be available 24/7 and run through October 31.