Category: Events

CMS Memo QSO 20-39-NH: Nursing Home Visitation – COVID-19 (Revised 11-12-2021)

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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.

General Licensure Requirements – REGULATION UPDATE NOTICE

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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/.

2021 Annual SLCR Provider Meeting

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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

 

COVID-19 Health Care Staff Vaccination IFC-6: Presentation Slides and Video

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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.

SNF Quality Reporting Program (QRP) Submission Deadline Reminder

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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 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:

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 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:

Pioneer Network’s Virtual Symposium

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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.

FAQs for NHSN users that report weekly COVID-19 Vaccination Data for LTC Facilities

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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.

Evaluation and Assessment Measures for Title XIX Recipients and Applicants – REGULATION UPDATE NOTICE

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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/.

Level of Care Transformation

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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)
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Join by phone
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Pioneer Network Hot Topics – Culture Change in Action

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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.

Action Pact’s Conversations with Carmen

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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.

2021 Annual SLCR Provider Meeting – SAVE the DATE

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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.

New Enrichment Booklet for Residents

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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.

MHCA Virtual Convention 2021

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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.

Pioneer Network Hot Topics – Culture Change in Action

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October 21, 2021: Someone Just for Me: Recognizing a Critical Role for Volunteers
Speaker: Dr. Paul Falkowski, Ph.D., Gerontologist, Author, Speaker, Educator

Long before COVID-19, professionals working in long-term care knew about the devastating effects of social isolation. Now because of COVID-19, social isolation has become an all too familiar term to the general population. We heard reports of people passing due to being disconnected from their families and friends during the past year. But what about the people who did not have family or friends?

Creating and sustaining intimate relationships takes time and commitment. In this session, you will learn the critical components for creating “authentic” relationships. You will learn how to recruit, screen for, and train a cadre of volunteers, who go on to become “companions” or, as one older woman observed, “…someone that is here just for me.” We’ll look at the transformational power volunteers like these can have on the people you serve, the people serving them, the volunteers themselves, and your surrounding community.

Action Pact’s Conversations with Carmen

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October 15, 2021: Why Employees Leave and Ideas for Honoring, Retaining and Recruiting Them
Guest: Linda Shell, RN, PhD; with 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.

Action Pact’s Conversations with Carmen

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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.

Community Education Webinar from VOYCE

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November 9, 2021: Protect Your Hard Earned Assets – How to Stay Financially Secure
Presenter: Lauree Peterson-Sakai, SVP, Aging Risk Strategy Leader, Wells Fargo

Join VOYCE for this Community Education webinar. Remember the adage “Knowledge is Power”? That certainly applies to becoming well-informed on all that is involved with aging! Join Wells Fargo’s Aging Client Service Strategy Leader for an informative course on financial safety. Spend the hour breaking down what you need to know about identifying financial exploitation and providing easy tips on keeping you and your money safe throughout your golden years. Registration for this webinar is free.

For any enquiries, please contact jmcgeechan@voycestl.org.

10-Digit Mandatory Dialing Changes

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10-Digit Mandatory Dialing Changes Will Impact Fire Alarm Panel Automatic Dialing

The Federal Communications Commission (FCC) has adopted an order approving the designation of “988” as the 3-digit abbreviated dialing code for the National Suicide Prevention Lifeline. As a result of this designation, beginning October 24, 2021, a 10-digit telephone number (area code + phone number) will be required to complete all local calls from area codes 314, 417, 660, and 816. All licensed long-term care facilities in Missouri are required to have a fire alarm panel that dials a monitoring company during a trouble call or fire signal. It is imperative that facility staff verify or reprogram the fire alarm panel to ensure it will dial out with the area code. This will need to be confirmed with the fire alarm and/or monitoring company. For additional information regarding 10-digit mandatory dialing changes, please refer to the FAQs About 10-Digit Dialing document developed by the Missouri Public Service Commission.

VOYCE Professional & Community Education Series Webinar

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October 12, 2021: Cannabis and CBD for Older Adults and LTC Residents

The use of cannabis and CBD products as alternative medical treatments has been widely contested in the United States. Yet, the use of these products can be highly beneficial to patients with a variety of health conditions – many of which are prevalent in aging and long-term care populations. Join us for a discussion with local experts about the function, benefits, and options for medical cannabis and CBD use. This course will also discuss the legal considerations for individuals and long-term care organizations interested in trying these alternative therapies. This webinar is available to both long-term care serving professionals and interested community members.

VOYCE Professional Education Series Webinar

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September 28, 2021: Eliminating Elderspeak through Compassionate Communication

Understanding elderspeak as a type of biased communication is vital to prevent future ageist behavior towards older adult patients and, thus, improve health outcomes. Elderspeak, most commonly found in long-term care settings, has been identified as a growing communication barrier between younger and older generations, especially in healthcare. Effective communication between patients and providers improves trust and adherence to treatment plans. Health communication and cultural sensitivity training are crucial for incoming, young health providers. As Boomer clinicians age and retire, they will be replaced by millennials who will need to learn how to navigate intergenerational relationships with their new Boomer patients.

Monoclonal Antibody Infusion Medication Information

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There has been a significant change in the ordering process for monoclonal antibody infusion medications. If you are currently utilizing these medications, please review the attached notice and plan on attending the webinar tomorrow. Also attached is information on reporting usage through the Teletracking system. Reporting through this system is highly encouraged as the usage reported will determine future amounts allocated to the state.

 Status Update re: Monoclonal Antibody (mAb) Infusion Medication Ordering:

Missouri Department of Health and Senior Services (DHSS) was notified by U. S. Department of Health and Human Services (HHS) yesterday, September 14, 2021, that effective immediately the states are responsible to review and approve all monoclonal antibody medication orders. This includes orders for REGEN-COV (casirivimab and imdevimab) and the Eli Lilly cocktail of bamlanivimab/etesevimab through AmeriSource Bergen. This was DHSS’ first notification of this change. We had no prior information to allow for planning, development of platforms for ordering/approvals or procedures, or messaging. Thus, all of this is occurring currently and as quickly as possible. Information on this change is still forthcoming from HHS, thus we may have process implementation delays at the state level as a result.

mAb Request Process Implementation and Timeline:

DHSS will host a webinar to introduce the state’s new mAb request process, details are below:

Friday, September 17, 2021

10:30-11:30 a.m.

Join from the meeting link

https://stateofmo.webex.com/stateofmo/j.php?MTID=mcb62b527fff05778bd574584e06c8b6d
 

Join by meeting number

Meeting number (access code): 2462 582 1044

Meeting password: pcGjudFE679
 

Tap to join from a mobile device (attendees only)
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Transfer and Discharge Procedures – REGULATION UPDATE NOTICE

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The Department of Health and Senior Services, Section for Long-Term Care Regulation has drafted emergency and proposed amendments affecting the transfer and discharge hearings referenced in regulation set 19 CSR 30-82.050.

The emergency amendment for 19 CSR 30-82.050 was filed on September 1, 2021, with an effective date of September 16, 2021 and expiration of March 14, 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 October 1, 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 amendments will be from October 1, 2021 – October 31, 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/.