Action Pact’s Conversations with Carmen

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

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

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

10-Digit Mandatory Dialing Changes

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

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

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

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


Join by meeting number

Meeting number (access code): 2462 582 1044

Meeting password: pcGjudFE679


Tap to join from a mobile device (attendees only)
+1-650-479-3207,,24625821044## Call-in toll number (US/Canada)
+1-312-535-8110,,24625821044## United States Toll (Chicago)

Transfer and Discharge Procedures – REGULATION UPDATE NOTICE

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 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

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:

The proposed amendment can be reviewed on our website at:

LTC Bed Availability Portal Reminder

Reminder: After submitting the initial survey, a confirmation email will be provided for a link to update your survey each day (instead of submitting a new survey). Submitting a new 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 To view instructions on utilizing the dashboard, click on ‘Instructions’ under the map for information.

Action Pact’s Conversations with Carmen

September 17, 2021: Living Life Outside of Groups – Dispelling the Pressure to Hold Them

Most residents end up spending most time in their room, with or without a pandemic. We have needed to hone helping people live life outside of groups all along. Groups can never be 24/7 or meet everyone’s needs anyway. Gift residents with lots of ideas of things to do beyond the norm and beyond television. Encourage people with time on their hands to try something new, do things they have not done in a while, refocus their capabilities, live out passions in adaptive ways and not lose their taste for life no matter their abilities. Work with people to tell their life story, share wisdom, leave a legacy, develop the invention, book or song in their heart, armchair travel, plan, sing, study, sort photos, serve others, and more. What a great moment in time to get creative and go deeper with people. Learn how to have every team member honor and validate every individual’s’ life role/contribution to your community.

DHSS COVID-19 Vaccination Booster Doses Survey

The Department of Health and Senior Services is planning for the upcoming approval of booster COVID-19 vaccination doses and long-term care facilities will be a priority. The federal pharmacy program used to administer first and second doses will not be available, so it is important to ensure long-term care facilities receive the needed support for the administration of booster doses. We are asking for your feedback regarding your facility’s readiness to administer booster doses.

For those SNFs (Medicaid/ Medicare certified) that already completed the NHSN survey, we already have your results no further action is needed.

For questions regarding this survey, please contact Lana Hudanick at or 314-982-8260. Please reply by September 15, 2021.

COVID-19 After Action Report (AAR) Survey – Deadline Extended

The deadline to complete the DHSS COVID-19 After Action Report (AAR) Survey has been extended to Friday, September 3, 2021. Your assistance in helping us gather this important data is greatly appreciated. Please feel free to share the link with your state, regional, and local partners in the following categories:

  • Public Health/LPHA
  • Hospital
  • EMS
  • Emergency Management
  • Behavioral Health
  • Healthcare Coalition Leadership
  • State Agency Partners

Please let us know if you have any questions or difficulties with the survey.
John Whitaker –
Brendan Bagby –

Changes to Missouri’s Adult Abuse and Neglect Hotline Hours of Operation

The Department of Health and Senior Services (DHSS) is revising the hours of operation for the Missouri Adult Abuse and Neglect Hotline to 7:00 a.m. to 8:00 p.m., 365 days a year, effective September 1, 2021. The Hotline’s former hours of operation were 7:00 a.m. to midnight, 365 days a year. This change will allow the Department to better serve those who need to report concerns of abuse, neglect, and exploitation of vulnerable individuals 60 and older and people with disabilities between 18 and 59.

During fiscal year 2020, DHSS received and investigated 40,714 community and facility reports of abuse, neglect, bullying, and exploitation, involving seniors and adults with disabilities. That amounts to an average of over 111 reports every day. The number of cases continues to rise, but still vastly understates the extent of the problem as experts believe that for every case of adult abuse or neglect reported, as many as 23 cases go unreported.

In November of 2019, DHSS implemented the Adult Abuse and Neglect Hotline online reporting system allowing concerned citizens and mandated reporters to electronically submit reports of abuse, neglect, and exploitation in an efficient, secure, and confidential manner on a web-based platform. The online reporting portal is available 24 hours a day, 7 days per week and provides an alternative to calling the Adult Abuse and Neglect Hotline both during and outside of normal business hours. Since the implementation of online reporting, approximately one-third of all reports are submitted this way. While online reporting has helped to ease the Adult Abuse and Neglect Hotline’s call volume demands, additional efforts are still needed to ensure that no call goes unanswered. The new operational hours for the Hotline will allow for increased staffing during times of highest call volume. This will help reduce wait times for those reporting and make it easier to reach a trained intake professional between 7:00 a.m. and 8:00 p.m. Please note that 9-1-1 should be accessed for emergencies as the Adult Abuse and Neglect Hotline online reporting system is not intended for emergency response.

If you suspect abuse, neglect or financial exploitation of the elderly or an adult with a disability, you may call the Adult Abuse and Neglect Hotline toll-free at (800) 392-0210 or visit to make a report online.

If you have any questions regarding the change in the hours of operation for the Adult Abuse and Neglect Hotline, please reach out to the Department at 573/526-3625 or

Public Health: Better Health. Better Missouri.

Changes to the Weekly NHSN COVID-19 Vaccination Data Collection Forms for Long-Term Care Facilities

Changes are underway for CDC’s Weekly NHSN COVID-19 Vaccination Modules. In anticipation of recommendations for additional COVID-19 vaccine series, new questions on COVID-19 vaccine doses will be added to the current data collection forms in August 2021. The main changes to the forms for all three facility types are listed below:

  • Added question #4 for facilities to report on the cumulative number of individuals eligible to receive an additional dose or booster of COVID-19 vaccine.
  • Added question #5 for facilities to report on the cumulative number of individuals who received an additional dose or booster of COVID-19 vaccine (by manufacturer type).

To help facilities prepare for these changes, CDC is conducting listen-only training webinars.

Topic: Changes to the Weekly NHSN COVID-19 Vaccination Data Collection Forms for Long-Term Care Facilities
Date: Wednesday, Aug 25, 2021
Time: 2:30 – 3:30 PM ET

MHCA’s Annual Convention

August 22-25, 2021: MHCA 73rd Annual Convention & Trade Show
Location: Branson Convention Center, Branson

The long-term care industry faced enormous challenges in 2020 due to the COVID-19 pandemic. Thanks to your hard work and perseverance, along with widespread access to vaccines, we feel comfortable about gathering in person in Branson.

Click HERE to view a message from MHCA Executive Director, Nikki Strong, regarding an update to safety protocols and masking requirements for the MHCA 73rd Annual Convention & Trade Show.

Empowering Elder Well-Being with Supportive Technology

August 26, 2021: Empowering Elder Well-Being with Supportive Technology

Today’s elders have more ways than ever to stay connected with their loved ones, but tech support at Life Plan Communities and other senior living campuses isn’t always geared toward them – and common resources online may not include solutions unique to their needs.

Even though the strict lockdowns at nursing homes and other communal settings have eased considerably, the pandemic revealed the very real need for elders to master technology in order to combat loneliness, provide entertainment, and even stay on top of their health through apps and wearables.

On August 26 at 3 p.m. ET, Join GroovyTek, The Green House Project, and the Pioneer Network for a can’t-miss discussion on empowering elders with technology.

Using the International Council on Active Aging’s Seven Dimensions of Wellness as a guide, we’ll:

  • Explore the current state of older adults’ relationship with technology,
  • Discuss strategies to overcome barriers to adopting common tech tools,
  • Discover how tech can promote elders’ independence, wellbeing, and health,
  • Hear directly from an elder about her personal experience with tech,
  • And much more.

Pioneer Network’s Virtual Symposium

September 22, 2021: Envisioning the Future: Finding Meaning & Purpose

Pioneer Network is proud to present the third in its series of four Symposia for 2021, each based on the theme, Envisioning the Future. In this symposium, the focus is on Finding Meaning & Purpose. Speakers include residents and innovators in the field who will draw on their experiences, including the collective experiences encountered as we all lived through the pandemic. They will explore how to find meaning and purpose for those who live and work in senior living communities as well as how we can move forward in a way that assures that isolation becomes a thing of the past, acknowledging that wherever we may reside, life is lived best in community.

MC5 – Special Virtual Meeting

September 22, 2021: Finding and Keeping Great Co-Workers
Presenter: Clint Maun, CSP

Healthcare Providers have taken the needed action to fight a global pandemic and have established the required systems to contain and prevent the spread of the Corona Virus. The never-before-seen challenges we have experienced in 2020 has made it more vital than effort to have superior staff in all roles in 2021. We know healthcare professionals and staff can work together to achieve amazing success at workforce stabilization which will also benefit our customers. Join Clint Maun for an overview of proven teaming strategies during this time of opportunity, including processes to build workforce resilience and reduce burnout.

Join us for this important Virtual meeting.

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 4/1/21 through 6/30/21 is due August 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. The Service Center will be unable to assist on the weekend. Therefore, phone and email support will be concluded as of Friday August 13, 2021 at 8:00 p.m. (ET).

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

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. MDS data for 1/1/21 through 3/31/21 must be submitted no later than 11:59 p.m. on August 16, 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 IRFs, LTCHs, and 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 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:

Conversations with Carmen

August 20, 2021: A Beautiful Day in the Neighborhood
Guest: LaVrene Norton, Action Pact Founder & Executive Leader and Megan Hannan, Action Pact Consultant; with Host Carmen Bowman

Need help getting everyone out of the doldrums of COVID? Let free the spirit of joy and love – work together to bring back the simple pleasures of home. Create team on the fly. Let music and laughter rock the halls. Wave!

Think Neighborhood. Have a block party.

We begin again with a short presentation on the Artifacts of Culture Change as they can offer us a measurable road map. We will then head down the path to Neighborhood where culture change begins. Where good neighbors work together to enjoy and share the simple pleasures of daily life.

CNA Update Training – Staffing Series 2: Take off on the Journey to Improve Staffing

September 14, 2021: Staffing
Location: Ameristar Hotel, St. Charles

September 15, 2021: Staffing
Location: Oasis Hotel, Springfield

September 28, 2021: Staffing
Location: Stoney Creek Hotel & Conference Center, Independence

September 29, 2021: Staffing
Location: Comfort Inn, Macon

CNA Training Update in Missouri

We have been waiting a long time and finally we see the results coming at us from our efforts to update and improve the training of Missouri CNA’s. The process has changed significantly effective August 31, 2021 “technically”. Administrators, DON’s, RN Instructors, HR Staff and CNA Training Organizations will want to understand how these changes affect them and their programs. The CNA Registry process for verification of employment in the last 24 months has also changed and will be handled through a third party site. You should already be registered as an employer and your CNA’s in the new system. This session will review all the new regulations, the new forms and the new testing/registry process through TMU Headmaster.

Staffing Series 2: Take off on the Journey to Improved Staffing

In Series 1, we explored Staffing Turnover and Retention and formulated a Roadmap to take us on a journey to improve staffing, increasing stability and quality of care, life and service for our residents. In this series we will take off on the journey and concentrate on the areas that Series 1 attendants identified as needing the most work; Recruitment and On-Boarding/Training. We will rethink where we are spending recruiting dollars, share ideas for improving landing quality applications and then build on reducing turnover and improving retention with improved and best practice ideas for Staff on-boarding/Orientation and training. Administrators and HR Staff will benefit from this interactive session. If you missed the first session, you can view it on-line on SDS Training site through MANHA.

Trauma-Informed Care: Nursing Home Responsibilities & Plan of Action

October 5, 2021: Trauma Informed Care
Location: Oasis Hotel, Springfield

October 6, 2021: Trauma Informed Care
Location: Comfort Inn, Macon

October 7, 2021: Trauma Informed Care
Location: Ameristar Hotel, St. Charles

October 12, 2021: Trauma Informed Care
Location: Stoney Creek Hotel & Conference Center, Independence

Sponsored by Missouri Health Care Association & Missouri Association of Nursing Home Administrators

We will review the regulatory requirements, available resources and necessary policy and procedure changes to keep your facility on the right side of Trauma Informed Care Compliance.