2022 MOADD Summit

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

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

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
(573) 636-1014, ext. 1224

Eunice Halverson, Patient Safety Specialist
(573) 636-1014, ext. 1226

Nursing Home Staffing Study Blog and Stakeholder Listening Session

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

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

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

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

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

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

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

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

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

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

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/.

Free Dementia Training – Changing Talk: Online Training (CHATO) to Reduce Behavioral Symptoms in Dementia

CHAT educates staff about reducing elderspeak (infantilizing communication) and results in reduced behavioral symptoms and need for psychotropic medication for residents with dementia. The new online version (Changing Talk: Online Training (CHATO)) consists of 3; one-hour interactive online modules that provide flexible and accessible access for staff.

There is no cost, direct-care staff can earn 3 contact hours, and all staff get a Certificate of Completion for their file.

Benefits to you, your staff, and your residents include:

  • A person-centered approach.
  • Education about elderspeak and better communication strategies.
  • Reduction in resistiveness to care and other behavioral symptoms in residents with dementia.
  • Reduction in the need for psychotropic medication.
  • Convenient, online educational format for busy nursing homes.
  • Qualifies for CMS dementia care training hours requirements.
  • A free, nonpharmacological, evidence-based intervention is an excellent addition to a Quality Improvement Plan.

Here is also a one-page summary of the study.

Please see the website to learn more about CHATO and view our training resources or

Access the Google drive to download the NEW pilot research and CHATO National Trial information.

Interested parties can email Carissa Coleman (below) or complete the interest form on the website.

Carissa K. Coleman, PhD, MA
Research Assistant Professor
University of Kansas School of Nursing
t: 970-270-6839 | ccoleman3@kumc.edu

Prospective Reimbursement Plan for Nursing Facility and HIV Nursing Facility Services Reimbursement Rates Methodology

The MO HealthNet Division (MHD) is modifying the reimbursement plan for nursing facility and HIV nursing facility services to provide for the transformation of MO HealthNet nursing facility reimbursement rates by establishing a new reimbursement methodology, effective for dates of service beginning July 1, 2022. The primary changes from the current reimbursement include updating the cost base for the rates (i.e., rebasing), applying an acuity adjustment or Case Mix Index (CMI) to patient care costs, and providing quality based incentives or Value Based Purchasing (VBP) add-ons to the rate when the facility meets specified quality measures.

The following documents can be found at the MO HealthNet Alerts and Public Notices webpage:

An additional resource, The Missouri Medicaid Nursing Facility Reimbursement Methodology Summary for Fiscal Year 2023, created by MO HealthNet, provides a summary of the changes for the reimbursement plan found in the Prospective Reimbursement Plan for Nursing Facility and HIV Nursing Facility Services document.

Webinar Registration & Recap: Up to Date Vaccination Status: Surveillance Definition Change for COVID-19 Vaccination Modules

Information for NHSN users

The NHSN Vaccination Team hosted a webinar on Thursday, June 23rd to review changes to the definition for individuals considered Up to Date with COVID-19 vaccines for data reporting through the NHSN COVID-19 Vaccination Modules. We learned that some users were unable to join the webinar due to the number of participants exceeding capacity. We apologize for this inconvenience. To address this, NHSN is hosting a second webinar on the same topic (Up to Data Vaccination Status Surveillance Definition Change) on Tuesday June 28th from 12:00-1:00 PM Eastern Time.

Please click the link below to register for the webinar on Tuesday June 28th from 12:00-1:00 PM Eastern:


After registering, you will receive a confirmation e-mail containing information about joining the webinar.

We also wanted to provide answers to a few frequently asked questions that came up during the webinar:

  • The guidance we provided on how to report Up to Date COVID-19 vaccination applies to all facilities that report vaccination data through the NHSN COVID-19 Vaccination Modules including long-term care facilities (LTCF), dialysis facilities, acute care hospitals, inpatient psychiatric facilities, inpatient rehabilitation facilities, long-term acute care hospitals, and ambulatory surgery centers. The information provided regarding case reporting through the Resident Impact and Facility Capacity (RIFC) Pathways applies only to LTCFs.
  • NHSN’s surveillance definition of Up to Date with COVID-19 vaccines is based on CDC’s clinical considerations and Up to Date definition for the first day of the reporting quarter. CDC recently updated the definition of Up to Date vaccination, so the NHSN surveillance definition will change for Quarter 3, 2022, which begins during the reporting week of June 27, 2022 – July 3, 2022.
  • For LTCFs, the NHSN event-level (person-level) vaccination form will classify individuals as up to date and will apply this new definition beginning 6/27. In order for this to happen, you will need to enter date of birth beginning 6/27 for all individuals in the facility since age is now taken into consideration for determining up to date vaccination status. The Excel Data Tracking Worksheets have been discontinued for LTCFs and removed from the NHSN website since the event-level (person-level) vaccination tool is now available for LTCFs.
  • For all other non-LTC facility types (e.g., dialysis, acute care, ambulatory surgery, etc.), the Excel Data Tracking Worksheet is being updated to incorporate the new definition of up to date vaccination. It should be available in the coming weeks. This Excel tool will be maintained until the NHSN event-level vaccination forms are available for non-LTC facilities.

Community Education from VOYCE

July 12, 2022: A focus on Aging Ahead and St. Louis Area Agency on Aging
Presenters: Jan Keith, Director of Community Engagement, Aging Ahead and Jamie Saunders, Information & Assistance Coordinator, St. Louis Area Agency on Aging

Join VOYCE for this Community Education webinar presentation to learn about the valuable services for seniors offered by Aging Ahead and St. Louis Area Agency on Aging. We’ll learn about important services offered throughout the Greater St. Louis region including Senior Housing, Legal Services, Meals on Wheels, Health Insurance Marketplace, Long-Term Care assistance, and Medicare and Medicaid support.

2022 Annual SLCR Provider Meeting

August 24, 2022: Region 6
Location: Capitol Plaza Hotel & Convention Center, Jefferson City

September 1, 2022: Region 5
Location: Quality Inn & Suites, Hannibal

September 7, 2022: Region 4
Location: Stoney Creek Hotel & Conference Center, St. Joseph

September 8, 2022: Region 3
Location: Adams Pointe Conference Center, Blue Springs

September 15, 2022: Region 2
Location: Drury Plaza Hotel Cape Girardeau Conference Center, Cape Girardeau

October 5, 2022: Region 1
Location: Oasis Hotel and Convention Center, Springfield

October 12, 2022: Region 7
Location: Crowne Plaza St. Louis Airport, Bridgeton

The 2022 Updated Provider Meeting Agenda is now available. Please see the flyer for location details.


2022 Handouts
1. COMRU Online Application
2. CNA Testing and Renewal Process
3. LTC Regulatory Interpretive Guidance Update
4. Missouri Medicaid Case Mix
5. Section Update
6. Mental Health First Aid – Oct 12 2022
7. Mental Health Care & Crisis Planning For Nursing Facilities
8. ARPA Funding

2022 Enhanced Leadership Development Academy for LTC Leaders

Do you…..

❍ need a leadership course that addresses the unique challenges SNF leaders face?
❍ want to feel inspired and passionate about leading your SNF?
❍ want to connect with other SNF leaders and have access to free professional development, tools, and resources?
❍ want free CE credit without sacrificing quality and practical application?
❍ want to have the flexibility to learn at the pace and place the works best for you?

If you answer YES to any of these questions, this course may be for YOU!

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

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

MHCA Webinar – Developing New Leaders in Your Facility

Full series recordings are available through September 1, 2022: Developing New Leaders in Your Facility

Ensuring that potential or new supervisors have the skills to lead is vital to the achievement of your clinical, financial, regulatory, and resident experience goals. Far too often staff are promoted simply because they were exceptional in their current roles. A great nurse, cook, or admission coordinator may not yet be ready to be a great unit manager, food service or marketing director. This series will help your people make that leap – and familiarize you with the strategies you need to help them succeed!

MU Care of the Older Adult

August 19-20, 2022: Care of the Older Adult
Location: Holiday Inn Executive Center, Columbia & Virtual

This conference will provide health professionals the opportunity to gain knowledge in interdisciplinary approaches to clinical management and ethical treatment of older adults, a forum to discuss complex care issues common to all who care for the older adult and an awareness of innovative models of geriatric care delivery. The focus is on promoting excellence in gerontology health care by keeping abreast of the latest evidence-based practice.

This conference will be a hybrid event, you may attend in-person or online/virtual. If you choose to attend virtually, information will be emailed to you prior to the conference, using the email address you provide during registration.

Provider Feedback Survey

The Section for Long-Term Care Regulation is again seeking input from providers we serve. We are asking for your help in identifying areas in our Section where excellent customer service is provided and areas where we need to focus on improving our customer service experience. Please take a couple minutes to complete our 2022 Provider Feedback Survey by June 30, 2022 at https://www.surveymonkey.com/r/72PRNZY.