Pre-Admission Screening and Resident Review (PASRR) Flexibility Ending May 11, 2023

With the recent announcement from the White House regarding the official end of the Public Health Emergency on May 11, 2023, the waiver that allowed nursing homes to admit new residents who have not received PASRR Level I screenings and Level II evaluations will terminate on May 11, 2023.

That date is beyond the 60 notice that CMS has previously said would be given to allow states to unwind any COVID related changes to their PASRR program. As such, CMS will expect states to resume the completion of PASRR activities prior to admission as of May 12, 2023.

The PASRR process requires that all applicants admitting to Medicaid-certified nursing facilities be screened for possible serious mental disorders or intellectual disabilities and related conditions. This initial pre-screening is referred to as PASRR Level I, and is completed prior to admission to a nursing facility. A negative Level I screen permits admission to proceed and ends the PASRR process unless a possible serious mental disorder or intellectual disability arises later. A positive Level 1 screen necessitates an in-depth evaluation of the individual by the state-designated authority, known as PASRR Level II, which must be conducted prior to admission to a nursing facility.

Long-term care facilities, hospitals, and other referral agencies should educate admission and discharge planners to this requirement- as it is a return to pre-COVID activities that they may be unfamiliar with.

iQIES for Minimum Data Set (MDS) Submission Release on April 17, 2023

CMS is excited to announce that the transition of the Minimum Data Set (MDS) assessment submission and reporting functionality to the Internet Quality Improvement and Evaluation System (iQIES) will occur on Monday, April 17, 2023.

To properly prepare for the transition, the QIES Assessment Submission and Processing (ASAP) system for MDS submissions will be turned off on Thursday, April 13 at 8:00 p.m. ET. Providers should submit completed MDS records prior to 8:00 p.m. ET on April 13 to QIES (ASAP) or wait until 8:00 a.m. ET on April 17 to submit data in iQIES. Providers are expected to take into account all requirements when determining the date they submit completed MDS records, including but not limited to, submission timeliness, claims processing, and care planning requirements.

CMS will provide additional information through various email notifications regarding training, technical guidance, details on what to expect, and more.

Register for an iQIES Account

Please note that failure to obtain access to iQIES prior to April 17, 2023 will impact your ability to submit MDS records. As mentioned in previous communications, nursing home and swing bed providers who are required to submit data to CMS must have at least one staff person assigned and approved as the facility Provider Security Official (PSO), who works for the provider and is responsible for approving all other users for their facility. For information and instructions to register for an iQIES account, please visit: https://qtso.cms.gov/news-and-updates/action-required-register-iqies-account.

iQIES Service Center

If you have questions or require assistance, please contact the iQIES Service Center at iqies@cms.hhs.gov or by phone at (800) 339-9313. Please note that call volume may be higher than normal during this time.

AADD Conference

May 15-16, 2023: 32nd Annual Aging with Developmental Disabilities Conference
Location: St. Charles Convention Center

The Annual Aging with Developmental Disabilities Conference has a goal of bringing the aging and developmental disability professionals together to learn about best support models and practices and the most current information on aging with a developmental disability. Through information, education, and networking, participants from across the United States will have a better understanding of both medical care, medical changes and best practices that will help them support people with developmental disabilities with living their best life as well as end-of-life care.

CMS Releases Updated Resources to Prepare for the May 11 End of the COVID-19 Public Health Emergency and National Emergency

January 30: The Biden Administration announced its intent to end the COVID-19 national emergency and public health emergency declarations on May 11, 2023. To ensure a smooth transition and help protect the health and well-being of the American people, CMS has taken immediate action to update fact sheets and other supporting resources to prepare for changes that will occur beginning on May 11.

Action Pact’s Conversations with Carmen

This year Carmen Bowman will be hosting and presenting the Back to the Future: Moving Dining Forward series with Linda Bump MPH, RD (Registered Dietitian, Licensed Nursing Home Administrator and Action Pact consultant).

February 17, 2023: Are your residents still enduring restricted diets?
March 17, 2023: Are your residents still offered the outdated altered consistency diets?
April 21, 2023: Are your residents still offered artificial food/supplements?
May 19, 2023: Are your residents still only offered the main meal or the alternate/token choice?
June 16, 2023: Are your residents still offered set meal times?
July 21, 2023: Are your residents still offered institutional meals?
August 18, 2023: Are your residents still not involved in preparing food?
September 15, 2023: Is your dining experience still institutional?
October 20, 2023: Are you still not offering the opportunity for people to help themselves?
November 17, 2023: Are you still not celebrating various ethnicities & incorporating themes into the life of your home starting with food and the dining experience?

Temporary Service Disruption – Adult Abuse and Neglect Hotline Online Reporting

The Department of Health and Senior Services regrettably informs you that the Adult Abuse and Neglect Hotline Online Reporting System will experience a temporary service disruption starting at 10p.m. February 8 until 6a.m. February 9 to allow for scheduled maintenance and updates. During this time, please make all Adult Abuse and Neglect Hotline Reports using our toll-free number, 800-392-0210, which is operational from 7a.m. to 8p.m., 7 days a week, 365 days a year.

We apologize for any inconvenience this may cause and thank you for your patience and continued partnership as we work to keep Missouri seniors and adults with disabilities safe.

To report Adult Abuse, Neglect, or Financial Exploitation online, go to www.Health.Mo.Gov/abuse.

 

Registration Open – Promoting COVID-19 Bivalent Vaccinations for Older Adults: Long-Term Care Provider Perspectives

February 9, 2023: Promoting COVID-19 Bivalent Vaccinations for Older Adults Webinar (3:00-4:00 p.m. ET)

Register for the upcoming Communities of Practice webinar focused on promoting COVID-19 bivalent vaccinations for older adults and residents/staff in long-term care settings; speakers will present successful strategies in increasing bivalent booster uptake in their communities.

Moderated by CDC’s State, Tribal, Local, and Territorial (STLT) Task Force.

Featuring presentations from:

  1. Patrick Cote, PharmD, Director, Pharmacy Services, Good Samaritan Society (Sanford Health), North Dakota
  2. Kaylea Watkins, RN, CIC, Infection Preventionist, Providence Mount St. Vincent, Seattle, WA
  3. Winter Viverette, MAIO, MATD, Infection Prevention Specialist, Healthcare Settings, Chicago Department of Public Health
  4. Karen McDonald, BSN, RN, Vice President, Chief Clinical Officer, Mission Health Communities

Register Now: https://phf-org.zoom.us/webinar/register/WN_5y6WJDbzQduEy5z1exaBxQ

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 10/1/22 through 12/31/22 is due February 14, 2023.

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:

CMS PBJ webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ
PBJ Reference Manuals – https://qtso.cms.gov/vendors/payroll-based-journal-pbj-vendors/reference-manuals
PBJ Training – https://qtso.cms.gov/training-materials/payroll-based-journal-pbj

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 and NHSN data for 7/1/22 through 9/30/22 must be submitted no later than 11:59 p.m. on February 15, 2023.

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:

CMS SNF QRP Data Submission Deadlines webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-Data-Submission-Deadlines
CMS SNF QRP Help webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-QRP-Help
CMS SNF QRP Measures and Technical Information webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-Measures-and-Technical-Information
CMS SNF QRP Training Webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-Training

DMH Free Webinar – Tools for Everyone

February 9, 2023: 1:00 Registration
February 14, 2023: 1:00 Registration
February 22, 2023: 10:00 Registration
February 28, 2023: 1:00 Registration

Presenter: Kathleen Deppeler, Director of Positive Supports

Tools of Choice is an evidence-based program focused on the implementation of universal positive practices. This two-hour introductory training is open to community members, parents, and professionals. It covers key concepts of the Tools of Choice curriculum, including:

  • What is Behavior?
  • Building Positive Relationships
  • How to Increase Desirable Behavior

Join the Positive Support Consultants in learning strategies to make positive change by implementing universal positive practices.

MC5 Event

February 17, 2023: Culture Change and Hospice End of Life Care
Location: Farmington Public Library

In this presentation, it will be discussed promoting a culture change of person-centered care with the perception of hospice and end-of-life care and provide knowledge on how receiving the full hospice benefit promotes better quality of life and dignity.

February 22, 2023: Unload Medication Overload: Making Sense of Polypharmacy and Deprescribing (Virtual Meeting)
Presenter: Hedva Barenholtz Levy, PharmD, BCPS, BCGP, Director, HbL, PharmaConsulting

Medication overload or polypharmacy is a main culprit of medication-related problems, reduced quality of life and high healthcare costs among older individuals.

Consequences of polypharmacy are multifold and can be prevented with a more judicious approach to medication use. Efforts to address widespread medication overload are gaining momentum, including deprescribing of drug therapy. Professionals who work with older adults need to be familiar with the latest trends and strategies to optimize or “right-size” medications and serve as patient and family advocates.

Missouri Developmental Disabilities Council Training

March 6-7, 2023: Springfield, 8:30 – 4:30 Registration Link

March 7, 2023: 12:30 – 4:30 Registration Link

March 8-9, 2023: Independence, 8:30 – 4:30 Registration Link

March 9, 2023: 12:30 – 4:30 Registration Link

March 27-28, 2023: Columbia, 9:00 – 5:00 Registration Link

March 28, 2023: 1:00 – 5:00 Registration Link

March 29-30, 2023: St. Louis, 9:00 – 5:00 Registration Link

March 30, 2023: 1:00 – 5:00 Registration Link

Niagara University Disability Awareness Training has received funding from the Missouri Developmental Disabilities Council to provide education for anyone involved in emergency planning, preparedness, response, and recovery as it relates to individuals with disabilities and access and functional needs.

This program identifies the responsibilities of both emergency management personnel and disability advocates during an emergency. It also introduces the four modules necessary for proper response that include Disability Awareness Training, the Americans with Disabilities Act specific to Emergency management, emergency plan content, and Inclusive Planning and Active Participation.

LeadingAge Webinar Series – Essentials of the LTC Director of Nursing Role Part 2

March 29, 2023: Essentials of the LTC Director of Nursing Part 2
March 30, 2023: Essentials of the LTC Director of Nursing Part 2

LeadingAge Missouri in coordination with LeadingAge Iowa is pleased to announce a virtual series that will take place in three segments over the first half of 2023 that will aid in developing the Director of Nursing (DON) role in nursing homes. Elements of this series will focus on budgeting and quality assurance; survey processes and regulations; and human resources, customer service, and leadership.

Each segment of this series is designed to provide in-depth information and discussion on each topic without taking the series in a sequential order or taking all 3 sections of the series. By making each of the 3 segments standalone, you can better address succession planning by having individuals attend as their nurse leadership skills are identified. An additional section in this series will be added to the events calendar in June.

Dementia Across the Continuum: Exploring Best Practices in Every Setting

April 28, 2023: Dementia Across the Continuum: Exploring Best Practices in Every Setting
Location: Saint Louis University Campus

The workshop will discuss the benefits of a multidisciplinary approach to maximize functional abilities at each dementia stage and include expert presenters from hospital, home, rehab, and long-term care settings. Learners will gain skills for effective communication strategies as well as a structured and organized approach to identify appropriate interventions across dementia care settings.

Speakers include Dr. Lenise Cummings-Vaughn, a Washington University of St. Louis Physician in the Division of Geriatrics and Associate Medical Director at Parc Provence; Dr. Beth Templin, a Board Certified Geriatric Physical Therapist and founder of HouseFit, an innovative outpatient physical therapy company; Dr. Sarah Pease, Occupational Therapist at Memory Care Home Solutions; Amy Sobrino, Social Worker at Memory Care Home Solutions; and insight and advice from people living with dementia and their care partners on best practices.

Course approval applications are being submitted for six hours of continuing education credit for nursing home administrators, physical therapists, physicians, psychologists, occupational therapists, speech therapists, and social workers.

HQI/ASCP Webinar Invite

January 31, 2023: Clearing the Path for a Healthy New Year: Improving Bivalent Booster Rates in Long-Term Care

Join a FREE interactive panel discussion with frontline pharmacists and nursing home staff who will discuss effective strategies for improving bivalent COVID-19 vaccine rates in skilled nursing homes. You will have the opportunity to pose questions to these national and frontline leaders.

This session will be led by American Society of Consultant Pharmacists (ASCP) Chief Executive Chad Worz, PharmD, BCGP, FASCP and Health Quality Innovators (HQI) Vice President and Senior Consulting Manager Sheila McLean, MBA, LNHA, CPHQ.

We invite nursing home administrators, directors of nursing, infection preventionists and pharmacists to join this session to learn new tactics and workflows that reduce staff stress, and how to improve vaccination rates by building and expanding on already established pharmacy partnerships.

 

CMS Memo: QSO 23-05-NH: Updates to the Nursing Home Care Compare Website and Five Star Quality Rating System: Adjusting Quality Measure Ratings Based on Erroneous Schizophrenia Coding, and Posting Citations Under Dispute

Memorandum Summary

  • Adjusting Quality Measure Ratings: CMS will be conducting audits of schizophrenia coding in the Minimum Data Set data and, based upon the results, adjust the Nursing Home Care Compare quality measure star ratings for facilities whose audits reveal inaccurate coding.
  • Posting Citations Under Dispute: To be more transparent, CMS will now display citations under informal dispute on the Nursing Home Care Compare website.

Please see the full memo for complete details at https://www.cms.gov/medicare/provider-enrollment-and-certification/surveycertificationgeninfo/policy-and-memos-states/updates-nursing-home-care-compare-website-and-five-star-quality-rating-system-adjusting-quality.

Health Education Unit Updates

The DHSS Health Education Unit is conducting Weekly Instructor Info Webinars/Q&A Meet-Ups. These sessions will be held same day and time each week – Tuesdays at 2:00 p.m.

January 31, 2023: Instructor Info Meet Up Meeting
February 7, 2023: Instructor Info Meet Up Meeting
February 14, 2023: Instructor Info Meet Up Meeting
February 21, 2023: Instructor Info Meet Up Meeting
February 28, 2023: Instructor Info Meet Up Meeting

 

Series of the Month Webinar
February 9, 2023: Regional Test Sites Vs. Closed Test Sites
2:00-3:00 p.m.

Please see the CNA Registry webpage for past meetings and more information.

If you have questions, please call our office at 573-526-5686.

Medicare from Start to Finish

January 17, 2023: Live Virtual Workshop
March 22, 2023: In-Seat Workshop
July 12, 2023: In-Seat Workshop
September 13, 2023: In-Seat Workshop
November 8, 2023: Live Virtual Workshop

This 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.

Free Mental Health Education

January 19, 2023 (1:00 p.m.): Registration
January 26, 2023 (9:30 a.m.): Registration

Tools of Choice is an evidence-based program focused on the implementation of universal positive practices. This two-hour introductory training is open to community members, parents, and professionals. It covers key concepts of the Tools of Choice curriculum such as: What is behavior, building positive relationships, and how to increase desirable behavior. Join the Positive Support Consultants in learning strategies to make positive change by implementing universal positive practices. Information presented at each training will be the same and is being offered two different dates for convenience.

Presenter: Kathleen Deppeler, Director of Positive Supports
Target Audience: Anyone interested in learning more about Tools of Choice

Action Pact – Conversations with Carmen

January 20, 2023: Back to Food = Love, Life, Health and Wellbeing = Compliance and Culture Change

This is the first in the 2023 series, Back to the Future: Moving Dining Forward.

From token to true choice, using regulations and standards to help people living in long-term care to eat what they want to eat, and to live the lives they want to live.

Come out of the pandemic better. Take advantage of this time and do it different. Learn how to shift your culture to honor each individual and get back to normal, to HOME, particularly in all things dining and vibrant daily living.

Each webinar will be framed by culture change practices, the Dining Practice Standards, leaning into CMS requirements and the Artifacts of Culture Change 2.0, the domains of wellbeing embedded in the CMS RoPs, and Kitwood’s basic human needs.

RAI Process from Start to Finish

February 7-8, 2023: Live Virtual Workshop
April 4-5, 2023: In-Seat Workshop
August 8-9, 2023: In-Seat Workshop
October 17-18, 2023: In-Seat Workshop
December 5-6, 2023: Live Virtual Workshop

This 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 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.

Virtual MC5 Meeting

January 17, 2023: Changing the Culture of Aging Through Meaningful Engagement
Presenter: Joan Devine, RN, Former Director of Education, Pioneer Network

Historically as we age, society has told us that our days of contributing are over and it’s time to sit back, relax and become the receiver of care and services. Based on this belief, the goal for many providers of senior services has been to design passive activities, things to keep people busy; to help pass the time. Communities around the country and around the world have heard the voice of Elders, and that voice is telling them that keeping busy is not enough!

It’s about engagement, meaning and purpose, and a chance to contribute to the greater good. What communities are learning is that when Elders are part of a “community commitment”, it not only benefits them and their senior living community, it sends a message that Elders are still valuable members of society.

This virtual session will explore what active engagement looks like based on the principles of the Citizenship Model as well as by the stories of nursing homes and assisted living communities that were recipients of the Pioneer Network’s Community Commitment Awards.

LeadingAge Webinar Series – Essentials of the LTC Director of Nursing Role

January 18-19, 2023: Essentials of the LTC Director of Nursing Role

LeadingAge Missouri is pleased to offer a joint education with LeadingAge Iowa in a virtual series that will aid in developing the Director of Nursing (DON) role in nursing homes. Elements of this series will focus on budgeting and quality assurance; survey processes and regulations; and human resources, customer service, and leadership.

This is meant to be an ongoing education series and each segment of this series is designed to provide in-depth information and discussion on each topic without taking the series in a sequential order or taking all three sections of the series. By making each of the three segments standalone, you can better address succession planning by having individuals attend as their nurse leadership skills are identified. Additional sections in this series will be added to the events calendar in March and June.

LeadingAge Management Strategies for Workers Compensation in Today’s Long Term Care Environment

February 15, 2023: Day 1 Registration
February 16, 2023: Day 2 Registration

June 7, 2023: Day 1 Registration
June 8, 2023: Day 2 Registration

August 9, 2023: Day 1 Registration
August 10, 2023: Day 2 Registration

October 11, 2023: Day 1 Registration
October 12, 2023: Day 2 Registration

Learn the elements of Total Safety Management, a comprehensive behavior-based safety program, to reduce employee injury and minimize workers compensation expense. Learn about claims management and the HCFM workers compensation insurance trust.

 

Click on the Zoom link above for both days of the desired session to register.

Financial Planning Webinar for Older Missourians

January 24, 2023: Financial Planning Webinar for Older Adults

Financial planning is for everyone. This includes taking the steps necessary to ensure that your desires regarding the future of your personal care, medical care, property, and resources are accurately recorded for your loved ones to follow.

Latasha Barnes with Legal Services of Eastern Missouri will discuss how you can use simple estate planning tools to plan for the future.