2024 SLCR Annual Provider Meetings

Sponsored by the Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation

There is no cost to attend any of these meetings. Please see the flyer.

September 4, 2024: Region 2
Location: Drury Plaza Hotel & Convention Center, Cape Girardeau

September 5, 2024: Region 7
Location: Crowne Plaza St. Louis Airport, Bridgeton

September 18, 2024: Region 1
Location: Oasis Hotel & Convention Center, Springfield

September 24, 2024: Region 6
Location: Special Olympics Missouri, Jefferson City

September 26, 2024: Region 5
Location: Moberly Municipal Auditorium, Moberly

October 1, 2024: Region 4
Location: Stoney Creek Hotel, St. Joseph

October 2, 2024: Region 3
Location: Adams Pointe Conference Center, Blue Springs

NSHN Reporting Essentials for LTC Webinar

HQI presented a webinar for all Nursing Homes in MO, free of charge, on March 13th in cooperation with MHCA and MANHA regarding the top citation F884 titled: Don’t Get Tagged: NHSN Reporting Essentials for Long-Term Care Facilities.

You can find the slides for the webinar and recording here: Don’t Get Tagged: NHSN Reporting Essentials for Long-Term Care Facilities | HQIN.

Infection Prevention Books

The Healthcare-Associated Infections/Antimicrobial Resistance Program is providing copies of Infection Prevention Guide to Long-Term Care, 2nd edition, and The Infection Preventionist’s Guide to the Lab free of charge to all Missouri Skilled Nursing Facilities, Intermediate Care Facilities, Assisted Living Facilities and Residential Care Facilities. Please utilize these free resources for Infection Prevention in your facility. These books are being mailed via UPS to each facility and you should be receiving them soon.

If there are any questions please contact the Healthcare-Associated Infections/Antimicrobial Resistance Program at (573) 751-6113.

Health Education Unit News

CNA Testing

Headmaster D & S is now offering the knowledge portion of the CNA exam in Spanish.

This change is effective for those scheduling after 5/22/24. Please stay tuned for the updated Candidate Handbook to be added to the DHSS CNA Registry webpage.

For questions, please reach out to Headmaster D & S at 800-393-8664 or the DHSS Health Education Unit at 573-526-5686.

MO Health Ambassador Trainings

Attention Missouri Nursing Homes!

Register for a Free In-Person Health Ambassador Training

Sessions Will Be Held in Jackson/Cape Girardeau, Saint Louis and Springfield

Don’t miss this opportunity to register two individuals from your nursing home for a free regional in-person Health Ambassador Training in Missouri being presented by the Health Quality Innovation Network (HQIN) and Johns Hopkins University.

This training uses the Be REAL framework which focuses on building trust by forming relationships, targeting resources responsive to a facility’s population, and always keeping the door open for interactions to improve health outcomes such as immunizations and infection prevention.

Two people may register per facility and a maximum of 40 participants will be allowed for each session. Recommended participants include all staff, such as:

  • Nurses
  • Infection Prevention Nurses
  • Nursing assistants
  • Social services
  • Dietary
  • Environmental services
  • Also, please consider sending a resident, family member or volunteer.

These sessions will be interactive and include group discussion, small-group activities, games, and an opportunity to practice what has been learned. 

MO Health Ambassador Trainings

For questions, please contact us at ltc@hqi.solutions.

These trainings have been made available by the Health Quality Innovation Network (HQIN) and the Institute for Vaccine Safety – Johns Hopkins Bloomberg School of Public Health.

Program Bed and Service Availability Portal is now available!

Please note this portal refers to the number of beds available for admission-not the number of licensed beds.

The Long-Term Care Ombudsman Program Bed and Service Availability dashboard can now be accessed. Facilities and the public can now view how many beds facilities have available, and which residents they can serve, i.e., memory care, behavioral health, bariatric, etc. This information is beneficial to facilities, families, hospital discharge planners and the general public to determine bed availability and services throughout the State. The dashboard can be accessed at this link dashboard. For information regarding how to navigate the dashboard, access this link training video.

If you have any questions about the survey, please contact the Long-Term Care Ombudsman Program via email LTCOmbudsman@health.mo.gov or call 800-309-3282.

New QIPMO Newsletter – May 2024

The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls (Volume 11, Issue 3).

In this issue:

Are You Being Proactive?
Immunization Billing Assistance
QIPMO and ICAR Education Resources
Recognizing a Resident’s ACOC
ICAR Corner
Emergency Management

Please visit QIPMO’s website here for this and other previous newsletters.

MDS Reminders

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 1/1/24 through 3/31/24 is due May 15, 2024. Please submit PBJ data as soon as possible to avoid delays.

 

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. The following data must be submitted no later than 11:59 p.m. on May 15, 2024:

  • MDS data for 10/1/23 through 12/31/23;
  • NHSN data for COVID-19 Vaccination Coverage Among Healthcare Personnel for 10/1/23 through 12/31/23;
  • NHSN data for Influenza Vaccination Coverage Among Healthcare Personnel for 10/1/23 through 3/31/24.

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.

PASRR Change in Condition Resident Review Update

The process to submit a change in condition is now online.

DMH will no longer accept the Change in Condition PDF through the PASRR email. Any forms submitted by PDF will receive a message directing them to the online form to complete. This will optimize the process making it more efficient and effective, similar to the online process for the Level I/Level. Please use the following link for the online Change in Condition form: Resident Review of Change in Condition: Nursing Facility Notification to Missouri Department of Mental Health (redcapdd.azurewebsites.net). This will also be at the DMH website at Pre-Admission Screening and Resident Review (PASRR) | http://dmh.mo.gov.

Is Your Emergency Preparedness Plan Survey Ready?

Our team of experts at the Health Quality Innovation Network (HQIN) offers free support to ensure your facility’s emergency preparedness plan meets all the necessary criteria.

Take our online assessment, which guides you through a series of questions that will quickly identify what could be missing in your current emergency preparedness plan. After you submit your responses, an HQIN quality advisor will review your responses and provide you with tools and resources to help support survey readiness.

Ready to get started? Click HERE to Take the Assessment

Cyber Security Preparedness Reminder

Managers from the Division of Regulation and Licensure within the Missouri Department of Health and Senior Services recently attended an update meeting with the CMS Regional Office in Kansas City. An informative presentation was provided by Captain Skip Payne, Director of the Emergency Preparedness & Response Operations (EPRO). Please see the attached key points and reminders.

Simple Strategies for Enhanced Barrier Precautions – HQIN Newsletter April 2024

Please see the HQIN Newsletter – Simple Strategies for Enhanced Barrier Precautions – April 2024.

In This Newsletter:

  • Simple Strategies for Enhanced Barrier Precautions
  • Enhanced Barrier Precautions
  • Description of EBP
  • Implementation of EBP
  • QAPI in Action
  • Is Your Emergency Preparedness Plan Survey Ready?
  • ASCP Immunization Billing Support
  • HQIN Workforce Strategy Resources

2024 SLCR Annual Provider Meeting Topics

We are currently in the planning phase to host in-person provider meetings in all regions this year and are considering the best topics to provide the most beneficial information. We would like to hear from you about what LTC related topics and info you believe would be helpful and educational!

Please take a moment to complete a one-question survey by April 17, 2024 at https://www.surveymonkey.com/r/XTBKD66.

Phase III Listserv Announcement Update

Earlier this week you received information regarding Phase III of the Department of Health and Senior Services COVID Prevention and Response Project. This final Phase includes free PPE items shipped directly to all Missouri Skilled Nursing Facilities, Intermediate Care Facilities, Assisted Living Facilities and Residential Care Facilities.

Shipment of the PPE kits from Concordance Healthcare have begun!

Shipments will be coming to facilities directly from Concordance Healthcare via UPS. Signatures will be required by the UPS driver, so please alert your office staff of the expected delivery.

This is a one-time shipment of PPE which is being sent automatically to your facility.

The shipment will contain nine (9) boxes of:

  • 1 case Small Nitrile Gloves (10 Boxes of 250 gloves)
  • 1 case Medium Nitrile Gloves (10 Boxes of 250 gloves)
  • 1 case Large Nitrile Gloves (10 Boxes of 250 gloves)
  • 1 case Extra Large Nitrile Gloves (10 Boxes of 250 gloves)
  • 1 case Surgical Masks (300)
  • 1 case N95 Respirator Mask (200)
  • 1 case Large Isolation Gowns (10 Packs of 10 gowns)
  • 1 case Extra Large Isolation Gowns (10 Packs of 10 gowns)
  • 1 case ACON COVID Test Kits (12 boxes of 24 tests)

If your facility is registered as having over 100 beds, you shall receive two kits, for a total of 18 boxes of PPE.

These medical items will assist all long-term care facilities in providing needed infection protection for residents, staff, and visitors. These kits are being provided free of charge through the Nursing Home & Long-Term Care Facility Strike Team and Infrastructure Project.

As always should you have any questions regarding this project, please contact mary.menges@health.mo.gov.

HQIN Strategies to Use During Your Nursing Home Stand-Up Meetings

Entire Series Now Available for Download!

The Health Quality Innovation Network’s free 9-week education series is now available for download on our Resource Center. Download the topic(s) that you want to focus on in your facility or download the entire series and work through all nine weeks.

The five short, concentrated evidence-based talking points in each week can easily be included in daily stand-up meetings to increase staff knowledge on relevant topics. The program is designed to empower nursing home staff with practical knowledge to foster a safer environment and decrease preventable emergency room visits and hospital readmissions.

We’d appreciate your feedback on this education series. Please share your experience in using the content and materials offered in the Nursing Home Stand-Up Series.

VOYCE’s Upcoming Events

April 16, 2024: Community Education: Tips to Remain Fiscally Fit as You Age

Are you worried about being financially scammed, missing bill payments, or neglecting to review your bank account statements? Or have you struggled to update your beneficiaries? If so, a daily money manager can help. These financial professionals offer personal services to individuals, families, older adults, people with disabilities, busy professionals, high-net-worth individuals, and small businesses. Learn more about their services and how you can protect your assets as you grow older.

April 22, 2024: Caregivers’ Resilience and Family Resources

Becoming a sudden caregiver for your loved one can be overwhelming. Identify tips on how to sustain your lifestyle and invest in self-care.

May 2, 2024: Professional Development Webinar: Cultivating an LGBTQ+ Friendly Community

The National Gay and Lesbian Task Force has outlined that the population of LGBTQ+ older adults in the U.S. is expected to double in size, becoming six million strong by 2030. Questions about the availability of inclusive housing for older LGBTQ+ people are rising. The purpose of this presentation is to inform attendees about the barriers that LGBTQ+ elders face when seeking out housing and long-term care services. This presentation will also introduce attendees to the Long-Term Care Equality Index (LEI), a tool founded by SAGE and the Human Rights Campaign to assist Long Term Care Communities in becoming more inclusive to LGBTQ+ elders. Attendees will leave this presentation with actionable steps on how to get connected to the LEI and how to start making their communities more inclusive to LGBTQ+ older adults.

May 7, 2024: Legacy Planning 101: Don’t Leave Your Family Guessing

With proper assistance, planning for the next chapter of life need not be stressful. Learn from an elder law attorney about the five essential documents to honor friends’ and relatives’ wishes.

May 20, 2024: ABUSE – Verbal, Physical, Sexual, Financial – Help Protect Your Loved Ones

Learn how to identify the signs of abuse, how and where to report it, and how to support your loved one, friend, or family member if they are experiencing abuse.

MC5 Upcoming Meetings

April 19, 2024: We Honor Veterans Program and End-of-Life Care for Veterans
Location: Cape Girardeau Public Library, Cape Girardeau

The purpose of this program is to bring awareness to issues veterans face at end-of-life and to explain the We Honor Veterans Program. Veterans face different issues at end-of-life that are not often experienced by non-veterans. The We Honor Veterans Program helps navigate caregivers through these issues as well as provides education regarding resources within the community.

April 26, 2024: Person-Centered Program Planning
Location: Brentmoor Retirement Community, St. Louis

Programming is at the center of a community’s culture and can have a ripple effect throughout a community, by fostering inclusivity and an all-hands-on deck approach. We will be discussing various ways to incorporate person-centered values during the programming planning process; as well as giving examples of real-life programming that embodies the whole team and whole community approach. Attendees will be asked to bring a copy of the community activity calendar for an interactive approach to looking at those calendars through another set of lens’.

MANHA’s 2024 Annual Convention

June 2-5, 2024: Kick Off Your Summer with an Unforgettable MANHA Experience!
Location: The Resort at the Lake of the Ozarks

Missouri Association of Nursing Home Administrators is pleased to invite you to attend the 2024 Annual Convention. The goal of this conference is to provide meaningful, forward thinking, and real-time education to pave the path forward while acknowledging the past and working together.

CMS Memo: QSO-24-08-NH: Enhanced Barrier Precautions in Nursing Homes to Prevent Spread of Multidrug-resistant Organisms (MDROs)

Memorandum Summary

  • CMS is issuing new guidance for State Survey Agencies and long term care (LTC) facilities on the use of enhanced barrier precautions (EBP) to align with nationally accepted standards.
  • EBP recommendations now include use of EBP for residents with chronic wounds or indwelling medical devices during high-contact resident care activities regardless of their multidrug-resistant organism status.
  • The new guidance related to EBP is being incorporated into F880 Infection Prevention and Control.

Please see the full memo for complete details at https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos-states/enhanced-barrier-precautions-nursing-homes-prevent-spread-multidrug-resistant-organisms-mdros.

If you have questions regarding implementing EBP in your long-term care facility, please contact the Healthcare-Associated Infections/ Antimicrobial Resistance program at 573-751-6113.

COVID Prevention and Response Phase III Announcement – FREE PPE Kits are on their Way!

The Department of Health and Senior Services COVID Prevention and Response Project will embark upon Phase III this April. This final Phase will include free PPE items shipped directly to all Missouri Skilled Nursing Facilities, Intermediate Care Facilities, Assisted Living Facilities and Residential Care Facilities. These kits are being provided free of charge through the Nursing Home & Long-Term Care Facility Strike Team and Infrastructure Project.

Each Phase III PPE Kit will include Nitrile Gloves, Gowns, Isolation Masks (all in various sizes) and COVID test kits. Shipments will be coming to facilities directly from Concordance Healthcare via UPS. Shipments dates and information will be shared on the DHSS Listserv. Signatures will be required by the UPS driver, so please alert your office staff of the expected delivery. These medical items will assist all long-term care facilities in providing needed infection protection for residents, staff, and visitors.

Please watch the DHSS Listserv for additional information on when Concordance begins shipping these PPE items.

As always should you have any questions regarding this project, please contact me at mary.menges@health.mo.gov.

HQIN and ASCP Team Up to Offer Vaccine Billing Assistance

In an effort to promote and increase adult vaccinations, the Health Quality Innovation Network (HQIN) and the American Society of Consultant Pharmacists (ASCP) have teamed up to offer immunization billing assistance. Specifically, ASCP contacts will provide technical assistance for vaccine billing questions and process options to support immunization efforts.

Facilities striving to improve their COVID-19, flu and pneumonia vaccination rates can email requests or questions to ltc@hqi.solutions.

HQIN Strategies to Use During Your Nursing Home Stand-Up Meetings (Purposeful Conversations)

HQIN is presenting an educational series tailored for nursing home stand-up meetings, aimed at decreasing preventable emergency room (ED) visits and hospital readmissions. HQIN is sending out talking points that can be included in daily stand-up meetings to increase staff knowledge on relevant topics like effective communication, adverse drug events and infection prevention. The program is designed to empower nursing home staff with practical knowledge to foster a safer environment.

This week is the final week of the series. This week’s strategies include Purposeful Conversations. Below is an overview of information and resources.

  • Purposeful conversation refers to intentional and meaningful communication that serves specific objectives or goals. It goes beyond casual chitchat and aims to achieve specific outcomes.
    Print and discuss with the team the following resource, Go to the Hospital or Stay Here. Social services staff or nurses can use this decision guide to facilitate clear and informative conversations of a resident’s choice to “Go to the Hospital or Stay Here.”
  • Do all of your residents have a documented advanced directive? Review which residents are a full code, and which are a Do Not Resuscitate (DNR). Discuss how staff know which residents are DNR and what the current process is to communicate this to all staff.

Print and discuss Education on CPR for Residents/Patients and their Representatives with the clinical team to guide conversations when providing education for residents and their family.

Advanced directives should be reviewed upon admission, quarterly, and if a change in condition would warrant it. Use this Advance Care Planning Tracking Form to assist with tracking these reviews.

  • It is often helpful to involve the physician or healthcare provider, in addition to the resident and their family, in purposeful conversations during care plan meetings. You may want to have an ad hoc care plan meeting if a decline in condition is noted.  Discuss with the team the importance of being proactive with change in condition. Consider inviting the physician or nurse practitioner to participate in a care plan meeting to participate in difficult conversations.

Print and discuss A Patient’s Guide to Serious Illness Conversations from the Institute for Healthcare Improvement to guide these conversations.

  • Advanced care planning for vaccinations is a best practice. The Planning for COVID-19 Care Conversation Tool can assist with having purposeful conversations centered around vaccinations upon admission and at quarterly care plan meetings. Print and share the same resource with the admissions and clinical care plan team and discuss how it can be incorporated into current practice.