Long Term Care Facilities
Adult Day Care Programs
Long Term Care Facilities
Adult Day Care Programs
Facilities performing their own COVID-19 testing (antigen testing) must report positive results through one of the following portals:
Facilities using an external laboratory (PCR testing) must enter positive case information into MODROP.
The Missouri Disease Reporting Online Portal (MODROP). MODROP can be accessed directly from https://modrop.health.mo.gov/ or by using the existing ECD-1 link at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/case-reporting.php and selecting the MODROP button.
NOTE: The recommended browser for use of MODROP is Google Chrome. Other browsers may cause issues with MODROP.
Facilities will need to register for a MODROP account the first time they use the new portal. MODROP allows reporting of only COVID-19 cases. Reports of other reportable conditions may be faxed to 573-751-6417.
If you have any questions or encounter any issues utilizing MODROP or for questions about HL7 or CSV reporting, please reach out to the EpiTrax Help Desk via e-mail at epitrax@health.mo.gov.
Please see the FAQ and thank you for your efforts to provide complete and accurate COVID-19 data to public health.
Missouri has limited PPE reserves to assist in filling critical needs and prioritize healthcare providers providing direct care to confirmed or suspected COVID patients. Note requests should only be submitted after all normal supply chains, including the Missouri COVID Supply Solution, have been exhausted and you have a supply of twenty-one days or less on hand as the quantities and types of PPE available through the state are limited.
https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/ppe.php
DHSS offers TWO different types of rapid antigen test kits. DHSS offers ACON Flow Flex antigen test kits under the state CLIA waiver for testing in congregate care settings (In-Office) by testing personnel. DHSS also offers iHealth antigen test kits for At-Home testing.
Rapid Antigen Test Kit Application Portal (arcgis.com)
Long Term Care Facilities must make sure the ACON Flow Flex are added to the facility’s CLIA certificate:
Adding ACON Flow Flex to Your CLIA Test Menu
The CLIA program has developed an email template that you can copy and paste, fill in the blanks, and email to CLIA@health.mo.gov to update your test menu to include ACON Flow Flex.
Email Subject line: Add COVID-19 Testing to existing CLIA Certificate for [FACILITY NAME]
Lab/Facility Name: |
|
Existing CLIA Waived Lab #: |
|
Lab Director Name: |
|
Which COVID-19/ SARS-CoV-2 Waived Test system added? |
[ ] Abbott BinaxNOW COVID-19 Ag Card |
As the Laboratory Director or administrator/owner’s agent of record for the CLIA facility holding a Waived Certificate identified above, I wish to append my facility’s existing CLIA# to include additional testing for COVID-19. I attest that my facility will provide reasonable assurances that:
All tests results (both positive and negative) will be reported to the proper public health entities under federal and state requirements. See MO DHSS link regarding reporting: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/how-to-report-lab-results.php |
After three years of collaboration, review, discussion, and hard work, the Long-Term Care/Hospice Coordination of Care form and training video are complete, and available. The collaboration on this project was wonderful and we are so thankful to all of the partners who assisted and offered input.
The Bureau of Home Care and Rehabilitative Standards has a link to the form as well as more information on their Hospice web page. There is also a link via HQIN for an educational video featuring examples of health care personnel implementing the Long-Term Care & Hospice Coordinated Task Form Tool.
Long Term Care and Hospice Coordination of Care Form
Video – Long Term Care & Hospice Coordination of Care
The Health Education Unit would like to share pass/fail results of CNA tests taken over the last three months. The CNA test consists of two parts, the Knowledge Test and Skills Test. Also included below are the most missed skills and vocabulary words.
Knowledge Test
September – 151 passed/101 failed
October – 186 passed/116 failed
November – 186 passed/96 failed
Skills Test
September – 187 passed/37 failed
October – 186 passed/22 failed
November – 186 passed/32 failed
Most missed skills: taking blood pressure, pulse and respirations
Most missed vocabulary words: diet and ischemia
** Please remember to use the Headmaster Student Handbook for preparation of the knowledge and skills exam. The handbook contains information such as the ID requirements, examples of test questions, audio and virtual options for the knowledge test, testing policies, vocabulary words and test results. The handbook on Headmaster’s website can be found at D&S – Missouri Nurse Aide (hdmaster.com).
The Office of Dental Health conducted a dental screening survey of residents at 22 random long-term care facilities starting in 2020 and ending the summer of 2022. For those 22 long-term care facilities that participated-Thank you for allowing us into your facility in order to gather the necessary information for the dental screenings. We appreciate your willingness to allow us to come and visit your residents, especially after COVID. We know these past few years have been difficult with the pandemic, but we appreciate you working with us for this important information.
Attached is a break-down of what was found in those random nursing homes. While this is not looking at every older adult resident in the state, it is felt it represents a good amount to make assumptions on what would possibly be found if we conducted this screening on every older adult resident. As noted in the attachment, of those older adults with teeth, 40% of them have untreated decay and 29% are in need of periodontal care. The Office of Dental Health has been working with clinics to encourage them to provide care to this underserved population. We will also be developing some training for staff and caregivers on the importance of proper dental care.
Again, thank you for allowing us to conduct this screening. If you have any questions, please contact us at oralhealth@health.mo.gov or 573-751-5874. We wish everyone a safe, enjoyable and healthy holiday season!
In-person Adult MHFA Courses:
December 3, 2022 | 9:30a – 5:30p | Doniphan – Register Here
December 7, 2022 | 9:00a – 5:00p | St. Joseph, MO – Register Here
December 12, 2022 | 9:30a – 5:30p | Cape Girardeau – Register Here
In-person Youth MHFA Courses:
December 6, 2022 | 10:00a – 4:30p | Cape Girardeau – Register Here
December 7, 2022 | 8:30a – 3:30p | St. Louis – Register Here
Virtual Adult MHFA Courses:
December 9, 2022 | 8:30a – 3:30p | Virtual – Register Here
December 15, 2022 | 8:30a – 3:30p | Virtual – Register Here
Free trainings sponsored by Missouri’s Department of Mental Health and other sponsors. They are only available to individuals who live or work in Missouri. To find additional courses click here.
January 4, 2023: 2023 Train the Trainer
March 1, 2023: 2023 Train the Trainer
May 10, 2023: 2023 Train the Trainer
July 12, 2023: 2023 Train the Trainer
September 20, 2023: 2023 Train the Trainer
December 6, 2023: 2023 Train the Trainer
Participants must receive approval in order to attend this workshop. Those wishing to attend must submit the application and all other necessary paperwork to MALA at least two weeks prior to the workshop date.
February 1-3, 2023: Navigating the Storm
Missouri Association of Nursing Home Administrators is pleased to invite you to attend our Winterfest Convention and Trade Show. The goal of this conference is to provide long-term care administrators and their staff practical and inspirational education hours along with the opportunity to network and socialize with colleagues. It is also the only MANHA sponsored conference that provides you a chance to view the latest technology, products, and services offered by suppliers.
Memorandum Summary
Please see the full memo for complete details at https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/importance-timely-use-covid-19-therapeutics.
The fire alarm annual inspection, semi-annual inspection, and repairs must be performed by a qualified individual. Recently, SLCR has observed several instances across the state of unqualified individuals inspecting/repairing fire alarm systems. NFPA states the qualifications needed for the inspector performing these types of services.
NFPA 72, 2010 edition:
10.4.3 Inspection, Testing, and Maintenance Personnel. (SIGTMS)
10.4.3.1* Service personnel shall be qualified and experienced in the inspection, testing, and maintenance of systems addressed within the scope of this Code. Qualified personnel shall include, but not be limited to, one or more of the following:
(1)*Personnel who are factory trained and certified for the specific type and brand of system being serviced
(2)*Personnel who are certified by a nationally recognized certification organization acceptable to the authority having jurisdiction
(3)*Personnel who are registered, licensed, or certified by a state or local authority to perform service on systems addressed within the scope of this Code (The State of Missouri does not have its own certification program, therefore this option is not applicable.)
(4) Personnel who are employed and qualified by an organization listed by a nationally recognized testing laboratory for the servicing of systems within the scope of this Code
10.4.3.2 Evidence of qualifications shall be provided to the authority having jurisdiction upon request.
When completing the LSC portion of the survey, LSC surveyors must verify the inspections and maintenance performed on the fire alarm system(s) were completed and signed off by a qualified person from the listed qualifications in NFPA. The facility is required to provide this certification to the surveyors at the time of the survey. Some companies list the inspector qualifications on the inspection and maintenance reports. These same regulations do not apply to the sprinkler system.
National Institute for Certification in Engineering Technologies (NICET) is not the only option available for certifications, as inspectors can be qualified by other means; however, it is the most common nationally recognized certification. For NICET, the individual must be a Fire Alarm Systems Level II or higher. SLCR staff can search for an individual through the NICET website at: https://nicet.useclarus.com/view/verify/.
Please contact Scott Wiley (573-526-8552 or Scott.Wiley@health.mo.gov) and/or Steven Vest (573-526-8608 or Steven.Vest@health.mo.gov) with any questions regarding the qualifications of fire alarm inspectors.
The Centers for Medicare & Medicaid Services (CMS) has developed a series of interactive videos called “Quality in Focus” (QIF) on the Quality, Safety & Education Portal (QSEP). The 10-15 minute videos are self-paced. They will help providers and suppliers participating in the Medicare and Medicaid programs better understand how to improve health and safety in facilities.
The QIF series aims to increase the quality of care for people with Medicare and Medicaid by reducing the deficiencies most commonly cited during the CMS survey process, such as infection control and accident prevention. These resources will help providers and suppliers better understand surveyor evaluation criteria, recognize deficiencies, and incorporate solutions into their facilities’ standards of care, so they are more equipped to meet health and safety guidelines.
The QIF interactive videos are tailored for specific provider and supplier types, with 1-3 videos per type. Each interactive video focuses on a specific health or safety citation with the goal of identifying and resolving these deficiencies. QIF interactive videos are currently available for:
Please note that the information in the interactive videos is for informational purposes and is not meant to take the place of statutes, regulations, or official CMS policy.
Visit the Quality, Safety & Education Portal (QSEP) Training Catalog at https://qsep.cms.gov/ProvidersAndOthers/publictraining.aspx to access the “Quality in Focus” interactive videos. The videos can be found under the Quality in Focus tab.
Below is important information regarding modifications to the Point of Care Test Reporting Tool, the Long-term Care Facility COVID-19 Module, and the COVID-19 Vaccination Module. The changes described below took effect with the October 2022, NHSN release. Resources on the NHSN LTCF COVID-19 Module webpage and the COVID-19 Vaccination Modules webpage have been updated, where indicated, with revised forms, instructions, FAQs and CSV templates.
Point of Care (POC) Test Reporting Tool:
The following enhancements were made.
Additional POC devices were added to the NHSN system.
Although some are titled, “At-Home,” the devices below have been provided POC Emergency Use Authorization by the U.S. Food and Drug Administration. If you are using any of these devices, please check the model’s name and ensure you choose the correct device from the drop-down menu.
COVID-19 Pathway Data Reporting:
Please refer to the data reporting pathways below to learn about enhancements that were made within each pathway.
Resident Impact and Facility Capacity Pathway:
No enhancements
Staff and Personnel Impact Pathway:
No enhancements
Supplies and Personal Protective Equipment (PPE) Pathway:
No enhancements
Therapeutics Pathway:
An issue regarding csv upload for group and facility users was recently identified and a resolution has been implemented. Facility and group users are now able to successfully upload csv files.
State Veterans Homes COVID-19 Event Reporting Tool:
No enhancements
Weekly NHSN COVID-19 Vaccination Data Modules
Person-Level COVID-19 Vaccination Forms
If you use the optional Person-Level COVID-19 Vaccination Forms to submit your weekly COVID-19 vaccination data, demographic variables are now required for individuals currently in the facility (i.e., those without an end date or discharge date) to save and submit data. Please keep in mind that if you are unable to obtain this information, you can select ‘Unknown.’
Analysis Reports
The Long-Term Care COVID-19 Vaccination Coverage bar chart reports are once again available for use. These reports are called “Bar Chart – LTC HCP COVID-19 Vaccination Coverage” and “Bar Chart – LTC Resident COVID-19 Vaccination Coverage”.
CMS Reporting Deadline
The deadline for quarterly reporting of COVID-19 vaccination coverage data for long-term care facilities to fulfill CMS Quality Reporting Program requirements covering Quarter 2 of 2022 (April 1, 2022-June 30, 2022) is November 15, 2022.
For questions about any of these updates, please send an e-mail to the NHSN Helpdesk at NHSN@cdc.gov with the subject line identifying the topic of the message.
The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls (Volume 10, Issue 1).
In this issue:
Please visit QIPMO’s website here for this and other previous newsletters.
As previously announced, CMS is preparing to release the Internet-facing, cloud-based system, referred to as the Internet Quality Improvement and Evaluation System (iQIES) for Minimum Data Set (MDS) submission in early 2023.
Although the MDS submission functionality will not be available immediately, we strongly encourage Provider Security Officials (PSOs) to request access to iQIES as soon as possible, as doing so will allow for a smoother transition prior to the go live date. The individual designated as the PSO must work for the provider and will be responsible for approving or rejecting iQIES user access requests for their respective organizations, including vendors. A user will not be granted access unless a PSO approves the request. The first PSO for your provider will need to be approved by CMS. Once approved, PSOs can approve additional Provider Security Official role requests.
Organizations must complete the steps below to register a Provider Security Official as soon as possible:
***IMPORTANT: General user onboarding begins November 15, 2022. At that time, if your organization has not yet successfully registered at least one PSO, users will not be able to complete their access requests. The delay for assigning a PSO places an organization in jeopardy of a smooth transition to iQIES.***
Please see iQIES Quick Reference Guide – Provider Security Official for more information to onboard the PSO Role in iQIES: https://qtso.cms.gov/software/iqies/reference-manuals
Please Note: Currently, we are only onboarding MDS. You do not need to register for a HARP/iQIES account for Payroll Based Journal (PBJ) submissions.
Resources
For more information on HARP or iQIES, please refer to the following resources:
HARP
iQIES
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 see the DHSS Health Advisory entitled “Increased Respiratory Syncytial Virus (RSV) Activity in Missouri.”
For additional questions or to report an outbreak of severe respiratory illness, please contact your local public health agency or the DHSS’ Bureau of Communicable Disease Control and Prevention at 573-751-6113 or 800-392-0272(24/7).
Administrators due to renew in 2023 and forward are required to complete all required continuing education (CE) clock hours in-seat or can complete a maximum of half of the total required hours through online continuing education programs (web-based, teleconference, self-study and webinar).
Refer to the “License Renewal Checklist” on the website https://health.mo.gov/information/boards/bnha/.
Please contact the Board of Nursing Home Administrators with any questions or concerns at BNHA@health.mo.gov.
Applications Being Deleted
Please ensure all processed online applications and Level 2 screenings have been printed/saved for your records. Facilities (SNFs) will need to have copies of these documents prior to them being deleted.
Processed applications will be deleted from the COMRU online system 60 days after completion.
Additionally, effective November 4, 2022, if a correction has not been resubmitted back to COMRU within 60 days of notification, the online application will be deleted.
COMRU Webinar Training
There will be a webinar/Q&A session regarding the online process on Tuesday, November 15, 2022, 1:00 pm – 2:30 pm.
Join from the meeting link
https://stateofmo.webex.com/stateofmo/j.php?MTID=m2db3a8d7a9ebb09de234b4a6b7672597
Join by meeting number
Meeting number (access code): 2474 027 7616
Meeting password: W4mbfuJ2Hk5
Join by phone
1-650-479-3207 Call-in toll number (US/Canada)
+1-312-535-8110 United States Toll (Chicago)
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 4/1/22 through 6/30/22 must be submitted no later than 11:59 p.m. on November 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:
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
Nursing homes are required to electronically submit direct care staffing information to the Payroll-Based Journal (PBJ) system. Submissions must be received by the end of the 45th calendar day (11:59 PM Eastern Standard Time) after the last day in each fiscal quarter to be considered timely. PBJ data for 7/1/22 through 9/30/22 is due November 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:
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
November 8, 2022: Protecting Seniors from Financial Abuse and Fraud
Presenter: Lauree Peterson-Sakai, VOYCE Board Chair
Financial fraud is the fastest-growing form of elder abuse. Broadly defined, financial elder abuse is when someone illegally or improperly uses a vulnerable senior’s money or other property. Financial scams targeting seniors are prevalent and costly. The FBI estimates that seniors lose more than $3 billion each year to fraudsters. Scammers go after seniors because they believe older adults have a significant amount of money in their accounts. Unfortunately, seniors are susceptible to financial fraud due to higher levels of trust in those appearing to be official representatives of legitimate organizations and due to the ever increasingly complex methods fraudsters use to appear legitimate.
December 13, 2022: Signs of Abuse – How to Identify the Signs of Abuse and Protect Your Loved One
Presenter: Robin Pendelton, Training Technician, Missouri Department of Health and Senior Services
Abuse can happen to any older person. Knowing how to identify the different types of abuse, how to recognize the signs, and where to get help is vital. Abuse can happen to any older person, by a loved one, a hired caregiver, or a stranger. Abuse can happen at home, at a relative’s home, or in an eldercare facility. There are many different types of abuse including physical, emotional, sexual, abandonment, financial, and neglect.
November 15, 2022: Implementation and Use of Enhanced Barrier Precautions in Nursing Homes
Presenters: Abimbola (Bola) Ogundimu, DrPH, RN, CIC, CPHQ; Division of Healthcare Quality Promotion, CDC; Heather Jones, DNP, NP-C; Division of Healthcare Quality Promotion, CDC; and Linda Behan BSN, RN, CIC; Consultant; Long Term Care Infection Prevention, LLC
Moderator: Kara Jacobs Slifka, MD, MPH; Division of Healthcare Quality Promotion, CDC
You are invited to a webinar discussing Enhanced Barrier Precautions in nursing homes. Enhanced Barrier Precautions protect nursing home residents and staff from germs that can cause serious infections and are hard to treat.
Join for a detailed review and discussion about this CDC infection prevention and control recommendation. In addition, hear directly from a long-term care Infection Preventionist about her successes and challenges implementing Enhanced Barrier Precautions in several nursing homes. Presentations will be followed by a conversation with the experts about frequently asked questions from the field.
November 18, 2022: Person Centered Care While Individualizing Activities Year Round
Location: Cape Girardeau
This group of activities professionals will share ideas on how to individualize an activity program to meet resident’s needs. With the upcoming holiday season, they will focus on activities that are fun, engaging, and person centered throughout the holiday season as well as throughout the entire year. Come prepared to share your robust activity program ideas and learn how to develop activities program that residents can’t resist.
Memorandum Summary
Please view the latest CMS memo regarding revisions to SSF program at https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/revised-guidance-staff-vaccination-requirements.