Category: Long Term Care Blog

Artifacts of Culture Change 2.0

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Originally developed by Pioneer Network in collaboration with CMS, The Artifacts of Culture Change was revised in 2020. Artifacts of Culture Change 2.0 (ACC) is an internal implementation, inspiration, and self-assessment tool available for both SNF and AL and is a great tool to help re-ignite your person-centered journey.

Artifacts of Culture Change (Be sure to check out the drop-down menu on the left side of the page for more information, resources and On-Demand Videos)
Self-Assessment for Nursing Homes
Self-Assessment for Assisted Living Communities

Free Four-part Webinar Series: Brain Health and Trauma-Informed Care for People with Intellectual and Developmental Disabilities (I/DD)

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March 8, 2023 (1:00 pm – 2:00 pm): Trauma and Ableism as Social Determinant of Health for People with Intellectual and Developmental Disabilities
April 26, 2023 (1:00 pm – 2:00 pm): People with an Intellectual and Developmental Disability Experiencing Abuse: Tips, Tools, and Strategies for Providers
May 10, 2023 (1:00 pm – 2:00 pm): Beyond Silos: Trauma Informed Care for People with Intellectual and Developmental Disabilities

This four-part webinar series presented by the HealthMatters Program will focus on brain health and trauma-informed care through conversations with national peer advocate survivors, allies, and healthcare providers. Brain health and trauma resources for people with I/DD will be shared to increase awareness of systems change efforts to eliminate disability bias through culturally relevant healthcare.

The Green House Project Events

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March 29, 2023: Transform the Culture of Care

The alliance between The Green House Project and Pioneer Network brings together two leading drivers of cultural transformation in long-term care.

For organizations that don’t have the ability to build new or substantially renovate an existing building, we have an entire suite of solutions that bring the best of empowered, elder-directed care to even the most institutional settings.

Resident to Staff Aggression: Prevention & Response Training

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March 30-July 20, 2023: Resident to Staff Aggression: Prevention & Response Training (Webinar)
April 20, 2023: Resident to Staff Aggression: Prevention & Response Training (In Person)

Resident to staff aggression occurs, but it shouldn’t be thought of as just part of a caregivers’ job. Tools for prevention and response to resident aggression are critical for promoting worker safety and satisfaction as well as the resident experience. This interactive, application-based training will explore some of the reasons for resident aggression, provide strategies for violence prevention, de-escalation and during incident response as well as post incident response strategies that promote the prevention of future incidents. The role of policy, consistent and effective communication and a workplace violence prevention culture will be explored. Interactive learning experiences and discussions will help trainees practice and apply learning.

MALA’s ALF Community Based Assessment Training

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June 5-7, 2023: 2023 ALF Community Based Assessment Training
Location: Courtyard by Marriott, Columbia

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.

The Green House Project 2023 Conference

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July 23-26, 2023: Ready to Impact
Location: Pittsburg, PA

It’s official: Green House and Pioneer are coming together for one incredible event.

Everything you’ve come to expect from our conferences — fellowship, education, new ideas, and fun — now with even more leaders, caregivers, visionaries, and supporters from around the country and the world!

The theme of the first annual Center for Innovation Conference, Ready to Impact, reflects the power our organizations have under one banner. Together, let’s make 2023 a year of real change for elders in the United States and around the world, uniting in one voice to broaden the reach and deepen the impact of our work to build something better.

Funding Opportunity for Missouri Nursing Facility Strike Team and Infrastructure Award

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The Missouri Department of Health and Senior Services (DHSS) is excited to announce the Missouri Nursing Facility Strike Team and Infrastructure Award, a reimbursement opportunity available to Skilled Nursing Facilities (SNF) and Long Term Care and Other Nursing Facilities (LTC). Beginning March 1, 2023, facility owners and operators may apply for reimbursement for expenses incurred between July 1, 2022 and August 31, 2023, directly related to preparing, preventing, and responding to the COVID-19 pandemic.

If you operated a Skilled Nursing Facilities or Long Term Care and Other Nursing Facilities licensed with DHSS between July 1, 2022 and August 31, 2023, you are eligible for reimbursement for allowable expenses.

Owner/operator applicant must be registered as a vendor with the State of Missouri prior to submitting an application. If not already registered, visit https://missouribuys.mo.gov/registration. Vendor name and address used in registering as a vendor must be the same vendor name address used on the reimbursement application. Be sure to register only the operating entity and not all individual facilities owned by the same company.

Please see the attached Frequently Asked Questions and Application Checklist documents below.

Missouri Nursing Facility Strike Team and Infrastructure Award FAQ Checklist
Missouri Nursing Facility Strike Team and Infrastructure Award Application
Missouri Nursing Facility Strike Team and Infrastructure Award Eligible Facilities

All questions should be directed to the DHSS Strike Team via email at LTCStrikeTeam@health.mo.gov.

Public Health Emergency (PHE) 1135 Waivers: Updated Guidance for Providers

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On February 9, the Department of Health and Human Services (HHS) announced the Public Health Emergency (PHE) for COVID-19 will end on May, 11, 2023. COVID-19 remains a significant priority for the Biden-Harris Administration and over the next several months, the Centers for Medicare & Medicaid Services (CMS) will work to ensure a smooth transition. During the PHE, CMS has used a combination of emergency authority waivers, regulations, enforcement discretion, and sub-regulatory guidance to ensure easier access to care during the PHE for health care providers and their beneficiaries.

Some of the flexibilities that were created during the pandemic were recently expanded by the Consolidated Appropriations Act, 2023. Others, while critical during our initial responses to COVID-19, are no longer needed. CMS has made further updates to our CMS Emergencies Page with useful information for providers – specifically around major telehealth and individual waivers – that were initiated during the Public Health Emergency (PHE).

Please reference the following guidance in response to the PHE ending May 11, 2023:

Provider-specific fact sheets about COVID-19 Public Health Emergency (PHE) waivers and flexibilities: https://www.cms.gov/coronavirus-waivers

CMS COVID-19 Waivers and Flexibilities for Providers include:

  • Physicians and Other Clinicians
  • Hospitals and CAHs (including Swing Beds, DPUs), ASCs and CMHCs
  • Teaching Hospitals, Teaching Physicians and Medical Residents
  • Long Term Care Facilities (Skilled Nursing Facilities and/or Nursing Facilities)
  • Home Health Agencies
  • Hospice
  • Inpatient Rehabilitation Facilities
  • Long Term Care Hospitals & Extended Neoplastic Disease Care Hospitals
  • Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
  • Laboratories
  • Medicare Shared Savings Program
  • Durable Medical Equipment, Prosthetics, Orthotics and Supplies
  • Medicare Advantage and Part D Plans
  • Ambulances
  • End Stage Renal Disease (ESRD) Facilities
  • Participants in the Medicare Diabetes Prevention Program
  • Intermediate Care Facility for Individuals with Intellectual Disabilities

 Department of Health & Human Services Fact Sheet: https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html

In the coming weeks, CMS will be hosting stakeholder calls and office hours to provide additional information. Please continue to visit the CMS Emergencies Page for continuous updates regarding PHE sunsetting guidance as information becomes available to the public.

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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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.