March 14-18, 2022, is National Long-Term Care Administrator’s Week. During this week, please take the opportunity to say “thank you” and honor our Missouri administrators who lead our state’s long-term care communities. Administrators are the key players in the care of our residents. They are entrusted with the responsibility of managing the long-term care communities to ensure that their staff provide the highest level of quality care to our residents.
Category: Long Term Care Blog
CMS Memo: QSO-20-38-NH: Interim Final Rule (IFC), CMS-3401-IFC, Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency related to Long-Term Care (LTC) Facility Testing Requirements REVISED 03/10/2022
- CMS is committed to taking critical steps to ensure America’s healthcare facilities continue to respond effectively to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE).
- On August 25, 2020, CMS published an interim final rule with comment period (IFC). This rule establishes Long-Term Care (LTC) Facility Testing Requirements for Staff and Residents. Specifically, facilities are required to test residents and staff, including individuals providing services under arrangement and volunteers, for COVID-19 based on parameters set forth by the HHS Secretary. This memorandum provides guidance for facilities to meet the new requirements.
- Replaced the term “vaccinated” with “Up-to-date with all recommended COVID-19 vaccine doses” and deleted the term “unvaccinated.”
- Updated the recommendations for testing individuals within 90 days after recovering from COVID-19.
Please see the full memo at https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/interim-final-rule-ifc-cms-3401-ifc-additional-policy-and-regulatory-revisions-response-covid-19-0.
CMS Memo: QSO-20-39-NH: Nursing Home Visitation – COVID-19 REVISED 03/10/2022
- CMS is committed to continuing to take critical steps to ensure America’s healthcare facilities are prepared to respond to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE).
- Visitation Guidance: CMS is issuing new guidance for visitation in nursing homes during the COVID-19 PHE, including the impact of COVID-19 vaccination.
- Visitation is allowed for all residents at all times.
- Replaced the term “vaccinated” with “up-to-date with all recommended COVID-19 vaccine doses” and deleted “unvaccinated.”
- Updated visitor screening and quarantine criteria.
Please see the full memo at https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/nursing-home-visitation-covid-19-revised.
Medicaid Resource (Spend-Down) Limit
The Medicaid Resource (Spend-Down) Limit has been increased to $5,035 as of 07/01/21. Please see the link https://dssmanuals.mo.gov/wp-content/uploads/2018/10/appendix_j.pdf.
F569 states the facility must notify each resident/legal guardian that receives Medicaid benefits when the amount in the resident’s account reaches $200 less than the SSI resource limit.
The current $200 amount would be at $4,835 or higher.
Feel free to contact Lynn Gilmore, Lead Auditor, at 573-508-4150 if you have any questions.
New Updates to the Headmaster Student Handbook and Mock Skills for CNA Testing
Please see the updated Headmaster Student Handbook and Mock Skills including key step changes for those students testing March 15, 2022 and after.
Please visit Headmaster’s website for those changes at https://hdmaster.com/testing/cnatesting/missouri/MO_CNA_Home.htm.
For questions regarding the changes, please call the Health Education Unit at 573-526-5686 or email us at CNARegistry@health.mo.gov. You may also call Headmaster and ask for the Missouri Team at 1-800-201-0462.
Administrator License Renewals
Missouri licensed administrators (NHA or RCAL) expiring June 30, 2022, are due for license renewal. If you plan to renew, visit our website at www.health.mo.gov/bnha and follow the instructions provided in the Renewal Checklist. Once your renewal has been successfully processed, you will be issued a current license via email. Please note if you fail to renew by June 30, 2022, you cannot practice as a licensed administrator after that date. Visit our website for additional information regarding completing a late renewal.
NOTE – Administrators that are due to renew their license by June 30, 2022, have the option to complete any and/or all CE clock hours online through a board-approved training agency or approved by NAB/NCERS. This notice does not pertain to any future renewal cycles. This only pertains to those administrators with a license expiration date of June 30, 2022. If there are any questions or concerns, please email BNHA@health.mo.gov.
Governor Parson Announces Paula Nickelson to Lead Missouri Department of Health and Senior Services
During a press conference at the State Capitol, Governor Mike Parson announced that he has selected Paula Nickelson to serve as the Acting Director of the Missouri Department of Health and Senior Services (DHSS), effective March 1, 2022.
“Today, we are excited to announce Paula Nickelson as the new DHSS Acting Director,” Governor Parson said. “Paula was a key player in Missouri’s COVID-19 response efforts and has been a valued member at DHSS for more than 22 years. We are confident in her abilities and proud to welcome her to our Cabinet as we move forward from the COVID pandemic and prepare for what comes next in public health.”
Nickelson, a Missouri native, has served within DHSS for more than 22 years and has a distinguished career in public health and health care management. For most of her time with the Department, she has been a leader in several program areas, including maternal-child health, chronic disease prevention, and emergency preparedness and response.
Nickelson was also involved in the state’s H1N1 response and planning efforts following the 9/11 attacks. Most recently, she was instrumental in a number of COVID-19 response efforts.
Over the past two years, Nickelson has put her vast experience to work as a reliable, calming, and realistic leader to implement game-changing solutions during COVID-19. She helped establish the state’s first PPE warehouse, led an interagency team that implemented the “box it in” COVID mitigation strategy for long-term care facilities, oversaw the state’s antigen testing program, and led the implementation of the state’s decontamination system for N95 masks for health care workers when resources were still scarce.
Nickelson also developed strategies to establish state-funded monoclonal antibody infusion sites and was part of the team responsible for providing health care staffing support during two separate occasions.
“It is a great privilege to be asked to lead the Missouri Department of Health and Senior Services,” said DHSS Acting Director Paula Nickelson. “I am committed to enhancing our collaborative work with our local public health partners, our health care and behavioral health partners and all community partners. We will be focusing on the state’s leading causes of morbidity and mortality; prioritizing health equity; and ensuring updated data systems, performance management, and operational excellence tools are in place so we can serve Missourians in the best ways possible.”
Nickelson earned a Bachelor of Science in psychology from the University of Central Missouri and a Master of Education in counseling psychology at the University of Missouri-Columbia.
CNA Upcoming Testing
Note: These are not the only test sites available. Please contact Headmaster D&S if you are need a different testing location.
Headmaster D & S: 1-800-393-8664 – Please ask for the Missouri Team!
All Regional dates are viewable on the online calendar at https://mo.tmutest.com/calendar.
To help with scheduling your testing event, contact Headmaster a few days after the CNA course starts.
The following are updated CNA Testing sites.
Gladstone – Mercy Health
-
- March 10
- March 17
- March 24
St John/ St. Louis Area
-
- March 10
- March 15
- March 17
- March 24
- March 31
- April 12
- May 10
Farmington
-
- March 8
- March 14
- March 15
- March 22
Kansas City
-
- March 4
- March 7
- March 8
- March 17
- March 18
- March 22
- March 25
- March 29
- March 31
Virtual Knowledge
-
- March 5
- March 8
- March 9
- March 14
- March 16
- March 19
- March 21
- March 23
- March 26
- March 28
COVID-19 Reporting Changes
Effective 2/26/2022, facilities (RCF, ALF, SNF, ICF, and ICF-IID) no longer need to report the aggregate number of residents and staff tested during outbreak testing to the DHSS redcap portal. Below is a chart which outlines current reporting requirements.
|
|
Reporting Process/Form |
System |
Purpose/Description |
Required? |
Time Frame |
|
1 |
REDCap: DHSS |
Reporting form for all positive case results, including staff and residents. This includes POC and PCR testing.** |
Yes, for all SNF, ICF, RCF, ALF, ICF-IID and Adult Day Care |
Within 24 hours of positive result |
|
|
2 |
Web Portal: Managed by NHSN |
NHSN-required fields solely for certified nursing homes (SNF/NFs). |
Yes, for all certified SNF/NF. Voluntary for any state licensed only facility (RCF/ALF/Adult Day Care) or ICF-IID. |
Weekly, with a preference for submission on the same day each week |
|
|
3 |
Web Portal: NHSN |
POC test reporting that includes both positive and negative POC test results (even if potentially a false positive). |
Yes, for any facility not reporting to DHSS in Row 4 |
Within 24 hours of result of POC test |
|
|
4 |
Secure File Transfer/CSV file: DHSS |
POC test reporting that includes both positive and negative POC test results (even if potentially a false positive). |
Yes, for any facility not reporting to NHSN in Row 3 |
Within 24 hours of result of POC test |
**Effective 2/25/2022, the Electronic COVID-19 Case Reporting System now requires entry of laboratory (testing) information when Positive Test for COVID-19 is selected as the Reason for Reporting. This change will allow for the data to more easily be ingested into Epitrax and readily available to Local Public Health Agencies- reducing follow-up contacts and calls to facilities to obtain the information.
Updated CDC Guidance on Antigen Testing in Long Term Care Facilities
The Centers for Disease Control and Prevention (CDC) recently updated the following healthcare Infection, Prevention and Control (IPC) guidance document: SARS-CoV-2 Antigen Testing in Long Term Care Facilities | CDC. The core recommendations in this guidance have not significantly changed. The page was updated to:
- Streamline the guidance;
- Clarify the time period for confirmatory testing; and
- Add links to guidance on testing for determining length of work restriction for healthcare personnel with SARS-CoV-2 infection or exposure to SARS-CoV-2 and for mitigating staff shortages in healthcare settings.
WHITE PAPER: Antipsychotic Use in the Long-Term Care Setting
The Missouri Nursing Home Advisory Council and the Health Quality Innovation Network (HQIN) are pleased to share this white paper, which provides background on the use of antipsychotics in long-term care and recent trends in antipsychotic use.
Download this white paper for strategies and valuable resources to improve dementia care for your residents and reduce the use of antipsychotics.
Please contact HQI if you have questions
MLN Annual LTC Convention
April 6-8, 2022: 68th Annual Long-Term Care Convention
Location: Margaritaville, Osage Beach
MLN’s primary goal during the Annual Long-Term Care Convention is to provide educational and networking opportunities that help our valued members, long-term care administrators and professionals, health care providers and guests. This program has been approved for 18.5 licensed administrator continuing education hours (8.5 A and 10 PC) by the Missouri Board of Nursing Home Administrators.
MANHA Dementia Programing Seminar
April 7, 2022: Independence
April 27, 2022: Lake Ozark
April 28, 2022: St. Louis
Dementia Programming: A Hands-on Approach
Understanding and managing dementia is difficult, even on the good days. This seminar will focus on a presentation of practical knowledge for the care of individuals with dementia in long-term care, including a brief overview of dementia as an illness including the various types and symptoms and the stages of the illness. By identifying the progression of the disease, you can tailor the care and communication to fit the needs of the resident in a compassionate and person-directed way. You will also learn the practical steps of running an effective dementia unit in a long-term care facility, including the regulations that apply specifically to this type of care. This hands-on workshop will give you real-time practice and knowledge for not only interpreting the difference between actions and “behaviors”, but it will expand your understanding of clinical symptoms versus human reactions and building that knowledge into a safe, compassionate, living environment that is supportive to your residents and your staff.
CMP Applications for Portable Fans and Portable Room Air Cleaners
CMS has authorized the use of federal Civil Money Penalty (CMP) Reinvestment funds to purchase portable fans and portable room air cleaners with high-efficiency particulate air (HEPA, H-13 or – 14) filters to increase or improve air quality. A maximum use of $3,000 per facility including shipping costs may be requested. This opportunity is for facilities certified to participate in the Medicare and/or Medicaid programs. Since these are federal CMP funds, Residential Care and Assisted Living Facilities may not apply.
COVID-19_In-Person Visitation Application FAQ
COVID-19_In-Person Visitation Application Template
Please send completed applications to slcrcmp@health.mo.gov.
#VoicesOfLongCovid Campaign
DHSS is collaborating with Resolve to Save Lives, an initiative of the global health organization Vital Strategies, to launch their “Voices of Long COVID” campaign throughout Missouri to increase public awareness of the impact of and unknowns associated with Long COVID. Our end goal is to encourage vaccine uptake, particularly among people ages 18-29, so fewer Missourians struggle with the devastating effects of Long COVID.
The “Voices of Long COVID” campaign features testimonials from a diverse group of people ages 18-29 who are suffering from long-term complications of COVID-19 infection. The initiative follows Resolve to Save Lives’ recent national survey, which found that nearly a third of American adults are unaware of Long COVID, and that long-hauler stories can motivate 40% of unvaccinated people to consider getting a COVID-19 vaccine.
“The brave young adults featured in the campaign are sharing their reality in order to help others avoid the harms of COVID infection,” said Dr. Tom Frieden, President and CEO of Resolve to Save Lives (and former CDC director). “Thousands of Americans struggle with Long COVID every day. Their stories are important reminders that vaccination is our best tool to prevent this potentially life-altering condition.”
The campaign shows the real-life stories of three COVID long-haulers who have been battling debilitating health problems over the past year believed to be caused by their original COVID-19 infection:
- Katelyn Van Dyke, a 20-year-old Mizzou student who got COVID-19 in November 2020 and now has trouble breathing when walking and severe memory loss.
- Rob Smith, a 22-year-old who used to run five miles a day and now struggles to climb stairs, maintain a healthy social life and manage the uncertainty of his COVID-19 recovery due to ongoing fatigue and brain fog. He shares his story in Spanish and English.
- Isaiah Smith, a 26-year-old U.S. Air Force veteran, part-time student and essential worker who became infected with COVID-19 in October 2020 and now experiences extreme nausea, chest pain, shortness of breath, dizziness upon standing, heart palpitations and challenges with comprehension.
The patients spotlighted in the campaign want to warn others about the risks of being unvaccinated.
“Long COVID is real, and the struggle goes beyond what you can see,” Van Dyke said. “We don’t know enough about this condition yet, and there’s a good chance all of us know at least one person who is suffering from this. The best way to prevent COVID-19 and long COVID is to get vaccinated.”
“I’ve learned over the course of the past year that you should always value your personal health-this is especially needed among people who are refusing to get vaccinated,” said Rob Smith. “I’ve been trying to educate people about the long-term effects of COVID and the safety of the vaccine. The trade-off between COVID and the vaccine is not even close.”
Isaiah Smith is sharing his long COVID story “because I don’t want anyone else to experience what I’m going through.” He noted that some of his friends are vaccine-hesitant. “I tell them to talk to their doctor about getting the vaccine. They should avoid getting COVID at all costs because at the end of the day, they’re rolling the dice on what happens afterwards-they have no idea what’s going to happen.”
Missouri’s Long COVID webpage is at MOStopsCovid.com/LongHaul. If you would like to share educational materials, they can be found in both English and Spanish at this link.
Included are:
- Web banners in various sizes
- Radio ads in both 15- and 30-second spots
- Videos
- 15-second videos formatted for YouTube and Tremor
- 15- and 30-second stories formatted for Facebook, Instagram and Snapchat
COMRU Upcoming Q & A Sessions
Please join COMRU (Central Office Medical Review unit) for a Q & A session via WebEx.
February 18, 2022
Time: 10:00 a.m.
Meeting number (access code): 2460 218 4769
Meeting password: MfVVW7asP23
Join from the meeting link: https://stateofmo.webex.com/stateofmo/j.php?MTID=m39c2a820985815deeedb03d8a797224d
Join from a video system or application: Dial 24602184769@stateofmo.webex.com
You can also dial 173.243.2.68 and enter your meeting number.
Tap to join from a mobile device (attendees only)
+1-650-479-3207,,24602184769## Call-in toll number (US/Canada)
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Join by phone
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Global call-in numbers
CNA Testing Events
Needing to schedule a CNA test? The following are dates and locations are already set. Please call Headmaster to register.
February 12, 2022: Cape Girardeau
February 14, 2022: Farmington (opens to public 48 hours prior)
February 17, 2022: Macon
February 19, 2022: St. Charles Community College (opens to public 48 hours prior)
February 22, 2022: Friendship Village, St. Louis
March 7, 2022: Nichols Career Center, Jefferson City
March 9, 2022: North Central College, Trenton
April 4, 2022: Nichols Career Center, Jefferson City
May 9, 2022: Nichols Career Center, Jefferson City
Other dates and locations may be available. Please call Headmaster at 1-800-393-8664 and ask for the Missouri Team.
MALA Spring Conference
April 3-5, 2022: Missouri Assisted Living Association 2022 Spring Conference
Location: Camden on the Lake, Lake Ozark, MO
Information including the conference agenda and registration for attending the Missouri Assisted Living Association’s 2022 Spring Conference is now available.
State Antigen Testing Supply Portal Re-Opening Soon –
Please Read Information Below Carefully!
The Missouri Department of Health and Senior Services (DHSS) is pleased to announce that effective Thursday, February 10, 2022 at 8:00 a.m., we are reopening our antigen testing program! As you are aware, due to a nation-wide shortage of antigen tests and issues with receipt of tests from our distributor, it was necessary for us to suspend that program indefinitely in early January. For awareness, although Friday, February 11, 2022 is a state holiday, we will be accepting requests for tests, but no tests will be shipped on that day.
We have subsequently identified two distributors with adequate supply of ACON Flow Flex rapid antigen tests to allow us to reopen our antigen testing program. Information about ACON Flow Flex can be found here.
The transition to this different rapid antigen test requires the establishment of a new state-wide CLIA (although organizations with their own CLIA can continue to use their own) and thus verification of locations of testing and validation of training of all test administrators. Thus, it is not possible to simply transition existing BinaxNOW users to ordering for ACON Flow Flex – all existing users will need to re-apply to receive ACON Flow Flex, take the required training and provide verification of that training, resubmit a test plan inclusive of the infectious waste disposal plan, and provide the locations of testing in order to be approved to receive tests. Note: For organizations using their own CLIA, please be sure to add ACON Flow Flex to your CLIA waiver by contacting the state CLIA program (see additional information below).
New standing physician’s orders specific to ACON Flow Flex have been established for all tests users previously under a DHSS standing physician’s order. These new orders are available at: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/testing-resources.php.
The DHSS Rapid Antigen Test Kit Application and Resource web page includes the initial application and a subject index to answer questions we received during the previous distribution of antigen tests. The page also provides information about where to direct specific questions that test users may encounter. If a test user is unsure of where to direct a question, please contact antigentesting@health.mo.gov.
The DHSS Rapid Antigen Test Kit Application and Resource Page for ACON Flow Flex will be open effective 8:00 a.m. on Thursday, February 10, 2022 at: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/testing-resources.php.
Thank you for your continued work to fight COVID!
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? Check [X] all that may apply. |
[ ] 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 |
|
Updated CDC Guidance
On February 2, 2022, CDC updated the following healthcare infection prevention and control (IPC) guidance documents: Infection Control: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) | CDC and Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes | CDC.
Updates were made in these guidance documents to align with prior updates made for healthcare personnel with higher-risk exposures in the Interim Guidance for Managing Healthcare Personnel with SARS-COV-2 Infection or Exposure to SARS-CoV-2, which was released on December 23, 2021.
A review of the updates was given on a recent Clinician Outreach and Communication Activity (COCA) Call, which was recorded and is accessible here: Webinar January 13, 2022 – Updates to CDC’s COVID-19 Quarantine and Isolation Guidelines in Healthcare and Non-healthcare Settings. Additionally, a brief summary of the updates can be found below. Please consult the guidance documents for the full recommendations.
Vaccination status
- Updated the description of healthcare personnel, patients, and visitors as “up to date.” Read more here: Stay Up to Date with Your Vaccines | CDC
Use of N-95 respirators
*Please see complete guidance for full personal protective equipment recommendations
- CDC continues to recommend gown, gloves, eye protection and a NIOSH-approved N95 or equivalent or higher-level respirator when caring for patients known or suspected to be infected with SARS-CoV-2.
- In counties with substantial to high community transmission, a NIOSH-approved N95 or equivalent or higher-level respirator is also recommended instead of a facemask when caring for patients not known or suspected to have SARS-CoV-2 infection in the following higher-risk situations:
- All aerosol-generating procedures;
- Higher-risk surgical procedures;
- These respirators can also be used by HCP in situations where additional risks for infection are present, such as caring for a patient who is not up to date with all recommended COVID-19 vaccine doses, the patient is not able to wear source control, and the area is poorly ventilated. They may also be used if healthcare-associated SARS-CoV-2 transmission is identified.
Viral testing
- CDC continues to emphasize that anyone with even mild symptoms of COVID-19, regardless of vaccination status, should receive a viral test as soon as possible.
- Asymptomatic patients with close contact with someone with SARS-CoV-2 infection, regardless of vaccination status, should have a series of two viral tests for SARS-CoV-2 infection.
- Generally, test immediately (but not earlier than 24 hours after the exposure) and, if negative, again 5-7 days after the exposure.
- Testing is not generally necessary for asymptomatic people who have recovered from SARS-CoV-2 infection in the prior 90 days; however, if tested, an antigen test instead of a nucleic acid amplification test (NAAT) is recommended as some people may remain NAAT positive after they are no longer infectious.
Criteria to end isolation for patients with SARS-CoV-2 infection cared for in a healthcare facility
- Asymptomatic patients or those with mild to moderate illness and who are not moderately to severely immunocompromised: manage with recommended precautions for 10 days after their symptoms first appeared.
- Patients with severe to critical illness and who are not moderately to severely immunocompromised: manage with recommended precautions until at least 10 days and up to 20 days have passed since symptoms first appeared.
- Symptomatic and asymptomatic patients who are moderately to severely immunocompromised: a test-based strategy and (if available) consultation with an infectious disease specialist or other expert is recommended to determine when these patients can be released from isolation.
Quarantine for patients:
- Empiric use of Transmission-Based Precautions (quarantine) is recommended for patients who have had close contact with someone with SARS-CoV-2 infection if they are not up to date with all recommended COVID-19 vaccine doses. Duration of quarantine is described in the guidance.
- Quarantine is not generally needed following close contact with someone with SARS-CoV-2 infection for asymptomatic patients who are up to date on all recommended COVID-19 vaccine doses or who have recovered from infection in the prior 90 days. Potential exceptions are described in the guidance.
Visitation
- Even if they have met community criteria to discontinue isolation or quarantine, visitors should not visit if they have any of the following and have not met the same criteria used to discontinue isolation and quarantine for patients (typically until 10 days after last exposure or onset of symptoms has passed):
1) A positive viral test for SARS-CoV-2,
2) Symptoms of COVID-19, or
3) Close contact with someone with SARS-CoV-2 infection
- If visitation cannot be postponed the visitor might be subject to additional precautions.
This guidance on infection prevention and control will continue to be refined as additional information becomes available.
Life Support and Life Safety Code
There has been some confusion about the definition of “life support”, specifically related to the type of generator required. Life support refers to any function performed by equipment, which if stopped, could result in loss of human life or serious injuries. NFPA 99, 2012 edition: 3.3.42 defines Electrical Life Support Equipment as an electrically powered equipment whose continuous operation is necessary to maintain a patient’s life.
Life support is not limited to a ventilator. For example, it can be a BiPAP or suctioning machine. Facility staff should receive clarification from the physician prior to admission as to whether or not the equipment is necessary to maintain the resident’s life.
If a facility accepts a resident who requires life support, it is important to ensure all the following requirements are met per NFPA 99 and 110:
- The facility must have a definition of life support;
- The admission agreement must state the facility will accept a resident on life support;
- The generator must comply with the standards of a Type 1 Essential Electrical System (ESS) (a Type 1 EES has the most stringent requirements for providing continuity of electrical service – the Acceptance Testing paperwork will show the type), complying with the National Fire Protection Association (NFPA);
- Testing and maintenance must be maintained as outlined in the NFPA;
- Depending on the generator, the power must be split into two or three branches, that would include critical care, life safety and mechanical;
- There must be plans to show which rooms/areas are supported by the life support electrical system;
- All outlets must be marked (such as a red outlet cover) to show which plugs will support life support functions.
NFPA 110, 2010 edition:
4.4-Level. This standard recognizes two levels of equipment installation, performance, and maintenance.
4.4.1-Level 1 systems shall be installed where failure of the equipment to perform could result in loss of human life or serious injuries.
4.4.2-Level 2 systems shall be installed where failure of the EPSS to perform is less critical to human life and safety.
4.4.3-All equipment shall be permanently installed.
K915
Electrical Systems – Essential Electric System Categories
Critical care rooms (Category 1) in which electrical system failure is likely to cause major injury or death of patients, including all rooms where electric life support equipment is required, are served by a Type 1 EES.
CNA Upcoming Q & A Sessions
Please join the Health Education Unit and Headmaster D&S for a Q & A session via WebEx.
February 24, 2022
Time: 3:00 p.m.
Meeting number (access code): 2469 473 6547
Meeting password: XmZzZpGU333
Join from the meeting link: https://stateofmo.webex.com/stateofmo/j.php?MTID=m435f25d8d4673f8a5751b9a947ca7d99
Join from a video system or application: Dial 24694736547@stateofmo.webex.com
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March 2, 2022
Time: 10:00 a.m.
Meeting number (access code): 2461 178 6617
Meeting password: 8PrkA9XGZD6
Join from the meeting link: https://stateofmo.webex.com/stateofmo/j.php?MTID=m2652b2befd6a4e2b64bf3da2581863b3
Join from a video system or application: Dial 24694736547@stateofmo.webex.com
You can also dial 173.243.2.68 and enter your meeting number.
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New QIPMO Newsletter – February 2022
The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls (Volume 9, Issue 2).
In this issue:
- How Does the Vaccine Work?
- Regulation Road
- Hold It! Insulin Administration
- COVID Isolation Coding
- ICAR Corner: Hand Hygiene
- Coagulation and COVID-19
- Meeting Universal Needs
Please visit QIPMO’s website here for this and other previous newsletters.
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 data for 7/1/21 through 6/30/21 must be submitted no later than 11:59 p.m. on February 15, 2022.
The Minimum Data Set (MDS) 3.0 must be transmitted to CMS through the Assessment Submission and Processing (ASAP) system to the Quality Improvement Evaluation System (QIES). No additional reporting is required.
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
- SNF QRP CASPER Reports – https://qtso.cms.gov/system/files/qtso/cspr_sec13_mds_prvdr_5.pdfPDF Document
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 10/1/21 through 12/31/21 is due February 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
- PBJ FAQs – https://qtso.cms.gov/reference-and-manuals/payroll-based-journal-pbj-frequently-asked-questions-052020