Category: Long Term Care Blog

Community Education Webinar from VOYCE

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November 9, 2021: Protect Your Hard Earned Assets – How to Stay Financially Secure
Presenter: Lauree Peterson-Sakai, SVP, Aging Risk Strategy Leader, Wells Fargo

Join VOYCE for this Community Education webinar. Remember the adage “Knowledge is Power”? That certainly applies to becoming well-informed on all that is involved with aging! Join Wells Fargo’s Aging Client Service Strategy Leader for an informative course on financial safety. Spend the hour breaking down what you need to know about identifying financial exploitation and providing easy tips on keeping you and your money safe throughout your golden years. Registration for this webinar is free.

For any enquiries, please contact jmcgeechan@voycestl.org.

10-Digit Mandatory Dialing Changes

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10-Digit Mandatory Dialing Changes Will Impact Fire Alarm Panel Automatic Dialing

The Federal Communications Commission (FCC) has adopted an order approving the designation of “988” as the 3-digit abbreviated dialing code for the National Suicide Prevention Lifeline. As a result of this designation, beginning October 24, 2021, a 10-digit telephone number (area code + phone number) will be required to complete all local calls from area codes 314, 417, 660, and 816. All licensed long-term care facilities in Missouri are required to have a fire alarm panel that dials a monitoring company during a trouble call or fire signal. It is imperative that facility staff verify or reprogram the fire alarm panel to ensure it will dial out with the area code. This will need to be confirmed with the fire alarm and/or monitoring company. For additional information regarding 10-digit mandatory dialing changes, please refer to the FAQs About 10-Digit Dialing document developed by the Missouri Public Service Commission.

Advoque Safeguard Issued Respirator User Notice

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On September 17, 2021, Advoque Safeguard issued a user notice identifying 6 very small lots of the model SG100 N95 Particulate Filtering Respirator (TC-84A-9284) that require additional sampling for pressure testing. Any individual or organization in possession of any ASG100 product in the 6 lots should isolate the product and contact Advoque Safeguard Quality Control (qc@advoquesafeguard.com).

More information can be found on the NIOSH Manufacturer Notice webpage: https://www.cdc.gov/niosh/npptl/usernotices/noticesmanufact.html under Advoque Safeguard.

VOYCE Professional & Community Education Series Webinar

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October 12, 2021: Cannabis and CBD for Older Adults and LTC Residents

The use of cannabis and CBD products as alternative medical treatments has been widely contested in the United States. Yet, the use of these products can be highly beneficial to patients with a variety of health conditions – many of which are prevalent in aging and long-term care populations. Join us for a discussion with local experts about the function, benefits, and options for medical cannabis and CBD use. This course will also discuss the legal considerations for individuals and long-term care organizations interested in trying these alternative therapies. This webinar is available to both long-term care serving professionals and interested community members.

VOYCE Professional Education Series Webinar

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September 28, 2021: Eliminating Elderspeak through Compassionate Communication

Understanding elderspeak as a type of biased communication is vital to prevent future ageist behavior towards older adult patients and, thus, improve health outcomes. Elderspeak, most commonly found in long-term care settings, has been identified as a growing communication barrier between younger and older generations, especially in healthcare. Effective communication between patients and providers improves trust and adherence to treatment plans. Health communication and cultural sensitivity training are crucial for incoming, young health providers. As Boomer clinicians age and retire, they will be replaced by millennials who will need to learn how to navigate intergenerational relationships with their new Boomer patients.

Monoclonal Antibody Infusion Medication Information

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There has been a significant change in the ordering process for monoclonal antibody infusion medications. If you are currently utilizing these medications, please review the attached notice and plan on attending the webinar tomorrow. Also attached is information on reporting usage through the Teletracking system. Reporting through this system is highly encouraged as the usage reported will determine future amounts allocated to the state.

 Status Update re: Monoclonal Antibody (mAb) Infusion Medication Ordering:

Missouri Department of Health and Senior Services (DHSS) was notified by U. S. Department of Health and Human Services (HHS) yesterday, September 14, 2021, that effective immediately the states are responsible to review and approve all monoclonal antibody medication orders. This includes orders for REGEN-COV (casirivimab and imdevimab) and the Eli Lilly cocktail of bamlanivimab/etesevimab through AmeriSource Bergen. This was DHSS’ first notification of this change. We had no prior information to allow for planning, development of platforms for ordering/approvals or procedures, or messaging. Thus, all of this is occurring currently and as quickly as possible. Information on this change is still forthcoming from HHS, thus we may have process implementation delays at the state level as a result.

mAb Request Process Implementation and Timeline:

DHSS will host a webinar to introduce the state’s new mAb request process, details are below:

Friday, September 17, 2021

10:30-11:30 a.m.

Join from the meeting link

https://stateofmo.webex.com/stateofmo/j.php?MTID=mcb62b527fff05778bd574584e06c8b6d
 

Join by meeting number

Meeting number (access code): 2462 582 1044

Meeting password: pcGjudFE679
 

Tap to join from a mobile device (attendees only)
+1-650-479-3207,,24625821044## Call-in toll number (US/Canada)
+1-312-535-8110,,24625821044## United States Toll (Chicago)

NHSN COVID-19 Vaccination Data Reporting – Additional Dose Questions

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Recently, NHSN launched two new questions in the weekly COVID-19 vaccination module. During the reporting week of 8/23/2021 through 8/29/2021, facilities began reporting on the number of individuals eligible to receive additional or booster doses of COVID-19 vaccine (question #4) and the number of individuals who received additional or booster doses (question #5).

Facilities should refer to the CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States to determine which individuals are eligible to receive additional or booster doses. According to the current guidance, an additional mRNA COVID-19 vaccine dose is recommended for moderately to severely immunocompromised people after they completed an initial 2-dose mRNA vaccine series. Therefore, facilities should include the following individuals in question #4 as eligible to receive an additional dose of the COVID-19 vaccine:

  1. Received an initial complete 2-dose mRNA COVID-19 vaccine series at this facility or elsewhere since December 2020 (question 2); AND
  2. Eligible to receive an additional or booster dose of the COVID-19 vaccine, per CDC guidance noted above.

In response to questions, NHSN received about reporting additional COVID-19 vaccine dose or booster data, scenario examples are provided below to assist in determining how to respond to these new questions.

  • Facility A is unsure how to determine who in their facility is considered eligible for an additional dose or booster at this time.

Facilities should refer to the CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States to determine individuals who are eligible to receive additional doses or boosters after receiving an initial completed vaccination series. For more information about COVID-19 vaccine indications for individuals who are immunocompromised, please see the FAQs at: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/immunocompromised.html.

  • Facility B has a staff member who only received dose 1 of the Moderna COVID-19 vaccine. However, this staff member expressed an interest in receiving an additional dose of the vaccine.

The facility would not include the staff member in questions 4 and 5 on the data collection form since he/she did not complete an initial COVID-19 vaccination series.

  • Facility C cannot determine if an individual is eligible for an additional dose at this time because they do not know the individual’s health status to determine if they are immunocompromised.

If a facility is unable to determine whether an individual is considered eligible to receive an additional dose or booster at this time, the individual should not be reported in question 4 or question 5 on the data collection form.

For reporting through the NHSN COVID-19 vaccination modules, assume these two staff members were eligible to have received an additional dose of the COVID-19 vaccine. Include these two staff members in question 4 and question 5 of the data collection form.

  • After reviewing the current Interim Clinical Considerations for Use of COVID-19 Vaccines, facility E does not have any individuals who are eligible to receive an additional dose or booster of COVID-19 vaccine.

This facility should report that zero individuals are eligible to receive an additional dose or booster of COVID-19 vaccine in question 4. The new question 4 and question 5 on the data collection form are required fields. A value must be entered for each of these questions for the form to be saved successfully. A zero (“0”) should be entered for question #4 and a zero “0” entered for question #5 (select any manufacturer from the dropdown). This will allow the form to save successfully.

Updated resources, including training materials, data collection forms, table of instructions documents, and other supporting materials are available on the following webpages:

Weekly HCP & Resident COVID-19 Vaccination | LTCF | NHSN | CDC
Weekly HCP COVID-19 Vaccination | HPS | NHSN | CDC
Weekly Patient COVID-19 Vaccination | Dialysis | NHSN | CDC

Frequently asked questions (FAQ) have also been updated (please see questions 23-27) and can be accessed using this link: https://www.cdc.gov/nhsn/hps/weekly-covid-vac/faqs.html.

We appreciate your efforts to report these critical data accurately and completely. We encourage updates to previously entered data as needed. If you have any questions or concerns, please let us know. As always, questions can be sent to NHSN@cdc.gov using ‘COVID-19 vaccination’ in the subject line of the message.

COVID Testing Information

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State Orders for Abbott BinaxNOW Tests

Missouri is experiencing constrained supplies of the BinaxNOW COVID antigen test cards. Thus, effective September 9, 2021, DHSS is implementing a revised BinaxNOW test ordering cadence in order to conserve supply and assure the optimum availability of BinaxNOW COVID antigen tests for all users. Until further notice, please order no more than two weeks supply of BinaxNOW tests for use by your facility or organization. If our supply allows larger quantities to be ordered, we will modify this process accordingly at that time and notify all users. https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/testing-resources.php

To Reinstate Direct Shipments of Abbott BinaxNOW from the Federal government:

Providers should email their facility information, shipping address and the BinaxNOW delivery Point of Contact for the facility and request to be added back onto the direct shipment list to Binax.Team@hhs.gov. Please be aware reinstatement depends upon available supply of tests to the Federal government and this can take several weeks to begin receiving shipments again.

Reimbursement for OUTBREAK Testing

A reminder that in order to furnish immediate aid and relief in response to the state of emergency due to the spread of COVID-19, the State of Missouri has made some funds from the Coronavirus Relief Fund available to Missouri Long Term Care facilities with COVID-19 Outbreaks. These funds are available to Long-Term Care facilities that experience an outbreak (one or more positive cases) and are conducting base-line facility testing and some immediate follow-up testing in order to contain outbreaks. For more information: https://apps.dss.mo.gov/LongTermCareCovid19Invoices/.

Transfer and Discharge Procedures – REGULATION UPDATE NOTICE

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The Department of Health and Senior Services, Section for Long-Term Care Regulation has drafted emergency and proposed amendments affecting the transfer and discharge hearings referenced in regulation set 19 CSR 30-82.050.

The emergency amendment for 19 CSR 30-82.050 was filed on September 1, 2021, with an effective date of September 16, 2021 and expiration of March 14, 2022. The emergency amendment can currently be viewed at https://www.sos.mo.gov/adrules/EmergenciesforInternet/emergency. The proposed amendment covering this same material will also be published in the same issue of the Missouri Register. The Register publication date is October 1, 2021 for the emergency and proposed amendments and can be found at http://www.sos.mo.gov/adrules/moreg/moreg.asp.

NOTE: The public comment period for the proposed amendments will be from October 1, 2021 – October 31, 2021. The Department will be accepting comments during the comment period by mailing the comments to: Carmen Grover-Slattery, Regulation Unit Manager, Section for Long-Term Care Regulation, Division of Regulation and Licensure, PO Box 570, Jefferson City, MO 65102-0570 or by emailing to: RegulationUnit@health.mo.gov.

The proposed amendment can be reviewed on our website at: https://health.mo.gov/about/proposedrules/.

LTC Bed Availability Portal Reminder

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Reminder: After submitting the initial survey, a confirmation email will be provided for a link to update your survey each day (instead of submitting a new survey). Submitting a new survey results in multiple surveys showing on the map with different bed numbers. This makes it difficult to know which totals are current. Please use the link emailed after the initial submission to edit facility bed availability. Please do not submit an “initial” submission more than once. If information does not change from day to day, the submitter can simply update the date and submit – the prior day’s information will populate.

The survey information will populate an accompanying dashboard that will be available to hospitals to use as a tool in finding placement for those patients who would be best served in a long-term care setting. This dashboard may be accessed at https://mophep.maps.arcgis.com/apps/opsdashboard/index.html#/f1e0745f93fe46b482d8ff4585f821bf. To view instructions on utilizing the dashboard, click on ‘Instructions’ under the map for information.

Action Pact’s Conversations with Carmen

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September 17, 2021: Living Life Outside of Groups – Dispelling the Pressure to Hold Them

Most residents end up spending most time in their room, with or without a pandemic. We have needed to hone helping people live life outside of groups all along. Groups can never be 24/7 or meet everyone’s needs anyway. Gift residents with lots of ideas of things to do beyond the norm and beyond television. Encourage people with time on their hands to try something new, do things they have not done in a while, refocus their capabilities, live out passions in adaptive ways and not lose their taste for life no matter their abilities. Work with people to tell their life story, share wisdom, leave a legacy, develop the invention, book or song in their heart, armchair travel, plan, sing, study, sort photos, serve others, and more. What a great moment in time to get creative and go deeper with people. Learn how to have every team member honor and validate every individual’s’ life role/contribution to your community.

DHSS COVID-19 Vaccination Booster Doses Survey

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The Department of Health and Senior Services is planning for the upcoming approval of booster COVID-19 vaccination doses and long-term care facilities will be a priority. The federal pharmacy program used to administer first and second doses will not be available, so it is important to ensure long-term care facilities receive the needed support for the administration of booster doses. We are asking for your feedback regarding your facility’s readiness to administer booster doses. https://www.surveymonkey.com/r/VTT296F

For those SNFs (Medicaid/ Medicare certified) that already completed the NHSN survey, we already have your results no further action is needed.

For questions regarding this survey, please contact Lana Hudanick at Lana.hudanick@heatlh.mo.gov or 314-982-8260. Please reply by September 15, 2021.

COVID-19 After Action Report (AAR) Survey – Deadline Extended

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The deadline to complete the DHSS COVID-19 After Action Report (AAR) Survey has been extended to Friday, September 3, 2021. Your assistance in helping us gather this important data is greatly appreciated. Please feel free to share the link with your state, regional, and local partners in the following categories:

  • Public Health/LPHA
  • Hospital
  • EMS
  • Emergency Management
  • Behavioral Health
  • Healthcare Coalition Leadership
  • State Agency Partners

https://survey123.arcgis.com/share/d20126ad3a05496d87dbf3b4b65d7592?portalUrl=https://mophep.maps.arcgis.com

Please let us know if you have any questions or difficulties with the survey.
John Whitaker – John.Whitaker@health.mo.gov
Brendan Bagby – Brendan.Bagby@health.mo.gov

Changes to Missouri’s Adult Abuse and Neglect Hotline Hours of Operation

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The Department of Health and Senior Services (DHSS) is revising the hours of operation for the Missouri Adult Abuse and Neglect Hotline to 7:00 a.m. to 8:00 p.m., 365 days a year, effective September 1, 2021. The Hotline’s former hours of operation were 7:00 a.m. to midnight, 365 days a year. This change will allow the Department to better serve those who need to report concerns of abuse, neglect, and exploitation of vulnerable individuals 60 and older and people with disabilities between 18 and 59.

During fiscal year 2020, DHSS received and investigated 40,714 community and facility reports of abuse, neglect, bullying, and exploitation, involving seniors and adults with disabilities. That amounts to an average of over 111 reports every day. The number of cases continues to rise, but still vastly understates the extent of the problem as experts believe that for every case of adult abuse or neglect reported, as many as 23 cases go unreported.

In November of 2019, DHSS implemented the Adult Abuse and Neglect Hotline online reporting system allowing concerned citizens and mandated reporters to electronically submit reports of abuse, neglect, and exploitation in an efficient, secure, and confidential manner on a web-based platform. The online reporting portal is available 24 hours a day, 7 days per week and provides an alternative to calling the Adult Abuse and Neglect Hotline both during and outside of normal business hours. Since the implementation of online reporting, approximately one-third of all reports are submitted this way. While online reporting has helped to ease the Adult Abuse and Neglect Hotline’s call volume demands, additional efforts are still needed to ensure that no call goes unanswered. The new operational hours for the Hotline will allow for increased staffing during times of highest call volume. This will help reduce wait times for those reporting and make it easier to reach a trained intake professional between 7:00 a.m. and 8:00 p.m. Please note that 9-1-1 should be accessed for emergencies as the Adult Abuse and Neglect Hotline online reporting system is not intended for emergency response.

If you suspect abuse, neglect or financial exploitation of the elderly or an adult with a disability, you may call the Adult Abuse and Neglect Hotline toll-free at (800) 392-0210 or visit www.health.mo.gov/abuse/ to make a report online.

If you have any questions regarding the change in the hours of operation for the Adult Abuse and Neglect Hotline, please reach out to the Department at 573/526-3625 or DSDSOfficeofConstituentServices@health.mo.gov.

Public Health: Better Health. Better Missouri.

CDC Health Advisory/DHSS Health Alert

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Please see the CDC Health Advisory entitled, “Rapid Increase in Ivermectin Prescriptions and Reports of Severe Illness Associated with Use of Products Containing Ivermectin to Prevent or Treat COVID-19” and the DHSS Health Alert “Self-medication with Ivermectin for the Treatment and Prevention of COVID-19.”

Should you have any questions, please contact the Missouri Department of Health and Senior Services’ Bureau of Communicable Disease Control and Prevention at 573-751-6113.

Onsite Clinical and On the Job Training for Students Entering Health Care (Nurses, Nurse Aides, Therapy)

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SLCR has received questions regarding whether or not Skilled Nursing Facilities can be a clinical or on the job training sight for students entering health care fields. The quick answer is YES! Long-term care facilities can use the guidance from CMS memo QSO 20-39-NH and DHSS visitation guidance as a way to say “YES” to hosting schools who are training our next workforce in long-term care. Students can be considered health care workers who are not employees of the facility but provide direct care to the facility’s residents. They can be permitted to come into the facility as long as they are not subject to a work exclusion due to an exposure to COVID-19 or showing signs or symptoms of COVID-19 after being screened. Facilities should work with the schools to ensure they are aware of infection control policies and procedures and to whom questions can be addressed.

The most recent visitation guidance from CMS and DHSS can be accessed on our website: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/professionals.php.

For questions related to this, please contact Angela.Duvall@health.mo.gov.

Updated Standing Orders and Affidavits for Third Dose of COVID-19 Vaccine

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Following recent announcements from the US Food and Drug Administration and the Centers for Disease Control and Prevention, certain immunocompromised individuals can begin receiving third doses of COVID-19 vaccine in Missouri.

A third dose of the PfizerNBioTech or Moderna vaccines may be administered to moderately to severely immunocompromised people due to a medical condition or combination of immunosuppressive medication or treatments including but not limited to the following:

  • Immunocompromised due to solid organ transplant and taking immune suppressing medications
  • Immunocompromised due to active treatment for solid tumor and hematologic malignancies
  • Immune compromised due to Receipt of CAR-T cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
  • Moderate to severe primary immunodeficiency (eg., DiGeorge, Wiskott-Aldrich Syndromes)
  • Immunocompromised due to Advanced or untreated HIV infection
  • Immunocompromised due to “Active treatment with high-dose corticosteroids or other drugs that may suppress immune response: high dose corticosteroids (ie.,≥ 20 mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis (TNF) blocker or other biologic agents that are immunosuppressive or immunomodulatory”

Individuals who do not meet the criteria for “moderately to severely immunocompromised” do not need a third dose at this time.

In line with federal guidelines, Missouri will use a self-attestation model for people who are moderately to severely immunocompromised. Individuals will not be required to provide documentation of their health status, and they can get third doses at all venues where first and second doses are available.

This guidance does not apply to those who received the Janssen/Johnson & Johnson vaccine. For people who received either Pfizer-BioNTech or Moderna’s COVID-19 vaccine series, a third dose of the same mRNA vaccine should be used. A person should not receive more than three mRNA vaccine doses at this time. If the mRNA vaccine product given for the first two doses is not available or is unknown, either mRNA COVID-19 vaccine product may be administered. Individuals should wait at least 28 days between their second and third doses.

Announcements from federal health officials came after the analysis of studies demonstrating that immunosuppressed people are more likely to get severely ill from COVID-19, are at higher risk for prolonged infection, are more likely to transmit the virus, and experience lower vaccine effectiveness.

Additional information regarding this guidance can be found on the CDC website at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html.

Interim clinical considerations for use of COVID-19 vaccines can be found at https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html.

Missouri’s revised standing orders can be found at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/statewide-orders.php.

LTC Updates and Materials

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Due to the recent increase in COVID activity in skilled nursing facilities as well as outbreaks in assisted living communities, here are some resources that may be of interest to your members and ask that you share this material as widely as possible.

Below, you will find a fact sheet and social media graphics that reiterates important infection prevention strategies, including promoting COVID-19 vaccinations and continuing to wear a mask. This factsheet can be emailed to staff or used as a poster to reinforce the urgent actions CDC is asking of all healthcare providers and staff in long-term care facilities.

Additionally, there are also two slide decks that were reviewed on our partner call last week. The first slide deck summarizes the urgent action CDC recommends for protecting residents and staff from COVID infections as well as information about how CDC is working to ensure vaccine access for long-term care facilities. The second slide deck provides additional information about monoclonal antibody treatment.

LTC Infection Control Delta Factsheet
2021-08-11 LTC MAb update Slide Show
NH partner summary_21-08

 

Finally, below are links to existing web resources. Please share these as well.

Healthcare Staffing Contract with SLS Health

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The Department of Health and Senior Services has entered into a contract with SLS Health to assist with staffing needs for healthcare facilities, including long-term care facilities. The contract will allow skilled nursing, intermediate care, assisted living or residential care facilities to access the contract to secure healthcare staffing according to a firm, fixed rate. Payment for the staffing costs will be borne by the respective facility. Please see below attachments for additional information about the contract, how to access staffing resources, and applicable rates.

Missouri’s COVID-19 Healthcare Augmentation LTC slides
Attachment B

Revocation of NIOSH Certification

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As of August 13, 2021, any Shanghai Dasheng Health Products Manufacture Co., Ltd. respirator with a NIOSH approval label containing a revoked approval number is no longer NIOSH-approved and cannot be manufactured, assembled, sold, or distributed.

See the link below to find the approval numbers of the respirators that have been de-certified. The approval number starts with TC-84A. If you can’t find this number on the respirator or its packaging, it was never NIOSH approved in the first place and shouldn’t be used, but if it has any of the listed TC numbers in the link below on the respirator itself or its packaging, you should discontinue use immediately and remove from use any that have been distributed.

https://www.cdc.gov/niosh/npptl/resources/pressrel/letters/respprotect/CA-2021-1038.html

Changes to the Weekly NHSN COVID-19 Vaccination Data Collection Forms for Long-Term Care Facilities

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Changes are underway for CDC’s Weekly NHSN COVID-19 Vaccination Modules. In anticipation of recommendations for additional COVID-19 vaccine series, new questions on COVID-19 vaccine doses will be added to the current data collection forms in August 2021. The main changes to the forms for all three facility types are listed below:

  • Added question #4 for facilities to report on the cumulative number of individuals eligible to receive an additional dose or booster of COVID-19 vaccine.
  • Added question #5 for facilities to report on the cumulative number of individuals who received an additional dose or booster of COVID-19 vaccine (by manufacturer type).

To help facilities prepare for these changes, CDC is conducting listen-only training webinars.

Topic: Changes to the Weekly NHSN COVID-19 Vaccination Data Collection Forms for Long-Term Care Facilities
Date: Wednesday, Aug 25, 2021
Time: 2:30 – 3:30 PM ET
https://cdc.zoomgov.com/webinar/register/WN_tC-VNNB_QIaHs5IslpwmcQ

DHSS COVID After Action Report Survey

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Below is a link to the Missouri Department of Health and Senior Services COVID-19 after action survey. This survey is designed to gather feedback from a variety of healthcare and public health partners and organizations. Please respond by selecting the discipline that reflects your organization and submit one survey per organization, excluding state agency partners. Your responses to this survey should be based on your organizations role and perspective of the COVID response. Receiving input from a variety of stakeholders, at all levels of the response, will help us better identify our strengths and weakness of the public health and medical services emergency Support function.

https://survey123.arcgis.com/share/d20126ad3a05496d87dbf3b4b65d7592?portalUrl=https://mophep.maps.arcgis.com

Please see this FAQs for more information. Thank you in advance for your participation!

Smoke Zones vs. Fire Zones

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We have recently noticed several facilities that have used their fire alarm zones as part of their evacuation plan. The fire alarm zones are the zones on the fire alarm panel used to help staff identify the location of the fire. These are different from smoke zones, which are the zones in the building created to prevent the spread of smoke and fire and allow staff time to complete a full evacuation of the building. Many facilities have fire alarm zones that do not match the smoke zones in the facility. Often times there are more fire zones to help staff identify the location of a fire.

To start a smoke zone evacuation, it may be necessary to evacuate multiple fire alarm zones at the same time. The evacuation plans need to have these smoke zones clearly labeled and all staff need to know where they will move the residents in the event of a fire. The facility cannot base their evacuation plans on the fire alarm zones.

In this example, the facility has eight fire alarm zones (Fire Zones 1-8). The facility has a smoke barrier wall that divides the facility into two smoke zones (Smoke Zones A and B). The facility also has a secured unit, but the controlled egress doors (locked keypad doors) are not a part of the smoke barrier wall, so the secured unit is part of Smoke Zone A.

If a fire occurs in Fire Zone 4, it means that an evacuation of all residents would need to occur throughout Smoke Zone B, which would include all residents in Fire Zones 3, 4, and 5. The evacuation plan may mention things like room number, dining rooms, etc., but should avoid using fire zones to describe the smoke zones. Although it is important to know which smoke zone activated the fire alarm system, staff cannot move the residents from Fire Zone 4 to Fire Zone 5, as they are still within Smoke Zone B. Staff must completely move the residents out of Smoke Zone B.

In addition, it is significant to note if a fire occurred in Smoke Zone A (i.e. Fire Zones 1 or 6), the staff would need to move residents in the secured unit from Smoke Zone A. Staff cannot leave the residents in the secured unit since a smoke barrier wall does not protect the secured unit and it is not its own smoke zone.

The facility must have the evacuation plans posted on at least every floor of the facility [19 CSR 30-85.022 (33)(B)(2)] which directs all staff, residents, and visitors where to go in the event of a facility evacuation. The policy and procedure for evacuations also needs to be in the emergency preparedness manual.

NFPA 99, 2012 edition
15.7.4.3.1: Where buildings are required to be subdivided into smoke compartments, fire alarm notification zones shall coincide with one or more smoke compartment boundaries or shall be in accordance with the facility fire plan.

MHCA’s Annual Convention

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August 22-25, 2021: MHCA 73rd Annual Convention & Trade Show
Location: Branson Convention Center, Branson

The long-term care industry faced enormous challenges in 2020 due to the COVID-19 pandemic. Thanks to your hard work and perseverance, along with widespread access to vaccines, we feel comfortable about gathering in person in Branson.

Click HERE to view a message from MHCA Executive Director, Nikki Strong, regarding an update to safety protocols and masking requirements for the MHCA 73rd Annual Convention & Trade Show.