Category: Long Term Care Blog

Community Testing Opportunities

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The next round of community testing events will take place in the following counties. Additional events are expected to be scheduled throughout the coming weeks. Missourians can register now for these events at health.mo.gov/communitytest and also continue to check back for future opportunities to be tested at an event nearby.

County

Location

City

Dates

Times

Osage

Osage County Fairgrounds

Linn

October 26

8AM – 1PM

Howell

Lybyer Enhanced Technology Center

West Plains

October 27

12PM – 5PM

Cole

First Assembly of God

Jefferson City

October 27

9AM – 5PM

Phelps

Lions Club Den & Park

Rolla

October 28

2PM – 7PM

New Madrid

Public Safety Center

New Madrid

October 29

9AM – 1PM

Greene

Ozark Empire Fairgrounds

Springfield

October 30-31

Oct. 30 9AM – 7PM

Oct. 31 7AM – 4PM

Butler

Whitely Park

Poplar Bluff

October 30

9AM – 5PM

Miller

Eldon Community Center

Eldon

November 2

9AM – 2PM

Moniteau

Moniteau County Fairgrounds

California

November 4

9AM – 2PM

Shelby

Shelby County Fairgrounds

Shelbina

November 6

9AM – 2PM

Buchannan

Heritage Park Softball Complex

St. Joseph

November 7

7AM – 3PM

Scotland

Scotland County Health Department/ Home Health Agency

Memphis

November 7

9AM – 2PM

Register for testing at:
www.health.mo.gov/communitytest
or call (877) 435-8411

EMAIL SCAM ALERT

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The Missouri Board of Nursing Home Administrators (Board) office was contacted by administrators of a suspicious email requesting donations. The email was forged to appear that it came from this office.

The email that the Board office uses is BNHA@health.mo.gov. If you receive an email that looks unfamiliar, or asks you to do something unusual, or asks you to do something quickly, do not click on any links in the suspicious email and do not reply to the email sender. Please check with the Board office by forwarding the email to BNHA@health.mo.gov or call (573) 751-3511.

New Resource – Dementia Care

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The California Partnership to Improve Dementia Care has created six resource videos on the topic of COVID-19 and residents living with dementia.

  • Activities for Patients with Dementia: Creative Ideas During COVID-19
  • Coping and Stress Management During a Pandemic
  • COVID-19: Tips for Reducing Emotional Distress in Patients with Dementia
  • How to Reduce Wandering in Patients with Dementia
  • Optimizing Dementia Care in the Era of COVID-19
  • Optimizing Person Centered and Family Dementia Care in the Era of COVID-19

The videos are housed on the link below:
https://www.leadingageca.org/Members/Partners.

Community Testing Opportunities

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The next round of community testing events will take place in the following counties. Additional events are expected to be scheduled throughout the coming weeks. Missourians can register now for these events at health.mo.gov/communitytest and also continue to check back for future opportunities to be tested at an event nearby.

 

County

Location

City

Dates

Times

St. Charles

The Family Arena

St. Charles

October 16-17

Oct. 16 10AM – 6PM

Oct. 17 8AM – 4PM

Jasper

Missouri State Southern University

Joplin

October 16

10AM – 6PM

Benton

Benton County Health Department

Warsaw

October 17

12PM – 5PM

Jefferson

Hillsboro Civic Center

Hillsboro

October 20

10AM – 7PM

Wright

Tri-County Fairgrounds

Mountain Grove

October 20

9AM – 1PM

Washington

Washington County Ambulance District

Mineral Point

October 21

11AM – 5PM

Dallas

Buffalo Prairie Middle School

Buffalo

October 21

10AM – 2PM

Barton

Cash Savers Grocery Store Parking Lot

Lamar

October 22

1PM – 6PM

Cape Girardeau

Arena Park

Cape Girardeau

October 23

7AM – 5PM

Texas

Brushy Creek Park

Houston

October 23

10AM – 2PM

Register for testing at:
www.health.mo.gov/communitytest
or call (877) 435-8411

 

MDS Changes for 10-1-20

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Missouri opted to collect PDPM HIPPS codes on OBRA assessments with an ARD of 10/1/20 or later. This means that SNFs and NFs in Missouri need to complete additional items on OBRA assessments not combined with a Medicare assessment. Additional items include:

  • GG0130 Self-Care items;
  • GG0170 Mobility items;
  • I0020 and I0020B Primary Medical Condition items;
  • J2100 Recent Surgery item. If J2100 is checked yes, J2300-J5000 are to be completed.

Training: QIPMO provided a webinar on 9/21/20 where Stacey Bryan, Missouri’s State RAI Coordinator, went over MDS changes for 10-1-20. To view a recording of this webinar please go to https://nursinghomehelp.org/event/september-monthly-webinar/. Please note, the RAI Manual pages to review for examples of diagnoses in each medical condition category for item I0020 is I-2 and I-3, not I-12 which is referenced in the webinar.

FAQ Document: Below is a FAQ document concerning the MDS changes for Missouri this October. This document will be updated as needed. The date a question and answer is added to the document will be beneath each answer.

MDS FAQ Document for MO 10-16-20 version

If you have any questions about this information please contact Missouri’s State RAI Coordinator, Stacey Bryan, at Stacey.Bryan@health.mo.gov or 573-751-6308.

MDS Rejections related to October 2020 Changes

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Missouri opted to collect PDPM HIPPS codes on OBRA assessments with an ARD of 10/1/20 or later. This means that SNFs and NFs in Missouri need to complete additional items on OBRA assessments not combined with a Medicare assessment. Additional items include:

  • GG0130 Self-Care items;
  • GG0170 Mobility items;
  • I0020 and I0020B Primary Medical Condition items;
  • J2100 Recent Surgery item. If J2100 is checked yes, J2300-J5000 are to be completed.

Multiple homes have reported their software has not incorporated the additional required items listed above for OBRA comprehensive and Quarterly assessments with an ARD of 10/1/20 or after. They report if they complete the MDS assessments without these items the assessments are rejected by the QIES ASAP system. Some homes report they are able to change a setting in their software themselves that will include these items on OBRA assessments. Some homes report they cannot change the setting in the software themselves, that they must contact their software vendor for this setting change. Most homes that encounter this issue say after their software setting is changed, they must open completely new MDS assessments because the additional items will not be added to the assessment they opened prior to the setting change.

If you are completing an OBRA comprehensive or Quarterly assessment that has an ARD on or after 10/1/20, please ensure the additional items listed above, required to calculate a PDPM HIPPS code, are NOT grayed out in your software. If you discover these items are grayed out, contact your software vendor as soon as possible before continuing with the assessment.

If you have any questions about this issue please contact Stacey Bryan at Stacey.Bryan@health.mo.gov or 573-751-6308. Thank you.

CONSUMER ALERT: Missouri State Board of Nursing Warns of Scam Targeting Missouri Nurses

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The Missouri State Board of Nursing is alerting Missourians of a scam targeting licensed nurses in the state. This scam can target nurses by either phone or mail.

Jefferson City – A Missouri licensed nurse alerted the Board’s office after she received a phone call from a person who falsely identified himself as being from the Missouri State Board of Nursing. She said she repeatedly received phone calls from a number identified as 573-751-0681, which is the official phone number of the Board of Nursing. The person calling said there was a case against her Missouri nurse practitioner license and indicated she should have received letters from the Board about this. He then passed her off to the “officer in charge” identified as Patrick Walker in the letter. After several calls, they demanded payment in the form of a bond to keep her license active while the case was being investigated.

The caller had the nurse’s address, Missouri license number and NPI number. He told her someone had written prescriptions in another state using her NPI number.

Missouri nurses are also being contacted by mail. In these instances, the nurses receive fake but official looking documents that appear to be sent by the Board of Nursing. These phony letters indicate the nurse is under investigation for allegedly trafficking illegal drugs, and that they will not be allowed to continue practicing past a certain date. Finally, the letter states that the nurse should contact the officer in charge of the investigation and lists a Missouri phone number. The letters are mailed to the nurse’s home address and both reference the nurse’s actual state license number.

“These scams are highly concerning as they’re targeting Missouri nurses during a time when they are devoting their attention to our state’s response to the health of our citizens,” said Lori Scheidt, executive director of the Missouri State Board of Nursing. “I am deeply concerned that these scammers are using address and licensing information, which is public record, to make their communications appear to be official.”

If nurses receive a call or communication they can search for their record using Licensure QuickConfirm at www.nursys.com. After the record is accessed, they can print a report that will show their license number, original issue date, whether they have a multistate or single state license and discipline status. Current or future employers can also verify licenses at www.nursys.com.

If nurses have not already done so, they are urged to enroll in Nursys® e‐Notify at www.nursys.com/EN/ENDefault.aspx. Enrollment in Nursys® e‐Notify. They will receive license renewal reminders, notification when a license is actually renewed and notification of any changes to their license or discipline status. When enrolling in e‐Notify, nurses can opt in to receive automated electronic reminders.

New Phase 3 Provider Relief Funding

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On October 1st, under the leadership of President Trump, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is announcing $20 billion in new funding for providers on the frontlines of the coronavirus pandemic. Under this Phase 3 General Distribution allocation, providers that have already received Provider Relief Fund payments will be invited to apply for additional funding that considers financial losses and changes in operating expenses caused by the coronavirus. Previously ineligible providers, such as those who began practicing in 2020 will also be invited to apply, and an expanded group of behavioral health providers confronting the emergence of increased mental health and substance use issues exacerbated by the pandemic will also be eligible for relief payments.

Providers can begin applying for funds on Monday, October 5, 2020.

“HHS has worked to ensure that all American healthcare providers receive support from the Provider Relief Fund in a fast and fair way, and this new round helps ensure that we are reaching America’s essential behavioral health providers and takes into account losses and expenses relating to coronavirus,” said HHS Secretary Alex Azar. “We’ve worked with all of the resources we have across HHS to ensure that America’s heroic healthcare providers know they can apply for support.”

HHS has already issued over $100 billion in relief funding to providers through prior distributions. Still, HHS recognizes that many providers continue to struggle financially from COVID-19’s impact. For eligible providers, the new Phase 3 General Distribution is designed to balance an equitable payment of 2 percent of annual revenue from patient care for all applicants plus an add-on payment to account for revenue losses and expenses attributable to COVID-19.

Further, HHS recognizes constraints such as the stay-at-home orders and social isolation have been particularly difficult for many Americans. A recent Centers for Disease Control and Prevention (CDC) report found the prevalence of  symptoms of anxiety disorder in the second quarter of 2020 was approximately three times those that reported in the second quarter of 2019 (25.5% versus 8.1%); and the prevalence of depressive disorder was approximately four times that reported in the second quarter of 2019 (24.3% versus 6.5%). Our behavioral health providers have shouldered the burden of responding and confronting this expanded challenge triggered by the pandemic. When traditional face-to-face counseling was restricted and new telehealth flexibilities were put in place in response to the pandemic, many behavioral health providers invested in and adopted – PDF telehealth technologies to continue providing patient care. While some Medicare or Medicaid behavioral health providers have already received prior General Distribution payments, others have not. Working with the Substance Abuse and Mental Health Services Administration (SAMHSA), HRSA developed a list of the nation’s behavioral health providers now eligible for funding, which includes, for example, addiction counseling centers, mental health counselors, and psychiatrists.

Eligibility

HHS is making a large number of providers eligible for Phase 3 General Distribution funding, including:

  • Providers who previously received, rejected or accepted a General Distribution Provider Relief Fund payment. Providers that have already received payments of approximately 2% of annual revenue from patient care may submit more information to become eligible for an additional payment.
  • Behavioral Health providers, including those that previously received funding and new providers.
  • Healthcare providers that began practicing January 1, 2020 through March 31, 2020. This includes Medicare, Medicaid, CHIP, dentists, assisted living facilities and behavioral health providers.

Payment Methodology – Apply Early

All eligible providers will be considered for payment against the below criteria.

  1. All provider submissions will be reviewed to confirm they have received a Provider Relief Fund payment equal to approximately 2 percent of patient care revenue from prior general distributions. Applicants that have not yet received Relief Fund payments of 2 percent of patient revenue will receive a payment that, when combined with prior payments (if any), equals 2 percent of patient care revenue.
  2. With the remaining balance of the $20 billion budget, HRSA will then calculate an equitable add-on payment that considers the following:
    • A provider’s change in operating revenues from patient care
    • A provider’s change in operating expenses from patient care, including expenses incurred related to coronavirus
    • Payments already received through prior Provider Relief Fund distributions.

We know providers want to receive payments shortly after submitting their information. However, this distribution requires cooperation on the part of all applicants. Again, HHS is urging all eligible providers to apply early; do not wait until the last day or week of the application period. Applying early will help to expedite HHS’s review process and payment calculations, and ultimately accelerate the distribution of all payments.

All payment recipients will be required to attest to receiving the Phase 3 General Distribution payment and accept the associated Terms and Conditions.

Application Deadline

Providers will have from October 5, 2020 through November 6, 2020 to apply for Phase 3 General Distribution funding. HHS’s top priority is ensuring as many providers possible have an opportunity to apply. HHS will continue to host webinars to assist providers through the application process and the call center is also available to address questions.

HHS recognizes the multifaceted challenges of this pandemic cannot be won without frontline healthcare providers focused on containing the virus and delivering holistic care. Funding for this Phase 3 General Distribution was made possible through the bipartisan CARES Act and the Paycheck Protection Program and Health Care Enhancement Act, which allocated $175 billion in relief funds to hospitals and other healthcare providers.

For updates and to learn more about the Provider Relief Program, visit: hhs.gov/providerrelief.

Community Testing Opportunities

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The next round of community testing events will take place in the following counties. Additional events are expected to be scheduled throughout the coming weeks. Missourians can register now for these events at health.mo.gov/communitytest and also continue to check back for future opportunities to be tested at an event nearby.

County

Location

City

Dates

Times

Buchanan

Krug Park

St. Joseph

October 10

7AM – 1PM

Bollinger

Bollinger County Health Department

Marble Hill

October 10

7AM – 12PM

Adair

NEMO Fairgrounds

Kirksville

October 12

7AM – 12PM

Wayne

Wayne County Courthouse

Greenville

October 12

7AM – 1PM

Boone

The Crossing Church

Columbia

October 13

7AM – 7PM

Lincoln

Lincoln County Fairgrounds

Troy

October 15

10AM – 6PM

Newton

Rocketdyne Church of Christ

Neosho

October 15

10AM – 6PM

St. Charles

The Family Arena

St. Charles

October 16-17

Oct. 16 10AM – 6PM

 

Oct. 17 8AM – 4PM

Jasper

Missouri State Southern University

Joplin

October 16

10AM – 6PM

Benton

Benton County Health Department

Warsaw

October 17

12PM – 5PM

Register for testing at:
www.health.mo.gov/communitytest
or call (877) 435-8411

 

Electronic COVID-19 Reporting of Point of Care Test Results to DHSS

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Many long-term care facilities (LTCFs) have received or will receive COVID-19 antigen point of care (POC) testing machines and supplies from the federal government to help facilitate timely testing of residents and facility staff. Through the distribution of the machines, LTCFs will act as the diagnosing provider and now the laboratory for the tests which requires reporting of all test results to the Missouri Department of Health and Senior Services (DHSS).

Properly submitting all test results (positive, negative, and other results) in a timely manner is important to the health and safety of the community. To expedite the reporting process, DHSS is requiring all facilities to submit test results in an electronic format with the ultimate goal of onboarding all LTCFs to electronic reporting within the next 30 days.

DHSS has assembled a team to assist you in this effort. Ryan Marsch and the DHSS Onboarding Team (ELR@health.mo.gov) will be your primary contacts as you onboard for electronic reporting of test results. Tracy Niekamp (tracy.niekamp@health.mo.gov) and Shelly Williamson (shelly.williamson@health.mo.gov) at the Division of Regulation and Licensure are also available to assist you with any questions.

Documentation and Reporting of Point of Care Test (POC) Results

By administering the POC tests, a LTCF is acting as a laboratory which is required to submit all COVID-19 test results (positive, negative, other) to DHSS for testing performed in their facility. The facility is also acting as the provider, and are required to submit case reports to DHSS.

Facilities, including K-12 schools, long-term care, and higher education institutions which administer POC tests may report all the necessary information for both the laboratory report and the case report on a single comma separated values file (CSV), which is a format-free version of a spreadsheet. A template will be provided to the facility by DHSS. Required data fields include facility information, patient demographics, lab results and basic information about symptoms.

The CSV file is then uploaded to a Secure File Transfer Protocol (SFTP) site, and is auto-ingested into the state’s disease monitoring platform, known as EpiTrax. This information is then immediately accessible to local and state health authorities.

For long-term care facilities, this means that they no longer need to complete an online CD-1 form for tests that they perform on-site, acting as a laboratory. Long-term care facilities must continue to submit an online CD-1 form to report positive COVID-19 cases that occur in their facilities if the test was performed by an external laboratory.

To successfully submit test results through SFTP, testing sites will need:

  • Reporting template from DHSS
  • Access to a computer/laptop with Microsoft Excel or an alternative application that can work with Excel files
  • Access to the Internet
  • User name and password for the secure upload site

There are three steps to onboarding to laboratory/case reporting:

Step 1: Starting Wednesday, October 7, DHSS will contact long-term care facilities in onboarding groups. Look out for an invitation email with the following resources:

  • A link to a brief survey for collecting contact information on the team member assigned to submit the data in your facility. Note: Once you receive this email, please complete this survey within 24 hours. If possible, we ask that you complete this survey in advance of the invitation email at this link: https://stateofmissouri.wufoo.com/forms/ma3vqye0hqzxkj/
  • This will help our team expedite this process and get you up and running as soon as possible.
    You may also find a link to this survey and additional information here: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/how-to-report-lab-results.php
  • A CSV Excel file to facilitate seamless reporting into EpiTrax, DHSS’ disease surveillance system
  • Electronic COVID-19 Laboratory Reporting Submission Instructions to walk through submitting files via SFTP
  • A second email with your SFTP credentials

Step 2: You will start to submit files via SFTP. To expedite this process, your first submission may consist of test data, as it will be for validation purposes only. DHSS will review the data for accuracy and reach out if any changes are necessary.

Step 3: Once your data is validated, you will go live for ongoing submissions. Properly formatted data ingests into EpiTrax where DHSS and local public health agencies document and track case investigation activities.

If you have questions about formatting your Excel files or how the process works, please contact ELR@health.mo.gov. There are over 1,000 facilities that may receive some type of point of care test, so be aware that there may be some delay in the onboarding process.

If you have already begun testing at your facility and need guidance for reporting while you work through the onboarding process, please contact ELR@health.mo.gov for assistance.

CLIA Requirements

Any site that performs laboratory testing must follow applicable regulatory requirements including federal, state and local mandates for testing, as well as requirements for the safety and confidentiality of personal information. Use of this authorized test is limited to Clinical Laboratory Improvement Amendment (CLIA) certified laboratories that meet the requirements to perform moderate, high or waived complexity tests and Point of Care (POC) settings operating under a CLIA Certificate of Waiver, Certificate of Compliance, or Certificate of Accreditation. If your site does not have a CLIA Certificate of Waiver or for more information about CLIA requirements, please contact the CLIA Program at DHSS by email CLIA@health.mo.gov or by telephone at 573-751-6318.

CMS Memo: QSO-21-02-NH

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Compliance with Residents’ Rights Requirement related to Nursing Home Residents’ Right to Vote

Memorandum Summary

  • The Centers for Medicare & Medicaid Services (CMS) is affirming the continued right of nursing home residents to exercise their right to vote.
  • While the COVID-19 Public Health Emergency has resulted in limitations for visitors to enter the facility to assist residents, nursing homes must still ensure residents are able to exercise their Constitutional right to vote.
  • States, localities, and nursing home owners and administrators are encouraged to collaborate to ensure a resident’s right to vote is not impeded.

Please see the full details in the memo.

Discordant Results between COVID-19 Point of Care Antigen and PCR Tests in Nursing Homes

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The Center for Health Policy Evaluation in Long-Term Care has issued, “Preliminary Report: Discordant Results between COVID-19 Point of Care Antigen and PCR Tests in Nursing Homes”. Discordant results include situations when an antigen test is positive, but the RT-PCR test is negative. (Please see the full report here.)

Recommendations made included:

  • Continued use of Point of Care devices for widespread testing in SNFs.
  • Ensure users understand the importance of following manufactures protocols and CDC recommendations to conduct confirmation testing when antigen tests are positive among asymptomatic individuals.
  • Need for clearer guidance on what providers should do when the antigen test and confirmation tests are discordant with respect to patient care decisions, cohorting decisions, family notifications, NHSN reporting, and triggering an outbreak investigation.

In response, the CDC has updated their Frequently Asked Questions to address facility response if confirmatory RT-PCR testing is performed in response to a positive antigen test and results are discordant. https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html#Testing-in-Nursing-Homes

Community Testing Opportunities

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The next round of community testing events will take place in the following counties. Additional events are expected to be scheduled throughout the coming weeks. Missourians can register now for these events at health.mo.gov/communitytest and also continue to check back for future opportunities to be tested at an event nearby.

County

Location

City

Dates

Times

Buchanan

Krug Park

St. Joseph

October 10

7AM – 1PM

Bollinger

Bollinger County Health Department

Marble Hill

October 10

7AM – 12PM

Adair

NEMO Fairgrounds

Kirksville

October 12

7AM – 12PM

Wayne

Wayne County Courthouse

Greenville

October 12

7AM – 1PM

Boone

The Crossing Church

Columbia

October 13

7AM – 7PM

Lincoln

Lincoln County Fairgrounds

Troy

October 15

10AM – 6PM

Newton

Rocketdyne Church of Christ

Neosho

October 15

10AM – 6PM

St. Charles

The Family Arena

St. Charles

October 16-17

Oct. 16 10AM – 6PM

 

Oct. 17 8AM – 4PM

Jasper

Missouri State Southern University

Joplin

October 16

10AM – 6PM

Benton

Benton County Health Department

Warsaw

October 17

12PM – 5PM

Register for testing at:
www.health.mo.gov/communitytest
or call (877) 435-8411

 

Community Testing Opportunities

Posted on

The next round of community testing events will take place in the following counties. Additional events are expected to be scheduled throughout the coming weeks. Missourians can register now for these events at health.mo.gov/communitytest and also continue to check back for future opportunities to be tested at an event nearby.

 

County

Location

City

Dates

Times

Greene

2nd Baptist Church

Springfield

October 2-3

Oct. 2 9AM – 7PM

 

Oct. 3 7AM – 5PM

Franklin

East Central College

Union

October 2-3

Oct. 2 8AM – 5PM

 

Oct. 3 7AM – 12PM

Johnson

Holden Community Activity Center

Holden

October 4

10AM – 4PM

Lafayette

The Crown

Odessa

October 6

7AM – 7PM

Pulaski

St. Robert Community Center

St. Robert

October 6

8AM – 2PM

Clay

First United Methodist Church

Kearney

October 7-8

Oct. 7 7AM – 7PM

 

Oct. 8 7AM – 3PM

Pettis

MO State Fairgrounds Swine Barn

Sedalia

October 7

10AM – 6 PM

Buchanan

Krug Park

St. Joseph

October 10

7AM – 1PM

Bollinger

Bollinger County Health Department

Marble Hill

October 10

7AM – 12PM

Adair

NEMO Fairgrounds

Kirksville

October 12

7AM – 12PM

Wayne

Wayne County Courthouse

Greenville

October 12

7AM – 1PM

Register for testing at:
www.health.mo.gov/communitytest
or call (877) 435-8411

CMS Memo: QSO-20-41-ALL

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Guidance related to the Emergency Preparedness Testing Exercise Requirements- Coronavirus Disease 2019 (COVID-19)

Memorandum Summary

  • Emergency Preparedness Testing Exemption and Guidance – CMS regulations for Emergency Preparedness require specific testing exercises be conducted to validate the facility’s emergency program. During or after an actual emergency, the regulations allow for an exemption to the testing requirements based on real world actions taken by providers and suppliers.
  • This worksheet presents guidance for surveyors, as well as providers and suppliers, with relevant scenarios on meeting the testing requirements in light of many of the response activities associated with the COVID-19 Public Health Emergency (PHE).

Please see the full details in the memo.

MHCA Annual Convention

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The Missouri Health Care Association’s 72nd Annual Convention has been extended through October 31, 2020. Please join us at our Virtual Conference from the comfort and safety of your home, facility or office. There is education for all Departments such as Nursing, Leadership, CNAs, Dietary, Maintenance and more! You can join in chat sessions with colleagues and friends as well as participate in our virtual exhibits.

DHSS Guidance for Long-Term Care Facilities to Establish Essential Caregiver Programs and to Allow Visits

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Revised guidance was released today for long-term care facilities in Missouri that choose to establish an Essential Caregiver program and/or resume general visits either inside or outside the facility. Facilities should have a policy in place to determine how contact with loved ones can occur while protecting the health of residents. Each facility will ultimately make the decision as to whether or not to adopt this guidance. Certified Skilled Nursing Facilities and Intermediate Care Facilities are required to follow the guidance provided in QSO-20-39-NH, titled Nursing Home Visitation – COVID-19.

The revised guidance is attached and can also be found at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/professionals.php under the Long-Term Care Facilities link.

DHSS Visitation Guidance 9-22-20

CMP Application Process for Outdoor Visitation Aids

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CMS has created a process to enable states to approve requests to purchase tents for outdoor visitation and/or clear dividers (e.g. Plexiglass or similar product) to create a physical barrier to reduce the risk of transmission during in-person visits. The parameters are detailed in the instructions portion of the application template (below). This template and process will reduce the amount of time for approval of CMP funds for tents and dividers that will assist homes in facilitating visits with residents and aid in prevention of the spread of COVID-19.

The application is for nursing homes certified to participate in Title 18 and Title 19 of the Social Security Act. We encourage companies that operate more than one home to complete one application for all certified homes to the extent possible. This will reduce the number of applications and will help expedite the approval process.

Applications should be submitted to slcr@health.mo.gov. Questions regarding the application process may be sent to this address as well.

Once an application is approved, SLCR will contact each applicant to explain the payment process, which will be similar to that of the CMP application/payment process for technology.

COVID-19 In-Person Visitation Application Template – 20200918
COVID-19 In-Person Visitation Application FAQ final – 20200918

PPE Available for Licensed Long-Term Care Facilities

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The Department of Health and Senior Services has gowns, alcohol prep pads, surgical masks, and shoe covers that can be ordered by long term care facilities in bulk. Please follow the survey monkey link (https://www.surveymonkey.com/r/KPY7ZWW) to place your order. If you are part of a larger corporation, your management company may want to submit an order for your organization.

Questions can be sent to Marcia.Davis@health.mo.gov.

Please note: If you have an active outbreak and submitted an order last week- do not submit another order this week. Thank you.

N95 Info

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Fit Under Fire: Situational Strategies to Achieve the Best Respirator Fit During Crisis

To aid healthcare facilities experiencing shortages of N95 respirators due to high demand across the nation, CDC developed the Strategies for Optimizing the Supply of N95 Respirators in Healthcare Settings which provides options on how to optimize supplies of disposable N95 filtering facepiece respirators (commonly called “N95 respirators”) in healthcare settings when there is limited supply. Proper fit of N95s is critical to your infection control/respiratory protection program.

For more information, please visit https://blogs.cdc.gov/niosh-science-blog/2020/03/16/n95-preparedness/.

Coding GG0130 Self-Care and GG0170 Mobility items on an OBRA MDS assessment not combined with a Medicare MDS Assessment

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This document was created to assist NHs in Missouri with coding GG0130 and GG170 items on OBRA MDS assessments not combined with a Medicare assessment. All of the guidance contained in this document comes from the Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User’s Manual Version 1.17.1.

Residents’ Rights to Vote – 2020 Elections

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Even though the COVID-19 pandemic has brought on many limitations and restrictions for nursing home residents, they still retain their right to vote. Below are some informational materials for residents and facilities to help achieve this during the 2020 elections.

  • Residents’ Right to VOTE – explains that residents still have the right to vote during the pandemic and what the facilities can/cannot do to assist with the voting process. The Ombudsman Program encourages facilities to hang this up so that residents can easily read it.
  • Voting – What Residents Need to Know – explains qualifications and eligibility to vote, voting options, how to register, how to locate a free notary for those who choose the mail-in option etc. Again, the Ombudsman Program encourages facilities to hang this up so that residents can easily read it.
  • Tip Sheet for Facilities – information for facilities only that simply explains best practices and ways they can help residents to vote.

Community Testing Opportunities

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The next round of community testing events will take place in the following counties. Additional events are expected to be scheduled throughout the coming weeks. Missourians can register now for these events at health.mo.gov/communitytest and also continue to check back for future opportunities to be tested at an event nearby.

 

County

Location

City

Dates

Times

St. Charles

The Family Arena

St. Charles

September 17-19

Sept. 17  7AM – 5PM

 

Sept. 18  10AM – 7PM

 

Sept. 19  7AM – 5PM

Madison

Cherokee Pass

Fredericktown

September 18

7AM – 12PM

Perry

Perryville City Park

Perryville

September 19

7AM – 3PM

St. Francois

Farmington Firehouse

Farmington

September 21

7AM – 3PM

Jefferson

Faith Community Church

House Springs

September 22-23

Sept. 22  10AM – 7PM

 

Sept. 23  7AM – 5PM

Vernon

Centennial Hall Building Vernon County Fairgrounds

Nevada

September 23

7AM – 3PM

Bates

Butler Aquatics Center Parking Lot

Butler

September 24

7AM – 12PM

Cape Girardeau

Arena Park

Cape Girardeau

September 25

7AM – 5PM

Clinton

Cameron High School

Cameron

September 26

7AM – 3PM

Register for testing at:
www.health.mo.gov/communitytest
or call (877) 435-8411