Category: Long Term Care Blog

Pioneer Network’s Hot Topics: Culture Change in Action Webinar

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Pioneer Network’s Hot Topics: Culture Change in Action Webinar

December 13, 2018: The Process Behind the Passion: How Your Care Community Can Support Person-Directed Care
Guides: Lisa Rill, PhD, Claude Pepper Center at Florida State University and Lori Gonzalez, PhD, Claude Pepper Center at Florida State University

Person-directed care is an essential goal for long-term care change agents. Decades of reform have led to some changes. However, there is still work to be done. This session presents the findings of a comparison of environment and practices between a traditional nursing home to a Green House home. The findings elucidate the importance of creating environments, practices and policies, and staffing that are intentionally designed for elders and their care partners. We will conclude by offering best practices that can be applied to any care setting and assist with starting a plan for change with the participants of the session.

October RAI Manual Updates Webinars

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October RAI Manual Updates Webinars

September 7, 2018: 9am – 11am and 1pm – 3pm
September 11, 2018: 10am – 12noon and 2pm – 4pm
September 12, 2018: 10am – 12noon and 2pm – 4pm
September 14, 2018: 9am – 11am
September 19, 2018: 9am – 1pm and 1pm – 3pm

QIPMO will be hosting webinars to go over the changes that CMS has made to the RAI Manual that will become effective on October 1, 2018. Listen in as we look at the changes and discuss the proper coding and the impact of the new items that have been added or changed.

Objectives

  1. Review the coding additions in section GG.
  2. Discuss the changed in Section I in regards to additional diagnosis.
  3. Review Section M clarifications and additional information regarding pressure ulcers.

Sign up at attendee.gotowebinar.com/RT/6655594964548465155.

MDS Section K Updates for 10-1-18

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MDS Section K Updates for 10-1-18

The RAI Manual v.1.16, dated 10-1-18, in Chapter 3 in Section K states CMS does not require completion of Column 1 (While Not a Resident) for items K0510C (Mechanically altered diet), or K0510D (Therapeutic diet), K0710A (Proportion of total calories the resident received through parenteral or tube feeding) or K0710B (Average fluid intake per day by IV or tube feeding). Some states continue to require completion of these items. It is important to know your State’s requirements for completing these items. If the State does not require the completion of these items, use the standard “no information” code (a dash, “-”).

There are no Missouri State Regulation requirements for the MDS. Any MDS records for residents in Missouri SNFs and NFs with an ARD of 10-1-18 or later will no longer be required to answer Column 1 (While Not a Resident) for items K0510C, K0510D, K0710A or K0710B; dashing will be allowed for these items. Please note- Column 2 (While a Resident) will still be required to be completed for these items.

2018 RAI User’s Manual and Item Sets Posted

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2018 RAI User’s Manual and Item Sets Posted

The MDS 3.0 RAI Manual v1.16, effective 10-1-18, has been posted to the CMS MDS 3.0 RAI Manual webpage at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursinghomeQualityInits/MDS30RAIManual.html. The RAI Manual can be found in the Related Links Section at the bottom of the webpage.

Also, the final versions of the 2018 MDS item sets (v1.16.1) were posted to the CMS MDS 3.0 Technical Information webpage at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIMDS30TechnicalInformation.html.

August Caregiver of the Month – Anita Cline

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August Caregiver of the Month – Anita Cline

Anita Cline has been chosen as Missouri’s Caregiver of the Month for August! Anita became the caretaker of her mother in law after her husband passed away. To read Anita’s story, go to health.mo.gov/seniors/caregiver.php. Here you will also find the nomination form and resources for caregivers.

If you know someone who puts his/her life on hold to care for a family member or friend, DHSS invites you to nominate them today for the Caregiver of the Month. In December, an overall Caregiver of the Year will be selected.

CMS Memo: QSO-18-24-ESRD: Survey Process for Reviewing Home Dialysis Services in a Long Term Care (LTC) Facility

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CMS Memo: QSO-18-24-ESRD: Survey Process for Reviewing Home Dialysis Services in a Long Term Care (LTC) Facility

  • Dialysis Services in a LTC Facility: Medicare participating End Stage Renal Disease(ESRD) facilities must comply with the Conditions for Coverage at 42 CFR Part 494.Under this provision, Medicare-approved ESRD facilities may provide dialysis services to LTC residents in a LTC facility with an approved Home Training and Support modality. ESRD facilities that provide home hemodialysis or peritoneal dialysis services to LTC residents must maintain compliance with these requirements, including the requirements set forth at §494.100: Care at home.
  • Survey Process for Evaluation of Home Dialysis in a LTC Facility: The ESRD Core Survey Process has been updated to include additional survey activities which address dialysis services provided by an ESRD facility to residents in a LTC facility.
  • Attachments: Included as an attachment to this memorandum is Exhibit IV: Survey Process for ESRD Surveyors Reviewing Dialysis in Nursing Homes for evaluation of home dialysis services provided in a LTC facility.

For more information, please see the full memo at www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/QSO18-24-ESRD.html.

Pioneer Network’s Hot Topics: Culture Change in Action Webinar

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Pioneer Network’s Hot Topics: Culture Change in Action Webinar

October 18, 2018: Dining Practices: Balancing Food Choice and Food Safety
Guide: Diane Hall, RD, President & CEO, Balanced Senior Nutrition

Learn how to integrate the new food safety requirements with person-centered dining. As we provide more variety of foods and more choices of when and where food is served, challenges for proper food handling and sanitation seem to begin to multiply. Balancing resident’s rights, infection control and food safety requirements can be tricky business.

Pioneer Network’s Hot Topics: Culture Change in Action Webinar

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Pioneer Network’s Hot Topics: Culture Change in Action Webinar

November 15, 2018: Building on the Successes of Phase 2 and Your Facility Assessment
Guides: Vickie Burlew, Health Care Consultant and Educator, Linchpin Quality Solutions, LLC and Joan Devine, Director of Education, Pioneer Network

As we approach the one-year mark of the implementation of phase 2 of the CMS Revised Rules of Participation, the principles of QAPI would tell us that is time step back and evaluate where we are. Are communities successfully implementing the new requirements? Has the Facility Assessment been completed and has it been used to support daily operations and successful survey outcomes? Are you prepared to meet the new Infection Prevention standards? What has been the impact of the new requirements related to Person-Centered Care and Quality of Life?

Nursing Facility Level of Care Stakeholder Meetings – Postponed

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Nursing Facility Level of Care Stakeholder Meetings – Postponed

In an effort to properly address the feedback received in previous stakeholder meetings, the August 21, 2018 Nursing Facility Level of Care (LOC) Stakeholder Meeting has been postponed until further notice.

The Department received over 500 comments concerning the proposed Nursing Facility LOC system. The Department wants to ensure all feedback is properly analyzed.

Further information regarding future meetings will be announced.

MC5 Fall Roadshows

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MC5 Fall Roadshows: Living On Purpose!

October 9, 2018: Living On Purpose: Building Community through Meaningful Engagement
Location: Integrity Home Care, Springfield

October 10, 2018: Living On Purpose: Building Community through Meaningful Engagement
Location: St. Joseph Medical Center, Kansas City

October 11, 2018: Living On Purpose: Building Community through Meaningful Engagement
Location: St. Charles Community College, Cottleville

Tired of calling Bingo? Are you hitting copy and paste on your programs month after month? Think there must be more out there? Join us as we discuss innovative concepts that will transform your community into a vibrant place for people to live and work. Through intentional programming methods, you can build a culture that promotes life and facilitates purpose daily.

Social Service Update: Regulatory Requirements of Mega Rule

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Social Service Update on Regulatory Requirements of the Mega Rule

September 18, 2018: Social Service Update on Regulatory Requirements of the Mega Rule
Location: Drury Plaza Hotel & Conference Center, Cape Girardeau

September 20, 2018: Social Service Update on Regulatory Requirements of the Mega Rule
Location: Holiday Inn St. Louis SW – Route 66, St. Louis

September 25, 2018: Social Service Update on Regulatory Requirements of the Mega Rule
Location: Oasis Hotel & Conference Center, Springfield

September 26, 2018: Social Service Update on Regulatory Requirements of the Mega Rule
Location: Stoney Creek Hotel & Conference Center, Independence

September 27, 2018: Social Service Update on Regulatory Requirements of the Mega Rule
Location: Courtyard by Marriott, Columbia

The Mega Rule Hit Social Services full force. Social Services will experience much focus during upcoming surveys. Administrators, social service, and nursing personnel will not want to miss this one, where discussion will include new requirements for the admission/discharge process, grievance procedures, abuse and neglect reporting, social services role in the management of psychotic agents, and the coming addition of Trauma Informed Care in Phase III.

New QIPMO Newsletter – August 2018

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New QIPMO Newsletter – August 2018

The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls – Volume 5, Issue 4.

In this issue:

  • Wanted: RN Coverage
  • The Revolving Door of MO Nursing Home Administrators
  • CPR – Let’s Do It or NOT
  • Alzheimer’s and Dementia
  • Resources for Infection Control
  • Caring for a Resident with a Pacemaker
  • Committees? Tasks?

Please visit QIPMO’s website here for this and other previous newsletters.

SNF Quality Reporting Program: Non-Compliance Letters

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SNF Quality Reporting Program: Non-Compliance Letters

CMS is providing notifications to facilities that were determined to be out of compliance with SNF QRP requirements for CY 2017, which will affect their FY 2019 Annual Payment Update (APU). Non-compliance notifications were mailed by the Medicare Administrative Contractors (MACs) and have been placed into facilities’ CASPER folders in QIES on July 9, 2018. Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59pm PST, August 7, 2018. If you receive a notice of non-compliance and would like to request a reconsideration, see the instructions in your notification letter and on the SNF Quality Reporting Reconsideration and Exception & Extension webpage.

Payroll-Based Journal (PBJ) Deadline

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Payroll-Based Journal (PBJ) Deadline

The submission deadline for PBJ is approaching. PBJ data for 4/1/18 through 6/30/18 is due on 8-14-18. CMS uses PBJ data to determine each facility’s staffing measure on the Nursing Home Compare tool on Medicare.gov website, and calculate the staffing rating used in the Nursing Home Five Star Quality Rating System.

CMS encourages facilities to check provider preview reports in the CASPER system for information regarding submitted PBJ data and to run CASPER reports (1700D Employee Report, 1702D Individual Daily Staffing Report, and/or 1702S Staffing Summary Report) to ensure their PBJ data was submitted accurately.

More information about PBJ can be found on the CMS webpage www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html.

Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Deadline

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Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Deadline

The submission deadline for the SNF QRP is approaching. MDS data for 1/1/18 through 3/31/18 is due on 8-15-18. Providers must submit all data necessary to calculate SNF QRP measures on at least 80% of the MDS assessments submitted to be in compliance with SNF QRP requirements.

As a reminder, it is recommended that providers run applicable validation/analysis reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.

The list of measures required for this deadline can be found on the CMS QRP SNF Quality Reporting Program Data Submission Deadlines webpage.

Conversations with Carmen

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Conversations with Carmen

August 10, 2018: Know Better, Do Better, Part 1
Guest: Sarah Brown, Executive Director, Empira

Empira is a consortium of Aging Service providers who are committed to improving the aging experience by knowing and doing better. Collectively, the organizations that make up Empira challenge the status quo by understanding the root cause of problems and outcomes. By understanding the root cause, they are able to create meaningful and sustainable culture change. They have created a signature series on

  1. Falls
  2. Restorative sleep
  3. Behavioral expression and
  4. Work of aging

Hear about their approach to quality improvement that focuses on human needs and behavior during this webinar.

Senior Day at the MO State Fair

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Senior Day at the Missouri State Fair

August 15, 2018: Senior Day at the MO State Fair
Location: Mathewson Building, Sedalia

Every August the MO Department of Health and Senior Services (DHSS) looks forward to partnering with the Missouri Association for the Area Agencies on Aging (ma4) for Senior Day at the Missouri State Fair. This year’s event is going to be held on Wednesday, August 15th at the Mathewson Building on the state fairgrounds in Sedalia. Senior Day is a fun event that includes live entertainment, free Bingo with prizes, line dance lessons, dance contest with prizes, and more! There will also be a special appearance from Ms. Missouri Senior. Please see the Senior Day flyer attached or visit the website above for more details.

Medicare Learning Network National Provider Call

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Medicare Learning Network National Provider Call

September 18, 2018: Dementia Care: Opioid Use & Impact for Persons Living with Dementia Call
Speakers: Dr. Karl Steinberg, Mariner Health Care; Dr. Abraham Brody, Hartford Institute for Geriatric Nursing; and Michele Laughman, CMS

National Partnership to Improve Dementia Care and Quality Assurance Performance Improvement (QAPI)

During this call, gain insight on opioid use in the post-acute and long-term care setting. Also, learn about the impact of opioid use on persons living with dementia. Additionally, CMS shares updates on the progress of the National Partnership to Improve Dementia Care in Nursing Homes. A question and answer session follows the presentations.

Nursing Facility Level of Care Stakeholder Meetings

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Nursing Facility Level of Care Stakeholder Meetings

For those of you unable to attend, we encourage you to review the presentations below.

NFLOC Stakeholder PPT (June 25, 2018)
NFLOC Stakeholder PPT (July 13, 2018)

**Also, the August 2nd meeting has been rescheduled for August 21 at the Governor’s Office Building in Jefferson City. Please see the updated flyer here.

CMS Memo: QSO-17-30- Hospitals/CAHs/NHs

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QSO-17-30- Hospitals/CAHs/NHs: Requirement to Reduce Legionella Risk in Healthcare Facility Water Systems to Prevent Cases and Outbreaks of Legionnaires’ Disease (LD)

  • Legionella Infections: The bacterium Legionella can cause a serious type of pneumonia called LD in persons at risk. Those at risk include persons who are at least 50 years old, smokers, or those with underlying medical conditions such as chronic lung disease or immunosuppression. Outbreaks have been linked to poorly maintained water systems in buildings with large or complex water systems including hospitals and long-term care facilities. Transmission can occur via aerosols from devices such as showerheads, cooling towers, hot tubs, and decorative fountains.
  • Facility Requirements to Prevent Legionella Infections: Facilities must develop and adhere to policies and procedures that inhibit microbial growth in building water systems that reduce the risk of growth and spread of Legionella and other opportunistic pathogens in water.
  • This policy memorandum applies to Hospitals, Critical Access Hospitals (CAHs) and Long-Term Care (LTC).  However, this policy memorandum is also intended to provide general awareness for all healthcare organizations.
  • This policy memorandum clarifies expectations for providers, accrediting organizations, and surveyors and does not impose any new expectations nor requirements for hospitals, CAHs and surveyors of hospitals and CAHs. For these provider types, the memorandum is merely clarifying already existent expectations.
  • This policy memorandum supersedes the previous Survey & Certification (S&C) 17-30 released on June 02, 2017 and the subsequent revisions issued on June 9, 2017.

Please see the memo for more details.

TMF Nursing Home Quality Improvement

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Spotlight on…

Quality measure review and proper documentation for loss of bowel and bladder control assists in improving the quality of care for your residents. Click on the following links to learn more about this quality measure and coding.

Quality Measure Specifications for MDS 3.0 Measure: Percent of Low Risk Residents Who Lose Control of Their Bowel or Bladder (Long Stay) (PDF, page D.14)
Quality Measure: Percent of Low-Risk Residents Who Lose Control of Bowel or Bladder (Long Stay) (Video)

2018 Frail Elderly Conference

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2018 Frail Elderly Conference

August 17-18, 2018: 28th Annual Conference Caring for the Frail Elderly
Location: Holliday Inn Executive Center, Columbia

The Caring for the Frail Elderly Conference is the premiere Midwest conference dedicated to improving care for the frail elderly. This inter-professional meeting advances care for older patients in clinical, hospital, nursing home, and end-of-life settings. Since 1991, this annual event has provided state-of-the-art information on medical management, interdisciplinary care, and system change for physicians, nurses, social workers, state surveyors, nursing home administrators, attorneys, pharmacists, and other professionals.

Pioneer Network’s Hot Topics: Culture Change in Action Webinar

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Pioneer Network’s Hot Topics: Culture Change in Action Webinar

September 20, 2018: Change: Managing It to Drive Success
Guides: Margie McLaughlin, MA and David Farrell, Vice-President of Sub-Acute Operations, Telecare

“Change will not come if we wait for some other person, or if we wait for some other time. We are the ones we’ve been waiting for. We are the change that we seek.” This statement delivered by President Obama describes perfectly the work of the Pioneer Network. For the past twenty years, WE are the ones creating the change we seek. In settings all across the country, committed staff have discovered ways to move from institutional care to individualized care. WE have reinvented systems to support the independent lifestyles and choices of residents. In the midst of it all WE have recognized the fine balance involved in leading and managing change- sometimes pulling in the reigns while other times letting out the clutch! During this session, you will discover foundational building blocks that support successful change and an array of examples and ideas describing ways that leaders have encouraged, managed and driven change to provide better lives for residents and staff alike.