Category: Long Term Care Blog

Life Safety Code Reminder

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Life Safety Code Reminder: The 2012 NFPA annual door inspections need to be completed by July 5, 2017

 

NFPA 80, 2010 edition:

 

3.3.95 Qualified Person. A person who, by possession of a recognized degree, certificate, professional standing, or skill, and who, by knowledge, training, and experience, has demonstrated the ability to deal with the subject matter, the work, or the project.

 

5.2.3.1 Functional testing of fire door and window assemblies shall be performed by individuals with knowledge and understanding of the operating components of the type of door being subject to testing.

 

5.2.3.2 Before testing, a visual inspection shall be performed to identify any damaged or missing parts that can create a hazard during testing or affect operation or resetting.

 

5.2.4 Swinging Doors with Builders Hardware or Fire Door Hardware.

5.2.4.1 Fire door assemblies shall be visually inspected from both sides to assess the overall condition of door assembly.

5.2.4.2 As a minimum, the following items shall be verified:

(1) No open holes or breaks exist in surfaces of either the door or frame.

(2) Glazing, vision light frames, and glazing beads are intact and securely fastened in place, if so equipped.

(3) The door, frame, hinges, hardware, and noncombustible threshold are secured, aligned, and in working order with no visible signs of damage.

(4) No parts are missing or broken.

(5) Door clearances do not exceed clearances listed in 4.8.4 and 6.3.1.7.

(6) The self-closing device is operational; that is, the active door completely closes when operated from the full open position.

(7) If a coordinator is installed, the inactive leaf closes before the active leaf.

(8) Latching hardware operates and secures the door when it is in the closed position.

(9) Auxiliary hardware items that interfere or prohibit operation are not installed on the door or frame.

(10) No field modifications to the door assembly have been performed that void the label.

(11) Gasketing and edge seals, where required, are inspected to verify their presence and integrity.

VOYCE Changing Landscape of the Long Term Care Conference

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VOYCE Changing Landscape of the Long Term Care Conference

June 8-9, 2017: 2017 Changing the Landscape of Long Term Care Conference
Location:  Renaissance St. Louis Airport Hotel on June 8 and Friendship Village Sunset Hills on June 9

Hear national and local experts discuss dynamic strategies, innovative tools and available long-term care options. The format has been set with two educational tracks throughout the conference on June 8; one for professionals working in long-term care and one for the general public who are looking for answers to the complexity of long-term care. June 9 consists of an all-day Post-Conference Intensive on “Doing Better Together: A Nursing Home Leader’s Guide to High Performance.” This event sold out this year!  See the registration packet for the full description of the topics and the national and local expert speakers.

 

Throughout the day there are multiple opportunities to interact with exhibitors who showcase long-term care services across Greater St. Louis. In addition to hearing thought-provoking speakers, facility administrators and social workers 13.75 CEUs over the two days! Registration for all includes breakfast and lunch.

 

Register online to join over 400 expected attendees

Sign Up as a Sponsor to reach the long-term care community including families needing your services

 

Please see the VOYCE event page for more information.

HealthCare-Associated Infections Summer Workshops

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HealthCare-Associated Infections Summer Workshops

June 6-7, 2017:  Central District HAI, Primaris, Columbia
June 20-21, 2017:  Southeastern District HAI, Saint Francis Medical Center, Cape Girardeau
June 27-28, 2017:  Eastern District HAI, Forest Park Drury Inn, St. Louis
July 20-21, 2017:  Northwestern District HAI, St. Joseph Medical Center, Kansas City
July 25-26, 20107:  Southwestern District HAI, Cox North Hospital, Springfield

 

Healthcare-Associated Infections (HAIs) cut across all care settings – acute, ambulatory and long-term. All settings are currently (or soon will be) required to have an infection control and prevention program including an antimicrobial stewardship plan. These workshops will provide the latest evidence regarding the prevention of HAIs across settings with a strong focus on incorporating this evidence in clinical practice. Regulatory considerations and specific strategies to bridge the gap in coordinating care when patients transition from one setting to another will be included.

 

Please see more information including the brochure and registration on the MU Sinclair School of Nursing’s page.

TMF QIN Spotlight On…

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Reducing Inappropriate Use of Antipsychotic Medications – Alternatives

There are multiple ideas and suggestions for reducing antipsychotic medication use through alternative strategies. It is suggested that use of alternatives be carefully monitored with frequent reassessment. Click on the following links to learn more.

 

Checklist: Activities that may help improve nighttime sleep for residents with dementia (PDF)

Antipsychotic Alternatives (PDF)

Non-Pharmacological Approaches to Address Behaviors

Pioneer Network Hot Topics Webinar Series

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Pioneer Network Hot Topics Webinar Series

June 15, 2017: The Care Plan Meeting in a Resident-Directed World(Part II)
July 20, 2017: Before and After the Care Plan Meeting
August 17, 2017: A Process for Care Planning for Resident Choice

Beginning in May, join us for the At the Table Webinar series where expert guides will explore with you Person-Centered Care Planning. Over the course of this four webinar series, you will gain an understanding of the new CMS conditions of participation, define processes and best practices, explore options for making the most of the meeting, and learn how to bring the care plan to life and balance risk for residents and your community. You can purchase the webinars individually for $59, or contact Pioneer Network Director of Education, Joan Devine to purchase the 4 Webinar Bundle at a discounted rate of $200.

2017 Pioneer Network Annual Conference

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2017 Pioneer Network Annual Conference

July 30-August 2, 2017:  Person-Directed Care is Happening – Be a Part of It: Be the Future!
Location:  Rosemont, IL

Pioneer Network hosts an annual conference to showcase innovative thought and best practices in the long-term care culture change movement – as well as providing an opportunity for people interested in many aspects of culture change to network and inspire each other. Past conferences have been attended by more than a thousand people from across the United States and other nations who care deeply about changing the culture of aging. As always, we strive to make this event meaningful for people who are just starting on the culture change journey to build a sense of home and community for our Elders -as well as those who have been actively engaged in this mission for some time. Register Today

The State RAI Coordinator is coming to a QIPMO MDS Support Group Meeting Near You!

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The State RAI Coordinator is coming to a QIPMO MDS Support Group Meeting Near You!

Stacey Bryan, the State RAI Coordinator will be presenting at Support Group Meetings across the state to discuss MDS Coding, new MDS items to be implemented 10/1/17, Phase 1 (implemented 11/28/16) and Phase 2 (to be implemented on 10/28/17) regulation updates/changes and much more. You don’t have to be an MDS Coordinator to attend, other staff that may find the information helpful include Social Services staff, ADONS, DONS and the Administrator. Don’t be blind-sided by the recent and upcoming changes, be in the know now! Visit the Nursing Home Help website at http://www.nursinghomehelp.org/supgr.html to see the specific location of where Stacey Bryan will be at the following meetings:

  • June 7th, 2017 from 1:00 P.M. to 3:00 P.M. in Willow Springs
  • June 8th 2017 from 11:00 A.M. to 12:30 PM. in Poplar Bluff
  • June 9th, 2017 from 9:30 A.M. to 11:30 AM. in Cape Girardeau
  • June 14th, 2017 from 1:00 P.M. to 3:00 PM. in Jefferson City
  • June 16th, 2017 from 9:00 A.M. to 11:00 A.M. in Kansas City
  • June 22nd, 2017 from 9:00 A.M. to 11:00 A.M. in St. Peters
  • June 23rd, 2017 from 9:00 A.M. to 11:00 A.M. in St. Louis
  • July 11th, 2017 from 9:00 A.M. to 11:00 A.M. in St. Joseph
  • July 17th, 2017 from 9:00 A.M. to 11:00 A.M. in Ozark
  • August 15th, 2017 from 9:00 A.M. to 11:00 A.M. in Springfield

Have you been to a QIPMO MDS Support Group Meeting lately???  You don’t have to be an MDS Coordinator to attend

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Have you been to a QIPMO MDS Support Group Meeting lately???  You don’t have to be an MDS Coordinator to attend

Often, the topics discussed are beneficial not only for MDS Coordinators but also for floor nurses, Social Services staff, DONs, ADONS and Administrators.  You can find a schedule of meetings and topics by going to the Nursing Home Help website found at http://www.nursinghomehelp.org/supgr.html.  Some past topics have included Quality Measures, QRP requirements, Phase 1 and 2 Regulation Implementation, discussions with the State RAI Coordinator and State Surveyors, PPS Scheduling, CAA documentation, Care Plans, MDS Review for Social Workers, Wounds, Section GG Coding, Behavior Documentation and ICD-10 Coding.  You are welcome to attend any meeting anywhere in the state, no RSVP needed.

QIES Security Notice: Disabling and Deleting Accounts (posted 05/16/2017)

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QIES Security Notice: Disabling and Deleting Accounts (posted 05/16/2017)

To better secure our applications, QIES security will require each user to successfully login every 60 days, effective June 26, 2017. If this does not occur, the account will be disabled and can only be re-enabled by contacting the QTSO Help Desk at (800)339-9313.

Accounts that have no activity for more than 365 days will be deleted. Once your account is deleted, you will not be able to use or re-enable the account. If your account is deleted, you will need to request access through CMS as you did originally; you will be assigned a new User ID and password when the access is granted.

 

If you have any questions concerning this information, please contact the QTSO Help Desk at help@qtso.com or (800) 339-9313.

 

New SNF QRP Report Category and SNF Review and Correct Report

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New SNF QRP Report Category and SNF Review and Correct Report

Effective June 1, 2017, a new report category called the SNF (Skilled Nursing Facility) Quality Reporting Program is available in the CASPER Reporting application. This report category contains the new SNF Review and Correct report.

 

The SNF Quality Reporting Program report category and SNF Review and Correct Report are available to all certified nursing-home and swing bed-based SNFs, corporate and third-party users responsible for submitting MDS 3.0 data for SNF providers, state users; QIO users, CMS Central Office and Regional Office users.

 

Data Calculation and Display

The SNF Review and Correct report displays facility-level results for the assessment-based quality measures listed below. MDS 3.0 data are used to calculate the quality measures.

  • Percent of Residents or Patients with Pressure Ulcers That Are New or Worsened (Short Stay) (NQF #0678).
  • Application of Percent of Residents Experiencing One or More Falls with Major Injury (Long Stay) (NQF #0674).
  • Application of Percent of Long-Term Care Hospital (LTCH) Patients with an Admission and Discharge Functional Assessment and a Care Plan that Addresses Function (NQF #2631).

 

If you have any questions concerning this information, please contact the QTSO Help Desk at help@qtso.com or 1 (888) 477-7876.

Delayed-Egress Locking Systems

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Delayed-Egress Locking Systems

National Fire Protection Association (NFPA) 101 2012 Delayed-Egress Locking Systems. 7.2.1.6.1.1  shows: Approved listed delayed-egress locking systems shall be permitted to be installed on door assemblies serving low and ordinary hazard contents in buildings protected throughout by an approved, supervised automatic fire detection system in accordance with Section 9.6 or an approved supervised automatic sprinkler system in accordance with Section 9.7 and where permitted in Chapters 11 through 43, provided that all of the following criteria are met:

  1. The door leaves shall unlock in the direction of egress upon actuation of one of the following:
    1. Approved, supervised automatic sprinkler system in accordance with Section 9.7
    2. Not more than one heat detector of an approved, supervised automatic fire detection system in accordance with Section 9.6
    3. Not more than two smoke detectors of an approved, supervised automatic fire detection system in accordance with Section 9.6
  2. The door leaves shall unlock in the direction of egress upon loss of power controlling the lock or locking mechanism.
  3. *An irreversible process shall release the lock in the direction of egress within 15 seconds, or 30 seconds where approved by the authority having jurisdiction, upon application of a force to the release device required in 7.2.1.5.10 under all of the following conditions:
    1. The force shall not be required to exceed 15 lbf (67N).
    2. The force shall not be required to be continuously applied for more than 3 seconds.
    3. The initiation of the release process shall activate an audible signal in the vicinity of the door opening.
    4. Once the lock has been released by the application of force to the releasing device, relocking shall be by manual means only.
  4. *A readily visible, durable sign in letters not less than 1 in. (25 mm) high and not less than 1⁄8 in. (3.2 mm) in stroke width on a contrasting background that reads as follows shall be located on the door leaf adjacent to the release device in the direction of egress: PUSH UNTIL ALARM SOUNDS DOOR CAN BE OPENED IN 15 (or 30) seconds.

 

Facilities may receive approval for 30 second release egress doors from the Authority Having Jurisdiction.  For the facility to receive 30 second release approval, the facility must submit in writing to the Section for Long-Term Regulation (SLCR), a letter detailing the risk(s) to the residents and/or hardship.  It will be the SLCR’s final decision on the approval of the extension and will be reflected in a letter to the facility.  It will be the facility’s responsibility to retain the SLCR approval letter for future reference.

 

Failure to obtain an approval letter from the SLCR will place the facility in noncompliance with Federal participation requirements and in the event of a recertification survey or federal monitoring survey for life safety code, result in a citation.

 

The facility letter detailing the risk(s) to the residents and/or hardship and facility layout indicating affected doors, can be submitted to be Scott.Wiley@health.mo.gov

HealthCare-Associated Infections Summer Workshops

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HealthCare-Associated Infections Summer Workshops

  • June 6-7, 2017:  Central District HAI, Primaris, Columbia
  • June 20-21, 2017:  Southeastern District HAI, Saint Francis Medical Center, Cape Girardeau
  • June 27-28, 2017:  Eastern District HAI, Forest Park Drury Inn, St. Louis
  • July 20-21, 2017:  Northwestern District HAI, St. Joseph Medical Center, Kansas City
  • July 25-26, 20107:  Southwestern District HAI, Cox North Hospital, Springfield

 

Healthcare-Associated Infections (HAIs) cut across all care settings – acute, ambulatory and long-term. All settings are currently (or soon will be) required to have an infection control and prevention program including an antimicrobial stewardship plan. These workshops will provide the latest evidence regarding the prevention of HAIs across settings with a strong focus on incorporating this evidence in clinical practice. Regulatory considerations and specific strategies to bridge the gap in coordinating care when patients transition from one setting to another will be included.

 

Please see more information including the brochure and registration on the MU Sinclair School of Nursing’s page.

VOYCE Conference

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VOYCE Conference

  • June 8-9, 2017: 2017 Changing the Landscape of Long Term Care Conference
  • Location:  Renaissance St. Louis Airport Hotel and Friendship Village Sunset Hills

Hear national and local experts discuss dynamic strategies, innovative tools and available long-term care options.

The format has been set with two educational tracks throughout the day; one for professionals working in long-term care and one for the general public who are looking for answers to the complexity of long-term care.

See the registration packet for the full description of the topics and the national and local expert speakers.

Throughout the day there are multiple opportunities to interact with exhibitors who showcase long-term care services across Greater St. Louis.

In addition to hearing thought-provoking speakers, facility administrators and social workers earn 7.25 CEUs.

Registration for all includes breakfast and lunch.

 

Please see the VOYCE event page for more information.

 

2017 ALF Resident Assessment Trainings

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2017 ALF Resident Assessment Trainings

  • June 26-28, 2017:  Best Western Capital Inn, Jefferson City
  • October 30-31, 2017:  Best Western Capital Inn, Jefferson City

As required by 198.005 RSMo and 19 CSR 30-86.047, residents of Assisted Living Facilities are required to undergo a community based assessment performed by an appropriately trained and qualified individual. This individual must complete a DHSS approved 24-hour training program prior to performing resident assessments. The MALA ALF Resident Assessment Training satisfies this regulatory requirement.

DON/Charge Nurse/CNA Conference – Readiness: Make it Happen!

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DON/Charge Nurse/CNA Conference – Readiness: Make it Happen!

  • September 20-21, 2017:  St. Louis

We are excited to invite Directors of Nursing, Charge Nurses, and Certified Nursing Assistants to attend an educational event catered to YOUR needs! This conference will be energetic and hands-on all while being in a learning environment. You will be given useful information to take back and implement in your home right away to better serve your residents. We will give you the confidence, knowledge, direction, and motivation needed to help you enhance your role of caring for the elderly.

 

Please see the full details including registration on MLN’s conference webpage.

The National Consumer Voice for Quality Long-Term Care – New Briefs Available

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The National Consumer Voice for Quality Long-Term Care – New Briefs Available

  • Three New Briefs Available in Series on Revised Nursing Facility Regulations

Consumer Voice, along with the Center for Medicare Advocacy and Justice in Aging, has released three new briefs in their issue brief series, “A Closer Look at the Revised Nursing Facility Regulations.”

  • Return to Facility After Hospitalization – This brief explains bed hold rights when a resident returns to a facility after a hospitalization. The brief provides information on advance notification of bed hold rights and residents’ rights if they return to a facility after a bed hold period has been exceeded.
  • Grievances and Resident/Family Councils – This brief covers the resident’s right to file grievances and the facility’s requirement to work to resolve those concerns promptly. Each facility must have a grievance policy and provide residents with information on how to file a grievance. Also, residents have a right to form a resident council, and family members and resident representatives have the right to form a family council.  The facility must act upon council concerns and recommendations.
  • Quality of Care – The substantive requirements for quality of care are retained in the revised regulations, and CMS has affirmed the regulations’ goals of supporting person-centered care and enabling each resident to attain his or her highest level of well-being. This brief covers those regulations as well as providing information on how the quality of care provisions have been reorganized in the revised regulations.

 

Read the other issue briefs in the series here.

Crimes Against Persons List

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Crimes Against Persons List

  • Crimes Against Persons List

On January 1, 2017, revisions to the Revised Statutes of Missouri (RSMo) resulted in changes to the list of disqualifying crimes.

 

For example:

Involuntary Manslaughter, prior to January 1, 2017, could have been a Class A or B felony under Chapter 565, making it a disqualifying crime. On January 1, 2017, the classification of Involuntary Manslaughter was changed to a C or E felony, making it no longer disqualifying. Any A or B felony conviction of Involuntary Manslaughter prior to January 1, 2017 remains disqualifying.

 

Criminal Water Contamination was listed as a disqualifying crime in RSMo Chapter 569 prior to January 1, 2017. On January 1, 2017, it was moved to RSMo Chapter 577, making it no longer disqualifying. However, convictions prior to January 1, 2017, remain disqualifying.

 

Because of the potential confusion, SLCR is removing the list of disqualifying crimes from the website. Providers must review the criminal background check to determine if the crime is disqualifying. Disqualifying crimes are any A or B felony violation of Chapter 565, 566 or 569, RSMo, or any violation of subsection 3 of section 198.070, RSMo, or of section 568.020, RSMo.

 

  • Good Cause Waiver

An individual who has been disqualified from employment with any Long Term Care provider type has the right to apply for a Good Cause Waiver (GCW), which, if granted, would not correct or remove the finding, but would remove the hiring restriction and allow the individual to be employed. This includes those individuals who have committed a disqualifying crime and thus have been disqualified from employment in a regulated nursing home. More information about Good Cause Waivers can be found on the DHSS website at:  http://health.mo.gov/safety/goodcausewaiver/.

 

If a provider has a question about a disqualifying crime or Good Cause Waivers, please feel free to contact the Section at 573-522-6228.

IRF, LTCH, SNF QRP: Registration Open for Review and Correct Reports Provider Training – Live Webcast on May 2, 2017

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IRF, LTCH, SNF QRP: Registration Open for Review and Correct Reports Provider Training – Live Webcast on May 2, 2017

CMS is hosting a live webcast for Inpatient Rehabilitation Facilities (IRFs), Long-Term Care Hospitals (LTCHs), and Skilled Nursing Facilities (SNFs) on Tuesday, May 2, 2017, from 2:00 to 3:30  p.m. ET.

 

This training will assist providers in better understanding how Review and Correct Reports fit within the overall Quality Reporting Programs. Additionally, the training will provide information about re-submitting data to correct errors prior to the quarterly submission deadlines to ensure the accuracy of the data which will ultimately be publicly displayed.

Visit the following webpages for more information and to register:

 

IRF Quality Reporting Training:  https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/IRF-Quality-Reporting/IRF-Quality-Reporting-Training.html

 

LTCH Quality Reporting Training webpage

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/LTCH-Quality-Reporting/LTCH-Quality-Reporting-Training.html

 

SNF Quality Reporting Training webpage

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-Training.html

Beneficiary Notices

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Beneficiary Notices

Effective April 13, 2017, questions regarding any of the Fee For Service Beneficiary Notice Initiative (BNI) notices may be sent to our new mailbox:  BNImailbox@cms.hhs.gov.

The BNI notices are:

  • FFS Advance Beneficiary Notice of Noncoverage (FFS ABN)
  • FFS Home Health Change of Care Notice (FFS HHCCN)
  • FFS Skilled Nursing Facility Advance Beneficiary Notice (FFS SNFABN) and SNF Denial Letters
  • FFS Hospital-Issued Notices of Noncoverage (FFS HINNs)
  • FFS Expedited Determination Notices for Home Health Agencies, Skilled Nursing Facility, Hospice and Comprehensive Outpatient Rehabilitation Facility  (FFS Expedited Determination Notices)
  • Important Message from Medicare (IM) and Detailed Notice of Discharge (DND) (Hospital Discharge Appeal Notices)
  • FFS Notice of Exclusion from Medicare Benefits – Skilled Nursing Facility (FFS NEMB SNF)

 

There is an exception for the Medicare Outpatient Observation Notice (MOON). Continue to send questions regarding the MOON to MOONMailbox@cms.hhs.gov.