The middle of Flu season is a perfect time to think about the benefits of handwashing and recognizing signs and symptoms. Staying informed about reported cases in Missouri and which areas have the highest confirmed cases, is just a click away! 2017 Influenza Reports
Consumer Voice, along with Justice in Aging and Center for Medicare Advocacy, have released new issue briefs in our series on the revised federal nursing facility regulations. The fact sheets can help residents, family members and advocates better understand the regulations. New fact sheets cover:
Understanding dementia residents who are unable to communicate on the same level as others can aid in the reduction of inappropriate antipsychotic use. However, meeting their needs can become challenging if their behaviors are not understood. Click on the following links to learn more.
Why Worry About Words? By Joan Devine
Action Pact Workshop
This interactive, experiential learning session will set you on the path to cooking up self-led teams in your environment. We all talk team and face the challenges of creating, maintaining and supporting teams. Team experience, shared leadership tools, and take away resources will flavor your own successful recipes for self-led teams. Don’t expect to sit still!
Please see the Action Pact event page for more information and registration.
The purpose of the Advanced Practice Assessment and Skills Workshop (regular conference) is to enhance the knowledge and skills of advanced practice registered nurses (APRNs) in all settings regarding how to assess, manage and treat commonly occurring health disorders across the lifespan. Hands-on workshops will be offered for advanced chest, abdominal and skeletal X-ray interpretation as well as basic and advance suturing. Topics will focus on the entire lifespan, including opioid addiction, chronic pain, ADHD, autism, geriatric mental health issues, common cardiac conditions, infectious diseases, antibiotic stewardship, skin assessment, and wound care techniques.
Please see the full description on the event page for more details.
Montessori for Aging and Dementia is an innovative approach to dementia care that can be adopted for individuals or groups as a philosophy of care. The goal of the Montessori program is to support people living with dementia by creating a prepared environment, filled with cues and memory supports, that enables individuals to care for themselves, others, their community, and their choices so that they may live as independently as possible. This two-day program focuses on the Montessori for Aging and Dementia program criteria as established by the AMI. Participants will receive handouts, a copy of the book I Care: A Handbook for Care Partners of People with Dementia and a certificate of completion from AMI.
Please see the brochure and registraion for more information.
Please view the quarterly report from the Section for Long-Term Care Regulation attached.
Engaging residents in their care and providing treatment alternatives assists in reducing the unnecessary use of antipsychotics. Click on the following links to learn more about reducing the use of antipsychotic medications.
ROP Phase 2: Getting Done By November
Please see the attached Life Safety Code Updates and Reminders for the latest information.
Creating a quality-driven environment within a nursing home requires staff stability. Establishing processes, setting expectations and supporting staff are important aspects of this concept. Click on the following links to learn more about enhancing staff stability.
Save the Date for the upcoming MC5 conference. Learn how to implement person-centered care while following the new regulations with Carmen Bowman, assess your risks and learn management strategies from Ray Miller, and understand the personal part of person-centered care with Karen Stobbe…along with a variety of other intensive speakers from around the adult-care continuum. This is one conference you don’t want to miss!! We will send out more information as it becomes available.
Please join this webinar to learn strategies, including documentation and communication, for a team-based approach toward reducing antipsychotic medications.
Please see the event page here for registration.
The Centers for Medicare & Medicaid Services (CMS) released its revised nursing home regulations. In this webinar, we will take a closer look at the following sections of the revised regulations:
Join this webinar to hear Justice in Aging, Center for Medicare Advocacy and Consumer Voice discuss changes in the regulations and their impact on the care delivered to consumers.
Space is limited. Register now.
The Section for Long Term Care had a conversation with CMS in 2016 regarding the IDR/IIDR Review Release Process. CMS Regions V and VII recently provided guidance on this topic. The Missouri IDR process for certified homes has been to send the Primaris decision letter along with our own letter upon review and completion of the IDR process. We have been instructed by CMS that the third party (Primaris) decision and rationale can no longer be shared with the providers. Following is an excerpt of this guidance. The S&C referenced below is attached for your review.
S&C Memo 12-08-NH provided Interim Advance Guidance for IIDRs and provided some information that is one of the bases for our decision to take this approach: “[T]he documents and written report created by the Independent IDR entity, the State and CMS, other than the final decision of the Independent IDR process, are pre-decisional and deliberative, and therefore are protected from disclosure under the deliberative process privilege. See EPA v. Mink, 410 U.S. 73, 88 (1973); see also 5 U.S.C. § 522(b)(5) (inter-agency and intra-agency memoranda and letters generated before adoption of final agency policy or decision are protected from disclosure under Exemption 5 of the Freedom of Information Act).” (Please note the correct U.S. Code citation is actually 5 U.S.C § 552(b)(5).) Therefore, CMS asserts this privilege to not disclose documents used in our deliberative processes. Although the quoted language from the S&C Memo is not in SOM Chapter 7, the rationale remains sound.
We have communicated with the IDR Contractor about this change. Primaris will no longer prepare a letter to the provider and will simply provide their decision and rationale through memo format. Our office will continue to review the Primaris information and prepare a letter to the providers with the final decision. The Section will then forward the SLCR Decision letter to the provider. At no time can we disclose the Primaris decision and rationale. This change applies only to certified facilities. The process will not change for those facilities that are state-licensed only.
Recommendations for Providers and Suppliers for Cyber Security: The Centers for Medicare & Medicaid Services (CMS) is reminding providers and suppliers to keep current with best practices regarding mitigation of cyber security attacks. We have outlined resources to assist facilities in their reviews of their cyber security and IT programs.
Please see the attached for more information. The S&C can also be found at https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-17-17.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending.
Communication is one of the key factors necessary for improving resident safety and overall care within a nursing home. Strong communication builds relationships between staff and residents. Click on the links below to learn more.
Music is a powerful, non-threatening tool that can be used to help individuals of all ages who struggle with mental health issues. It can be used to explore personal feelings and therapeutic issues such as self-esteem or personal insight. It can help make positive changes in mood and emotional states. It can also give individuals a sense of control over life through successful experiences. During our time together we will explore music and the therapeutic benefits it has on the human spirit.
For more information, please see the event site here. Online registration is also available here.
This CMS survey ascertains a community’s compliance with Care and Services for a Resident with Dementia, Unnecessary Drugs, Assessment and Care Planning. Become familiar with the survey, surveyor worksheets and how both have been integrated into the survey process. Most importantly, ensure you know best practices both recognized by CMS and the culture change movement. Learn to view “behaviors” as communication; recognize dementia-related communications; be individual-centered, not institution-centered as CMS requires; offer meaningful engagement by all staff all day to reduce antipsychotics. It’s time to create a proactive, preventive, individualized, resident -focused dementia care culture.
Please see the Action Pact event for more information including registration.
It’s a new year and your 2017 Provider Meetings are already in the works! The Quality Assurance and Education Unit staff are currently in the planning phase and are considering the best topics to provide the most beneficial information. We would like to hear from you about what LTC related topics you believe would be helpful, informative, and ‘worth the drive’. If you’ve also been thinking- Gee I wish they would do a presentation on……., then you are cordially invited to be part on our planning team! Please feel free to forward your suggestions to:
Staffing Data Submission Reminder: As of July 1, 2016, electronic submission of staffing data through the Payroll-Based Journal (PBJ) is mandatory for all Long Term Care Facilities. You have up to 45 days after the end of the quarter to submit data for Federal Fiscal Quarter 1 (October 1, 2016-December 31, 2016.) The final submission file for this quarter is due on February 14, 2017. Submit early to avoid system delays.
Please note that an updated policy manual and FAQ are now posted on the PBJ website.
For questions related to software or technical requirements, please email NursingHomePBJTechIssues@cms.hhs.gov
For questions related to PBJ policies, please email NHstaffing@cms.hhs.gov
PBJ website link: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html
A leader’s actions can shape the culture of an organization. Strategy 1 of the National Nursing Home Quality Care Collaborative’s “Change Package” stresses the expectation for excellence in leadership, strong mission and values, and an accepting non-punitive culture. Click on the following links to learn more.
Please see the MHCA event page for more information on these and other workshops.
More information about these and other training events can be found on MALA’s training & event webpage.