Laura Smith is the new Section for Long-Term Regulation Region 6 Program Manager. Laura has been with the Section for over 16 years, and has held various positions as a Facility Advisory Nurse. She has served as the interim Region 6 Program Manager in the past and most recently has been the complaint supervisor. Laura may be reached at 573-751-2270 or by email at laura.smith@health.mo.gov.
Category: Long Term Care Blog
The Section for Long-Term Care Regulation has created a Guidelines for Facility Self-Reporting
This document summarizes the reporting requirements of certified and state only facilities and provides contact numbers and other important information. The Guidelines for Facility Self Reporting is attached.
FCSR IMPORTANT NOTICE – Registration Fee increase
Effective October 1, 2016, the Family Care Safety Registry Worker Registration fee will increase to $13.00. The fee increase results from a change in state law and is required by the Missouri State Highway Patrol.
The Family Care Safety Registry will return Worker Registration forms, submitted with the incorrect fee, that are postmarked on or after 10/01/2016. Updated Worker Registration forms will be available to download at http://health.mo.gov/safety/fcsr no later than September 15, 2016, or may be obtained by contacting the FCSR toll free at 866-422-6872.
This information is available on the FCSR website and the Registration and Background Screening System (BSEES).
MLN 2016 DON/Charge Nurse/CNA Day
September 20-21, 2016: Director of Nursing Institute
September 20, 2016: Charge Nurse/CNA Day
Location: Orlando’s Event and Conference Center, St. Louis, MO
Missouri League for Nursing is 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 brochure on MLN’s website for more information.
Vibrant Living for Men
September 1, 2016: Vibrant Living for Men
Location: The Piper Assisted Living and Memory Care, Kansas City, KS
Presenter: Glenn Blacklock, Administrator
This all-day workshop will explore options for helping men to live more vibrant and satisfying lives. We will discuss the current state of most activity programs, which are often heavily focused toward activities enjoyed by women. We will also identify the reasons activities and pastimes can’t just be left to Activity professionals anymore. Everyone needs to be involved. This practice makes for an environment that opens the door for everyone in the organization to share their passions and interests. Relationships flourish and spontaneous things begin to happen. As men begin to rethink what they can and would like to do, they often find new purpose and meaning in their lives, and their once-vibrant spirits rise again.
For more information including registration, please visit the event page.
It’s Time to “Restore” Your Restorative Nursing Program
August 25, 2016: Webinar 11:30 a.m. – 1:00 p.m. CT
Presenter: Kathleen Weissberg from Select Rehabilitation
Registration Deadline is August 23, 2016.
This training session will review the philosophy, design, implementation, and successful documentation of a Restorative Nursing Program. Nurses, Nurse Assistants, Restorative Aides, and therapists all must work together in the facility to implement a rehabilitative approach that focuses on the resident’s function. Types of Restorative programs are reviewed along with role delineations for each. For each Restorative Program, documentation and coding guidelines, key training elements, and program goals are reviewed.
System Improvement Webinar: Internal Oversite (F281, F312)
August 4, 2016: Webinar 2:00 p.m. – 3:00 p.m. CT
Presenter: Liz Davidson from LeadingAge Iowa
Registration Deadline is August 2, 2016.
According to the Office of Inspector General’s (OIG) publication of the OIG Compliance Program Guidance for Nursing Facilities, conducting internal monitoring and auditing (oversight) is one of the key elements to successful compliance program. During this webinar, we will discuss key strategies, best practices, and tools to use to conduct internal monitoring and oversight within your organization. Case studies of actual F-tag citations for F281 (Professional Standards) and F312 (Activities of Daily Living), two of the most frequently cited F-tags nationally, will be used to help leverage a better understanding of how internal oversight can improve not only compliance, but overall quality of care.
Conversations with Carmen
July 22, 2016: What Kind of Culture Does Your Language Create?
Host/Presenter: Carmen Bowman, MHS
It is not news that the language of institutional care could use some work. Even CMS notes a needed language change by encouraging the elimination of labels such as “feeder” in its interpretive guidance for Tag F241 Dignity. Do these institutional words still abide in your culture? Facility, beds, frontline, work the floor, toileting, non-compliant, behaviors, difficult, activities, dietary, resident, elope, expire? Have you personally and community-wide adopted language that is softer, more normal, dignified? The best news? Changing language costs no money. Yes, changing language is a no-cost practice that does wonders to shift from an institutional culture to a home/natural/normal culture instead. Join us to learn more about the unintended consequences of traditional institutional language; word replacements to consider; and ideas on how to change language. Join our host Carmen Bowman as she shares from the paper she co-authored The Power of Language to Create Culture.
For more information including registration, please visit the Action Pact event page here.
TMF Free Learning Webinar
July 12, 2016: Vaccinating Adults: Don’t Miss Out on Opportunities for Prevention
Presenter: Carolyn Bridges, MD
Immunizations are one of the best ways to decrease the incidence of preventable diseases. This learning session will explore disparities in adult immunizations, standards of practice, effectiveness of vaccines and payment for adult vaccinations.
For more information including registration, please visit the event page here.
My Vote Matters
National Consumer Voice for Quality Long-Term Care
It’s Election Year! What are Your residents Thinking? Are they ready to Vote?
As we approach the Democratic and Republican conventions this month and the General Election in November, Americans are talking about the candidates, the issues at hand, and thinking about their vote. Voting is one of our most important civic responsibilities, yet too often individuals receiving long-term care and services do not have an opportunity to cast their ballot.
What can be done to help residents and other long-term care consumers exercise this right? What kind of assistance do they need? Getting registered? Getting to the polls? Filing an absentee ballot? When we involve residents in the political process, we all will benefit from it.
Consumer Voice is featuring two new consumer fact sheets with information about exercising this important right and cornerstone to our society.
Consumer Voice has also created a new issue page with great voting resources:
- What were successful ways accessible voting was incorporated in the 2012 election that we can use this year?
- How can ombudsman programs assist residents in exercising their right to vote?
- What can be done to tackle the unique challenges of voters with mental and physical disabilities?
- Plus, many more resources covering every facet of voting issues in long-term care
Residents can also be engaged in the election process by having an opportunity to talk about the issues important to them – both related to their daily life in the long-term care facility, to their community, and to society at large.
Get them started in discussions with their peers in the facility by inviting them to share their views. Be prepared with the My Vote Matters toolkit, which includes:
Invite Resident participation in the national discussion. Ask what they’re thinking and help engage them in the election process!
Teepa Snow’s Making a Difference
September 23, 2016: Making a Difference
Location: Sheraton Westport, St. Louis, MO
As one of America’s leading educators on dementia, Teepa Snow’s philosophy is reflective of her education, work experience, available medical research, and first hand caregiving interactions. Working as a Registered Occupational Therapist for over 30 years her wealth of experience has led her to develop Positive Approach® to Care techniques and training models that now are used by families and professionals working or living with dementia or other brain changes throughout the world.
Please see the flyer here for details and registration information.
Nursing Home Quality Improvement Spotlight On…
Every person interacting in a resident’s environment plays an intricate part in the outcome of that resident’s care. Interdisciplinary communication is the key to quality resident care in nursing homes, as any changes in a resident’s condition could greatly impact their life or quality of life. Visit the following links to learn more about improving communication.
New MDS Updates
Medication Classification Resources
The DRAFT RAI Manual v1.14 posted 5-11-16 and found at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursinghomeQualityInits/MDS30RAIManual.html) and S&C 16-15-NH dated 3-25-16 and found at www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-16-15.pdf include several websites CMS lists as resources for information on medications (including classification).
Page 881 of The Draft RAI Manual v1.14 includes the following medication resources:
- GlobalRPh Drug Reference, http://globalrph.com/drug-A.htm
- USP Pharmacological Classification of Drugs, http://www.usp.org/usp-healthcare-professionals/usp-medicare-model-guidelines/medicare-model-guidelines-v50-v40#Guidelines6. Directions: Scroll to the bottom of this webpage and click on the pdf download for “USP Medicare Model Guidelines (With Example Part D Drugs)”
- Medline Plus, https://www.nlm.nih.gov/medlineplus/druginformation.html
- The DrugLib.com Index of Drugs by Category, http://www.druglib.com/drugindex/category/
Page 41 of S&C 16-15-NH includes the following medication resources:
- MedlinePlus, https://www.nlm.nih.gov/medlineplus/druginformation.html
- National Library of Medicine Drug Information Portal, http://druginfo.nlm.nih.gov/drugportal/drug/categories.
- The Food and Drug Administration (FDA) webpage, Medwatch: The FDA Safety Information and Adverse Event Reporting Program , http://www.fda.gov/Safety/MedWatch/default.htm
- GlobalRPh Drug Reference, http://globalrph.com/drug-A.htm
- The TakeRX website’s generic drug prefix and suffix list, http://www.takerx.com/class.html
- The DrugLib.com Index of Drugs by Category, http://www.druglib.com/drugindex/category/
- The University of Maryland Medical Center Drug Interaction Tool, http://umm.edu/health/medical/drug-interaction-tool
If you have any questions about the above information, please contact Stacey Bryan, BSN, RN, State RAI Coordinator, Department of Health & Senior Services, Telephone 573-751-6308 or E-mail stacey.bryan@health.mo.gov.
CMS S & C Memo:16-29-LSC: Adoption of the 2012 edition of the National Fire Protection Association (NFPA) 101 – Life Safety Code (LSC) and 2012 edition of the NFPA 99 – Health Care Facilities Code (HCFC)
- The Centers for Medicare & Medicaid Services (CMS) has adopted by regulation the 2012 LSC and the 2012 HCFC. The regulation effective date is July 5, 2016.
- CMS will begin surveying for compliance with the 2012 LSC and HCFC on November 1, 2016.
- CMS will offer an online transitional training course for existing LSC surveyors to provide an update on the new requirements. The course will be available on September 2, 2016 via the CMS Surveyor Training Website.
- CMS will update the ASPEN program (i.e., the information system which tracks surveys) and CMS Fire Safety Forms (2786) prior to the November 1, 2016 survey start date.
Please see the memo at www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-16-29.html?DLPage=1&DLEntries=10&DLSort=2&DLSortDir=descending for more details.
Nursing Home Quality Improvement Spotlight On…
Using TeamSTEPPS?
Working as a team allows for information sharing, informed decision-making, team building, support, and efficiency. Particularly in long-term care, it improves resident and family satisfaction and also has the potential to reduce clinical errors and staff turnover. Click on the following video links to learn more.
Nursing Home Quality Improvement Spotlight On…
Is Your Organization Ready for TeamSTEPPS?
Are your leadership and key personnel involved and committed to change? TeamSTEPPs includes assessments to determine if your organization is ready to implement a teamwork initiative. Visit the following links to learn more.
Action Pact Workshop – The Benefits of Household Dining
July 21, 2016: The Benefits of Household Dining; Maxinizing Choice and Relationships in this Pleasure of Daily Life
Location: The Piper Assisted Living and Memory Care, Kansas City, KS
Presenter: Linda Bump
So, does dining really matter anymore? Have we already done as much as we can in changing dining to be more resident directed? Why must we continue to move our systems forward in honoring resident choice in dining and in creating relationship-based dining service systems?
There are many reasons:
- Because our residents are demanding it
- Because our residents deserve it
- Because CMS is advocating for increasing change
- Because we CAN, and simply
- Because it is the right thing to do!
Participants will explore each topic (see agenda) through lively discussion, the experiences of staff and residents pioneering work and personal exercises. Using the guidance and challenges of the New Dining Practice Standards to guide our thought from Mazlov’s early work to creating The Kitchen as a Great Good Place in our residents’ lives, participants will leave feeling prepared to meet the challenges ahead in maximizing dining as a pleasure of their residents’ lives.
For more information including registration, please visit the Action Pact event page here.
Nursing Home Quality Improvement Spotlight On…
Managing Behaviors: TeamSTEPPS in Long-Term Care
Developed by the Agency for Healthcare Research and Quality, TeamSTEPPS is an evidence-based program centered on communication and teamwork skills that involve reviewing organizational processes and systems to ensure resident safety while delivering care. Visit the following links to learn more.
New Generations Newsletter – Spring 2016
The Section for Long-Term Care Regulation has published New Generations – Volume 14, Issue 2, Spring 2016. This issue is now accessible on our website.
Please visit health.mo.gov/seniors/nursinghomes/providerinfo.php to view this publication along with a collection of previous newsletters.
Nursing Home Quality Improvement Spotlight On…
Managing Behaviors: Bullying
Bullying might be thought of as a behavior mainly exhibited by children, but it can occur in all age groups. Whether it involves verbal or physical abuse or antisocial behavior, bullying should not be tolerated in any setting, including long-term care. Visit the following links to learn more about the types of bullying behaviors and how to manage them.
Conversations with Carmen
June 17, 2016: Reducing Unnecessary Wheelchair Use
Guest: Leslie Jarema, LNHA, Director of Health Services, The Forest at Duke CCRC
Approximately two-thirds of nursing home residents are in wheelchairs the majority of the time. Although not talked about much, the negative, iatrogenic consequences of overuse of wheelchairs are many: accelerated loss of muscle mass, pressure sores, significant discomfort and physical strain from operating chairs which increase risks for falling, injuries from falls, depression and pneumonia. Older people’s health, mobility and self-image can suffer from too much time in wheelchairs. They are treated as less able, even spoken to differently, promoting a cycle of helplessness. The Forest at Duke is part of a movement that gives priority to the well-being of residents and their caregivers – above the functions of the nursing home or convenience of the staff. Join us and our guest Leslie Jerema to learn how she led her community to use wheel chairs for transport only and helps residents be as active as possible.
For more information, please visit the event registration page here.
Nurse of the Year
The March of Dimes is honored to pay tribute to the nursing profession and recognize extraordinary nurses throughout our community. The remarkable efforts of these individuals often go unsung and through Nurse of the Year, we are able to honor those who make a difference in the lives of so many.
To nominate a nurse, please complete the nomination form. March of Dimes will accept nominations from April 1, 2016 until June 27, 2016. Nominees will receive a Nominee Confirmation Email, and must complete an application by July 25, 2016 in order to be included in the selection process.
Fair Labor Standards Act (FLSA) Rules Impacting Overtime and Exemption Status Webinar
June 16, 2016: 1:00 p.m. – 2:00 p.m.
Registration Deadline is June 13, 2016
On March 14, 2016, the Department of Labor submitted the final proposed overtime rule updates of the Fair Labor Standards Act (FLSA) to the Office of Management and Budget. As a result, these updates could go into effect by late summer 2016. This webinar will present the finalized regulations and any unexpected surprises as nearly every employer in the nation will be affected by the U.S. Department of Labor’s proposed revisions. Their impact will touch not only how employers classify their exempt and non-exempt employees, but also the organization’s bottom line profits. Soon, employers will have to pay time-and-one-half overtime pay to many employees for hours worked over 40 in a workweek, and who had previously earned a straight salary under one of the white-collar exemptions.
Hot Topics: Culture Change in Action
June 14, 2016: The Role of the Medical Director and Attending Physician in Advancing Person-Centered Long-Term and Post-Acute Care
Presenters: Jonathan Evans, M.D., Past President, AMDA-The Society for Post-Acute and Long-Term Care Medicine and Christopher Laxton, Executive Director, AMDA-The Society for Post-Acute and Long-Term Care Medicine
How can we make life better for our elders and others who need care in our long-term care settings? Learn about the nursing home medical director and attending physician’s perspective on ways to improve quality, person-centeredness, and individual resident/patient choice.
For more information including registration, please visit the Hot Topics event page here.
CMS Memo S&C 16-21-ALL: Guidance to Surveyors on Federal Requirements for Providing Services to Justice Involved Individuals
Surveyor Guidance: The Centers for Medicare & Medicaid Services (CMS) are clarifying requirements for providing services to justice involved individuals in skilled nursing facilities (SNFs), nursing facilities (NFs), hospitals, psychiatric hospitals, critical access hospitals (CAHs), and intermediate care facilities for individuals with intellectual disabilities (ICFs/IID). Specifically, this guidance seeks to assure high quality care that is consistent with essential patient rights and safety for all individuals.
Please see the attached memo and scenarios below or you may visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-16-21.html?DLPage=3&DLEntries=10&DLSort=3&DLSortDir=descending.
SC16-21.01 Final Memo Justice-Involved
SC16-21.02 Scenarios Justice-Involved Individuals