New MDS Updates

New MDS 3.0 Quality Measure User’s Manual Available

The MDS 3.0 QM User’s Manual Version 10 was posted April 28, 2016, which includes new Quality Measures.  The MDS 3.0 QM User’s Manual v10.0 contains detailed specifications for the MDS 3.0 quality measures that are only MDS based.  The new manual can be found in the Download section at the bottom of the page at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-instruments/NursingHomeQualityInits/NHQIQualityMeasures.html.

 

New Measures Technical Specifications

There are also now QMs that are claims based in addition to being MDS based.  The specifications for these Quality Measures can be found in the download section at the bottom of the page at www.cms.gov/Medicare/Provider-Enrollment-and-certification/CertificationandComplianc/FSQRS.html.

 

Nursing Home Compare Five-Star Rating

Beginning in July 2016, five of the new measures (all except for the antianxiety medication measure), will be used in the calculation of the Quality Measure rating.  Gradual phase-in of the new measures will occur between July 2016 and January 2017.  Prior to July, the Technical Users’ Guide, which is also available in the downloads section of the CMS website (same link as above), will be updated to reflect the changes to the Quality Measure rating calculation.

 

Payroll-based Journal (PBJ)

Beginning in July 2016, all Medicare- and Medicaid-participating nursing homes must submit staffing

data to CMS through a new electronic system called the Payroll-based Journal (PBJ).  More information about staffing data submission is available at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html

For additional assistance with or questions related to PBJ registration process, please contact the QTSO Help Desk at 877-201-4721 or via email at help@qtso.com.

 

Draft RAI Manual v1.14

On May 11, 2016, CMS posted a new DRAFT RAI Manual v1.14 in the Related Links section at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursinghomeQualityInits/MDS30RAIManual.html so that users can preview significant changes before they become effective October 1, 2016.  There are many item set changes, including the new Chapter 3, Section GG: Functional Abilities and Goals. Chapter 2 and Chapter 3, Section A provide information on the new Part A PPS Discharge assessment.  Please note that it does not include Appendices F and H or replacement pages, which will be published with the final version 1.14 in September 2016.

 

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.

VOYCE’s Long Term Care Conference

June 10, 2016:  The Changing Landscape of Long Term Care Conference
Location:  Renaissance St. Louis Airport Hotel

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 on the VOYCE event web page here.

2016 Pioneer Network Conference

July 31-Auguest 3, 2016:  Revolutionizing the Culture of Aging
Location:  Hyatt Regency New Orleans, New Orleans, LA

This highly regarded, dynamic meeting weaves together the experiences and expertise in all sectors of the aging field, from C-suite corporate staff, administrators, managers, nurses, social workers, activity professionals, researchers, regulators to elders and care partners, etc.  Attendees are self-selected learners and “movers and shakers” interested in improvement and excellence in care and support of elders.  Attendees from past conferences enthusiastically report high satisfaction and comment on how different the Pioneer Network conference is from other conferences.  They share receiving benefit from:

  • Being with like-minded people from across the United States and internationally who share their passion for changing the culture of long-term care
  • Learning from experts who are on their “culture change journey”
  • Making connections that will help them with their personal and professional journey
  • Connecting with resources and vendors that can help them achieve their goals

Please visit the Pioneer Network’s Conference webpage here for more information including registration.

Nursing Home Quality Improvement Spotlight On…

Managing Behaviors: Mental Health Disorders

Nursing homes face many challenges when managing behaviors with schizophrenia and other mental health diagnoses.  These challenges include the need for staff training on behavior management, implementation of strategies to maintain resident safety and other changes that meet the needs of residents.  Click on the following links (PDFs) to learn more.

Teaching and Maintaining Behavior Management Skills in the Nursing Home
Tips and Techniques for Supporting Residents with Mental Illness: A Guide for Staff in Housing for Older Adults

 

CMS Memo S&C 16-22-LSC: Notification of Final Rule Published: Adoption of 2012 Life Safety and Health Care Facilities Code

Fire Safety Requirements for Certain Health Care Facilities:  On May 4, 2016, the Centers for Medicare & Medicaid Services (CMS) published a final rule titled “Medicare and Medicaid Programs; Fire Safety Requirements for Certain Health Care Facilities,” which updates the fire safety requirements for health care providers and suppliers.  This regulation requires certain providers and suppliers to meet the requirements of the 2012 edition of the Life Safety Code (LSC), National Fire Protection Association (NFPA) 101 and the 2012 edition of the Health Care Facilities Code, NFPA 99.

Please see the Press Release attached stating health care providers affected by this rule must comply with all regulations within 60 days of the date of the publication of the final rule (May 4, 2016).  More information is coming from CMS and we will provide updates as we receive them.

SC16-22 – Release of Final Rule LSC
Press Release for Fire Safety Requirements

New MDS 3.0 Quality Measure User’s Manual Available

The MDS 3.0 QM User’s Manual Version 10 was posted April 28, 2016 which includes new Quality Measures.  The MDS 3.0 QM User’s Manual v10.0 contains detailed specifications for the MDS 3.0 quality measures.  The new manual can be found in the Download section at the bottom of the page at https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-instruments/NursingHomeQualityInits/NHQIQualityMeasures.html.

If you have any questions, 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.

Pioneer Network Welcomes New Director of Education

Pioneer Network is pleased to welcome Joan Devine next week as our new Director of Education.  No stranger to us, Joan has long been a member of the Pioneer Network extended family!  She currently serves as Board President of MC5 (Missouri Coalition Celebrating Care Continuum Change), the state’s culture change coalition.  She has also been a frequent speaker at our conferences, in addition to the fearless leader of our group of dedicated onsite volunteers.

Joan has over 20 years of experience in leadership positions in senior services, supporting the clinical departments of Skilled Nursing and Assisted Living communities in Missouri and Illinois.  Her work has been devoted to preparing and equipping administrators and other care leaders to transform their homes and embrace resident directed care.

Joan holds a B.A. in Music Education/Music Therapy, a B.S. in Nursing and a Masters in Management.  She is also author of the book “Word of the Week:  Creating a Culture Change Dictionary” and is a certified Eden Educator and Mentor.

Conversations with Carmen

May 20, 2016:  Improving Mobility the “Advancing Excellence” Way
Guest:  Carol Benner, Advancing Excellence Campaign

For years we have talked about preventing and reducing falls, searching for the right solution.  We even tied people to their chairs to keep them from falling, not yet realizing that the key to preventing falls is to improve mobility.  Then we “alarmed” them, which only resulted in increased immobility.  Mobility is the key to maintaining both physical health and quality of life.  The Advancing Excellence Campaign has selected Mobility as one of its nine goals.  With an expert panel, it has prepared a full set of quality improvement tools to help assess, measure and improve mobility for nursing home residents.  This conversation will focus on:

  • What mobility is
  • Why maintaining/improving mobility is important
  • How to measure mobility using an evidence-based tool
  • How to incorporate mobility in your QAPI efforts
  • How to use a root cause analysis to help you identify areas for improvement

Please visit the event page here for more information including registration.

Nursing Home Quality Improvement Spotlight On…

Reducing the Inappropriate Use of Antipsychotic Medications

Inappropriate use of antipsychotic medications in long-term care is a significant issue affecting the safety of residents. Click on the following links to learn more.

TMF Recorded Event: Reducing the Inappropriate Use of Antipsychotic Medications (video)
Get the Facts About Antipsychotic Drugs and Dementia Care (PDF)
Nursing Home 411: Antipsychotic Drugs and Dementia Care

Coordination of Care

May 25, 2016:  Capitol Plaza Hotel, Jefferson City, MO

Join us for this session that will cover the beginning-to-end journey between Hospice and Nursing Facilities.  Learn how to know when it’s time for hospice, how hospice can benefit the facility, the resident, and the family. There will be panel discussion on Care Planning and End of Life Decisions, as well as providing grief counseling for family and facility employees.

Please see the brochure attached or visit MHCA’s event page here for more information.

Readmissions, Medication Safety and Behavioral Health Open Forum

May 4, 2016:  Noon – 1:00 p.m. CT

Attend this free WebEx event to meet with TMF QIN-QIO Readmissions, Medication Safety and Behavioral Health quality improvement consultants who will be available to answer questions and provide technical assistance.  During this monthly Open Forum, your team can network with other providers and TMF QIN-QIO staff, ask questions and problem-solve on topics such as:

  • Care Transitions
  • Readmissions Reduction
  • Medication Safety
  • Adverse Drug Events
  • Behavioral Health
  • Other issues your project may have

Registration is not required for this event.
Day of Event:  Please join 10 minutes prior to the presentation to ensure proper set up.
Call-in Number: 888-884-2150.  An operator will greet you and place you into the conference.
Note:  This open forum will only have audio.  Participants will not need to access a visual component.

Sexuality in Long Term Care: Open Your Mind (And Shut the Door, Please)

May 11, 2016:  Webinar 11:30 a.m. – 12:30 p.m. CT
Presenter:  Kathleen Weissberg from Select Rehabilitation
Registration Deadline is May 6, 2016

What is sexuality and why is it so seldom spoken of when talking about older adults, particularly those in long-term care?  This session explores the perspectives of residents, staff, and family members related to sexuality and intimacy.  Through case studies, it helps staff consider their views, identify barriers, and facilitate solutions and strategies when sexual expression becomes problematic.  Strategies for meeting resident sexuality needs without intercourse are explored.  Sexuality and intimacy as these relate to dementia, issues with consent, problematic behaviors, and the dilemma of “adultery” are addressed.  Finally, concepts important for guiding policy and procedure development are reviewed.

Click here for more information or to register

Mental Health First Aid

May 19, 2016:  Jefferson City, MO

Mental Health First Aid is an 8-hour course that gives people the skills to help someone who is developing a mental health problem or experiencing a mental health crisis.  The evidence behind the program demonstrates that it does build mental Health literacy, helping the public identify, understand, and respond to signs of mental illness.

Please visit MALA’s event page for more information and to register.

Reducing Adverse Drug Events and Readmissions

May 19, 2016:  Webinar Noon – 1:00 p.m. CT
Presenter:  Niki Carver, PharmD, CPPS Pharmacy Director, Arkansas Continued Care Hospital of Jonesboro

In this webinar, Niki Carver, PharmD, CPPS, will discuss adverse drug events (ADEs) related to warfarin, hypoglycemic drugs and opioids, and how they contribute to readmissions; she will also provide recommendations to address key factors contributing to ADEs related to these drugs.  In addition, participants will walk away with practical strategies for enhancing care transitions and preventing medication-related readmissions.  Continuing education credits will not be awarded for this presentation.

Please visit the event page here for more information and to register.

The Aging Services Workforce: The Key to Our Success

May 25, 2016:  Brooking Park, Chesterfield, MO
May 26, 2016:  Adam’s Mark of Kansas City, Kansas City, MO

Workforce is one of the most difficult issues aging service providers face in today’s environment.  LeadingAge Missouri and LeadingAge Kansas are excited to partner to bring you a day of learning and networking around the topic of Workforce.  It is important that we understand the components of this crisis so we can develop practices that support and attract workers who provide excellent care to seniors.  This joint Summit will provide insights and opportunities for discussion about what it takes to position yourself as an employer of choice in your community.  Dr. Robyn Stone, Cara Silletto and Steve Cohen will be a few of our exciting speakers.

Click here for more information
Click here to register online for St. Louis
Click here to resister for Kansas City

System Improvement Webinar: Pressure Ulcers (F314)

June 23, 2016:  2:00 p.m. – 3:00 p.m. CT
Presenter:  Liz Davidson from LeadingAge Iowa
Registration Deadline is June 21, 2016

The F-tag related to Pressure Ulcers is cited when a facility fails to ensure that a resident who enters the facility without a pressure sore does not develop pressure sores unless the individual’s clinical condition demonstrates that they were unavoidable; and a resident having pressure sores receives necessary treatment and services to promote healing and prevent new sores from developing.  During this webinar, we will take a closer look at the regulatory language included in F314, review the Evidence Based Practice and guidelines supported by the National Pressure Ulcer Advisory Panel (NPUAP), and review actual citations to help leverage a better understanding of how to maintain compliance with this key system.

Click here to register

Evidence Based Falls Risk Assessment and Intervention

August 10, 2016:  Webinar 11:30 a.m. – 12:30 p.m. CT
Presenter:  Kathleen Weissberg from Select Rehabilitation
Registration Deadline is August 8, 2016.

Fall risk assessments are a crucial tool in identifying which residents could be at risk for falling and, therefore, a candidate for a fall prevention program.  Fall risk assessments not only identify residents at risk, but also aid in recognizing the type of intervention that should be utilized.  They also assist in increasing staff knowledge in fall risk prevention and intervention strategies.  This webinar reviews the definition of a fall and intrinsic and extrinsic risk factors related to falls.  Evidence-based assessments demonstrated to be predictive of risk are reviewed as they relate to nursing and therapy practice with elderly clients.  This webinar reviews evidence-based intervention strategies applicable to a balance and fall management program including environmental modification, patient and caregiver education, and balance retraining activities.  Falls management program rationale and implementation is also discussed as well as interdisciplinary techniques and strategies to reduce fall risk in the elderly.

Click here to register

Action Pact 1-Day Workshop

June 9, 2016:  From Good Sleep to Wellness
Location:  Kansas City, KS

Participants will take an in-depth look at the impact of sleep or lack of sleep on the life of those they serve.  They will consider the causes and contributing factors, identifying those that can be changed and develop plans for addressing them based upon the concepts of high involvement and resident-directed care.

Please see the even details and registration info here.

Conversations with Carmen

April 22, 2016:  Dignity-Based Approach to Incontinence
Guest:  Susan Fry, Retired Culture Change Nurse Leader

Guest Susan Fry will report out on a multisite research study regarding a dignity-based approach to incontinence management. Join us to hear both the change steps and the exciting improved outcomes realized:

  • Disturbing residents less often increases comfort and dignity and respects natural sleep patterns, which improves alertness, appetite and nutrition while reducing confusion.
  • Reducing the risk for falls by supporting residents to sleep naturally through the night without the need to get up to use the bathroom.
  • Higher quality products keep skin dryer and promote skin health.
  • Better leakage protection encourages resident confidence and security.
  • Individualized care respects residents’ dignity and voiding patterns, and improves the level of participation in daily activities.

Please visit the event page here for more information and to register.