Category: Long Term Care Blog

CMS Memo S&C 16-04-NH: Focused Dementia Care Survey Tools

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In response to feedback from stakeholders and partners of the National Partnership to Improve Dementia Care in Nursing Homes, CMS is sharing the revised survey materials that were developed for the 2014 Focused Dementia Care Survey Pilot and 2015 expansion effort. The intent is that facilities would use these tools to assess their own practices in providing resident care.

Please see the memo and attachments 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-16-04.html?DLPage=1&DLEntries=10&DLSort=3&DLSortDir=descending.

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Person-centered care and resident choice: Giving elders a voice

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One perception often interfering with the adoption and implementation of person-centered care practices in nursing homes is apprehension by staff, administrators, and governing boards about potential legal liability and regulatory exposure if residents suffer injuries.  This is primarily because a number of person-centered practices, such as offering residents meaningful choices and honoring their decisions, represent significant deviations from prior accepted more paternalistic institution-centered practice.  To read the full article, please visit here.

The full Process for Care Planning for Resident Choice, which includes blank forms and case studies, are available at www.IdeasInstitute.com, www.BrushDeveloment.com, and www.momc5.com.

Person-Centered Care Tip

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Tip #12:  “Person-Centered Care and QAPI”
Person-Centered Care is one of nine Advancing Excellence goals — aligned with QAPI –which provide tracking charts and trend graphs to help your home monitor progress on your chosen goals.  While Advancing Excellence supports the QAPI approach, participation does not automatically mean you are implementing QAPI.

Please see the flyer here for more information.

On the Road…to Culture Change Additions

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Arbor Health
In July 2015, I visited Arbor Health, LLC in University City. Arbor Health is 45-resident residential care home that is dually licensed with the Department of Health and Senior Services and Department of Mental Health. Arbor Health is an all-male home…to read more and view photos, click here: Arbor Health

Victorian Place of Washington
In August 2015, Section for Long-Term Care Regulation Communications Representative Leslie Sebastian and I visited Victorian Place of Washington and The Arbors at Victorian Place. Victorian Place is a 48-resident assisted living home and The Arbors is a 32-resident assisted living home…to read more and view photos, click here: Victorian Place of Washington

Hot Topics Webinar

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December 17, 2015:  Creating and Shaping Experiences of At-Homeness
Presenter:  Sheila L. Molony, PhD, APRN, GNP-BC, Associate Professor of Nursing, Quinnipiac University

What does it mean to feel at home?  This webinar will define at-homeness and provide ways of fostering quality of living and thriving in all long-term care and living environments by focusing on specific experiences of at-homeness.  The discussion will include actions that can be taken to create, shape and maintain those experiences.

Please see the details and registration info on the Hot Topics event page here.

MC5 2016 Annual Conference – Flyer Update

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May 3-5, 2016:  Honoring the Past: Challenging the Future of Culture Change
Location:  Hilton Garden Inn, Columbia, MO

As the leader in promoting person-centered care and personal choice, MC5 provides this annual opportunity for care professionals and businesses to network in an exciting, and partnership-building event to bring the best ideas and services to the seniors of our state.

Please see the flyer here and stay tuned to MC5 for more registration details coming soon.

Culture Change with Carmen

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Alarms: The New Deficient Practice? Eliminating Alarms and Preventing Falls by Engaging with Life
Come on Long Term Care! Be the Best, Smash the Box and get ready for the Baby Boomers

February 10, 2016:  Osage Beach, MO
February 11, 2016:  Springfield, MO
February 12, 2016:  Sikeston, MO

Join Carmen Bowman for an all-day event at three locations as she discusses the use of alarms.  See how eliminating alarms has actually reduced falls in the homes that no longer use them.  She will also help you find out if your home is really offering the right ways to attract Baby Boomers.

Please see the flyer here for more details.

New Licensure and Certification Unit Manager

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The Section for Long Term Care Regulations welcomes Shay Patterson as the manager for the Licensure and Certification Unit.  Shay has been with the Section for several years, starting in Region 6 as a Facility Surveyor and most recently as part of the Regulation and Compliance Unit.  Shay is replacing Tracy Niekamp who accepted a position with the Department of Mental Health.  Please contact Shay with any licensure or certification questions; she will be happy to assist you.

2015 State of the Art Person-Centered Care Survey

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It has been almost a decade since the last national survey explored how care communities are moving away from more traditional systems of care and adopting individualized care practices.  Whether it is a change in how meals are served, daily routines, or an enhanced physical environment, the momentum for change is growing.  Even CMS is looking to embed Person-Centered Care much more deeply in their regulations.

Nursing homes that offer short and/or long term care and assisted living communities are invited to participate in the 2015 State of the Art of Person-Centered Care Benchmark Study.

You may access the survey here.

Region 6 – 2015 Annual Long-Term Care Provider Meeting

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Sponsored by the Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation

November 16, 2015:  Region 6
Location:  Jefferson City, MO

As requested, SLCR will be hosting separate meetings for ICF/SNF and RCF/ALF care providers this year.  Advance registration is not required.

Please see the agenda and handouts for this specific location below.  These handouts attached will not be provided at the meeting so please print them and bring them with you.

2015 Provider Meeting Agenda- Region 6
Resident Discharge Notice
Facility Self-Reporting
Money Follows the Person
Social Media in Long-Term Care
Path to Safety, Minimal Assistance, More than Minimal Assistance

Submitting Exceptions & Second Business Requests

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The Regulation Unit has established an email account that providers can now submit all their requests to one email address:  RegulationUnit@health.mo.gov.  Providers are to begin utilizing this email as soon as possible.

The main number for contacting the Regulation Unit has also been updated.

The instructions for submitting the Exceptions and Second Business requests have both been updated.  Please see those instructions below.

Instructions for Exceptions Request
Instructions for Second Business Request

Updated MDS Information – additional

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On October 1, 2015 a new version of the RAI Manual became effective, Version 1.13.  Most of the changes were minor but there is one important change to point out.  Prior to the update, Significant Change MDS’s were required if a resident enrolled in or discontinued hospice.  Those rules are still in effect, but now, a Significant Change MDS is also required when a resident changes hospice providers and remains a resident at the nursing home.  This new rule is in the RAI manual in Chapter 2 on page 21.  A Significant Change MDS may also be required in situations when the hospice providing services is purchased by another hospice provider.

The new manual can be found at:  www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursinghomeQualityInits/MDS30RAIManual.html.  Scroll to the bottom of the page.  The first link is the ENTIRE Manual.  The second link is just the pages that have been changed as of October 1, 2015.  You will also find a summary of the changes in the second link.

If you have any questions, you may 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.

TMF Readmissions/Medication Safety/Behavioral Health Open Forum

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November 17, 2015:  Medication Management During the Transition from Hospital to Primary Care
Presenter:  Becky L. Armor, PharmD, CDE, BCACP

Join this webinar to learn about a pilot study assessing types of medication discrepancies and adverse drug events in patients recently discharged from the hospital.

Please see the event registration page here for more details.

Hot Topics: Culture Change in Action Webinar

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November 11, 2015:  The Impact of the Green House Project and Action Pact;s Household Model
Presenters:  Susan Frazier Ryan, BSN, MA, Senior Director, The Green House Project
Megan Hannan, MS, Executive Leader, Action Pact

The Green House model and Action Pact’s Household model both provide self-directed living for the frailest among us. Each has unique characteristics, but also commonalities. Households and Green House homes both result in new physical layout, organizational redesign, and resident directed life. Join Senior Director of The Green House Project, Susan Frazier Ryan and Action Pact’s Megan Hannan, to gain insight into lessons learned about the process for creating deep and sustainable change. High involvement and serious investment from many stakeholders in the organization is the path to changing habits and systems that create new and sustainable culture. Regardless of the current physical layout, it is essential that cross discipline teams are engaged in the process and able to apply what they learn to their day to day work. Participants will leave this webinar with an understanding about the importance of transforming the thinking of the organization first in order to produce those changed behaviors that result in in quality resident directed living.

Please see the Hot Topics events page here for more registration details.

Nursing Home Quality Improvement Spotlight On…

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TMF QIN-QIO CDI Webinar now Available

The TMF QIN-QIO’s September webinar, “Key Interventions and Strategies for the Prevention of Clostridium difficile Infections,” by Robin Jump, MD, PhD, has been posted to the TMF QIN-QIO YouTube channel for viewing. Please click the following link to access the presentation:  TMF QIN-QIO Recorded Event.

You can also access this and other recordings by visiting the HAI Recorded Events page.

Region 7 – 2015 Annual Long-Term Care Provider Meeting

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Sponsored by the Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation

November 4, 2015:  Region 7
Location:  St. Louis, MO

As requested, SLCR will be hosting separate meetings for ICF/SNF and RCF/ALF care providers this year.  Advance registration is not required.

Please see the agenda and handouts for this specific location attached.  These handouts attached will not be provided at the meeting so please print them and bring them with you.

2015 Provider Meeting Agenda- Region 7
Ameren Missouri
Money Follows the Person
Social Media in Long-Term Care
Path to Safety, Minimal Assistance, More than Minimal Assistance

Region 2 – 2015 Annual Long-Term Care Provider Meeting

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Sponsored by the Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation

November 3, 2015:  Region 2
Location: Cape Girardeau, MO

As requested, SLCR will be hosting separate meetings for ICF/SNF and RCF/ALF care providers this year.  Advance registration is not required.

Please see the agenda and handouts for this specific location attached.  These handouts attached will not be provided at the meeting so please print them and bring them with you.

2015 Provider Meeting Agenda- Region 2
Antipsychotic Reduction in Dementia
Money Follows the Person
Social Media in Long-Term Care
Culture Change in Residential Care and Assisted Living
Path to Safety, Minimal Assistance, More than Minimal Assistance

Person-Centered Care Tip

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Tip #11:  “Communicate Caring When Words Fail”

Do I communicate what I mean? A person may ignore my words, yet react to how they view my attitude. Communication involves sending and receiving both verbal and non-verbal messages. As memory loss progresses, words may become confusing, and word-finding is often frustrating. A person with memory loss will often mirror the non-verbal messages of the caregiver, and search for prompts to tell them how to respond. With such communication challenges, how can we acknowledge and support the person’s feelings, when words may not make sense?

Please see the attached tip for more information.

Region 4 – 2015 Annual Long-Term Care Provider Meeting

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Sponsored by the Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation

October 28, 2015:  Region 4
Location:  St. Joseph, MO

As requested, SLCR will be hosting separate meetings for ICF/SNF and RCF/ALF care providers this year.  Advance registration is not required.

Please see the agenda and handouts for this specific location attached.  These handouts attached will not be provided at the meeting so please print them and bring them with you.

The agendas and handouts for the other provider meeting locations will be announced closer to their meeting dates.

2015 Provider Meeting Agenda- Region 4
Request Denied- Simple Environmental Changes to Increase Active Engagement
Money Follows the Person
Social Media in Long-Term Care
Path to Safety, Minimal Assistance, More than Minimal Assistance

Region 3 – 2015 Annual Long-Term Care Provider Meeting

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Sponsored by the Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation

October 29, 2015:  Region 3
Location:  Kansas City, MO

As requested, SLCR will be hosting separate meetings for RCF/ALF and ICF/SNF care providers this year.  Advance registration is not required.

Please see the agenda and handouts for this specific location below.  These handouts attached will not be provided at the meeting so please print them and bring them with you.

The agendas and handouts for the other provider meeting locations will be announced closer to their meeting dates.

2015 Provider Meeting Agenda- Region 3
Money Follows the Person
Social Media in Long-Term Care
Path to Safety, Minimal Assistance, More than Minimal Assistance

VOYCE’s Caregiver Award Luncheon

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December 3, 2015:  Caregiver Award Luncheon
Location:  Renaissance St. Louis Airport Hotel, St. Louis, MO

Celebrate the 35th anniversary of VOYCE at the Annual Caregiver Awards Luncheon.  The day will begin with a special reception for nominees and sponsors at 10:45 am with lunch and program beginning at 11:45 am as exceptional caregivers in long-term care are honored.

Please visit the Caregiver Awards Luncheon page here for more information including registration.

Updated MDS Information

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Updated RAI Manual
On October 1, 2015, a new version of the RAI Manual became effective, Version 1.13.  The new manual can be found at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursinghomeQualityInits/MDS30RAIManual.html towards the bottom of the page.  The first link is the ENTIRE Manual.  The second link is just the pages that have been changed.  Also, there is a summary of the changes with the second link.

Updated Quality Measure Manual
On October 1, 2015, a new version of the MDS 3.0 QM User’s Manual became effective, Version 9.0.  It can be found at: www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIQualityMeasures.html towards the bottom of the page and click on the 4th download (MDS 3.0 QM User’s Manual V9.0) OR at the following address: www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Downloads/MDS-30-QM-Users-Manual-V90.pdf.

Updated MDS 3.0 Provider User’s Guide
Section 1 (Introduction), Section 5 (Error Messages) and Appendix A were updated in the MDS 3.0 Provider User’s Guide in September 2015.  The updated guide can be found at www.qtso.com/mdstrain.html.

If you have any questions regarding the updates, you may 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.

Region 1 – 2015 Annual Long-Term Care Provider Meeting

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Sponsored by the Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation

October 23, 2015:  Region 1
Location:  Springfield, MO

As requested, SLCR will be hosting separate meetings for RCF/ALF and ICF/SNF care providers this year.  Advance registration is not required.

Please see the agenda and handouts for this specific location below.  These handouts attached will not be provided at the meeting so please print them and bring them with you.   **The Partnering for the Protection of the Vulnerable Population presentation handouts are not included but will be provided at the meeting.

2015 Provider Meeting Agenda- Region 1
Path to Safety, Minimal Assistance, More than Minimal Assistance
Social Media in Long-Term Care
Money Follows the Person
Partnering for the Protection of the Vulnerable Population