CMS released the two memos below this past week. Homes may begin to change their policies and procedures and implement current CDC guidance.
QSO-20-38-NH Testing Expired
QSO-20-39-NH Visitation REVISED
Here is the link to the current CDC guidance for nursing homes: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html#create.
Each May, the Administration for Community Living leads the celebration of Older Americans Month (OAM). The theme for OAM 2023 is Aging Unbound, which offers opportunities to explore a wide range of aging experiences and to promote the importance of enjoying independence and fulfillment by paving our own paths as we age. This May is the 60th anniversary of OAM and we can participate in Aging Unbound by embracing opportunities to change, exploring the rewards of growing older, staying engaged in our communities, and forming relationships.
This May, the Department of Health and Senior Services (DHSS) invites everyone to explore the benefits of growing older. No matter the age, it is always possible to form new relationships and engage in your local community. To learn more, please visit Health.Mo.Gov/oam.
On Wednesday, May 24, DHSS is hosting a Senior Resource Fair at the Capital Mall in Jefferson City, MO, 12:00-4:00 p.m. to celebrate OAM. Please see flyer. There will be a range of exhibitors offering resources and information to our Mid-Missouri Seniors!
The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls (Volume 10, Issue 3).
In this issue:
Please visit QIPMO’s website here for this and other previous newsletters.
Memorandum Summary
Please see the full memo for complete details at https://www.cms.gov/medicare/provider-enrollment-and-certification/surveycertificationgeninfo/policy-and-memos-states/guidance-expiration-covid-19-public-health-emergency-phe.
Nursing homes are required to electronically submit direct care staffing information to the Payroll-Based Journal (PBJ) system. Submissions must be received by the end of the 45th calendar day (11:59 PM Eastern Standard Time) after the last day in each fiscal quarter to be considered timely. PBJ data for 1/1/23 through 3/31/23 is due May 15, 2023.
Please submit PBJ data as soon as possible to avoid delays. CMS recommends running staffing reports in CASPER prior to the submission deadline to ensure the accuracy and completeness of submissions. Please remember, the Final File Validation Report verifies that the submission was successful.
Please note: If you need assistance with the PBJ quarterly submission and the deadline falls on a weekend, you must contact the QIES/iQIES Service Center no later than the Friday before the submission deadline, as the Service Center will be unavailable to assist on the weekend.
More information about PBJ can be found on the following webpages:
CMS PBJ webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ
PBJ Reference Manuals – https://qtso.cms.gov/vendors/payroll-based-journal-pbj-vendors/reference-manuals
PBJ Training – https://qtso.cms.gov/training-materials/payroll-based-journal-pbj
SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. The following data must be submitted no later than 11:59 p.m. on May 15, 2023:
The Minimum Data Set (MDS) 3.0 must be transmitted to the Centers for Medicare & Medicaid Services (CMS) through the Internet Quality Improvement and Evaluation System (iQIES). Data for the National Healthcare Safety Network (NHSN) measures must be submitted to the Centers for Disease Control and Prevention (CDC). No additional data submission is required for the claims-based measures.
As a reminder, it is recommended that providers run applicable MDS reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.
Swingtech sends informational messages to SNFs that are not meeting APU thresholds on a quarterly basis ahead of each submission deadlines. If you need to add or change the email addresses to which these messages are sent, please email QRPHelp@swingtech.com and be sure to include your facility name and CMS Certification Number (CCN) along with any requested email updates.
More information about SNF QRP can be found on the following webpages:
CMS SNF QRP Data Submission Deadlines webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-Data-Submission-Deadlines
CMS SNF QRP Help webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-QRP-Help
CMS SNF QRP Measures and Technical Information webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-Measures-and-Technical-Information
CMS SNF QRP Training Webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-Training
On April 17, 2023, the Centers for Medicare & Medicaid Services (CMS) transitioned to the Internet Quality Improvement and Evaluation System (iQIES) for Minimum Data Set (MDS) record submissions and reports.
All MDS submissions that were performed in the QIES Assessment Submission And Processing (ASAP) system prior to April 13 at 8:00 p.m. ET were processed in that system. As part of the migration, MDS data accepted into the ASAP system prior to the start of the migration were moved into iQIES. All new, modification, or inactivation records must be submitted in iQIES, even if the original record to be corrected was accepted into the QIES ASAP system.
As part of the migration, users are now able to access and run the user-requested reports in iQIES. User’s access to the reports is similar to the access in the Certification and Survey Provider Enhanced Reporting (CASPER) Reporting application, so long as their new HCQIS Access Roles and Profile (HARP) role allows access to generate and view reports. Users are only allowed to run reports for the providers to which they have access.
Register for an iQIES Account
For information and instructions to register for an iQIES account, please visit: https://qtso.cms.gov/news-and-updates/action-required-register-iqies-account.
User Manuals
Video Tutorials
Additionally, the iQIES Team has developed video tutorials to provide an overview of the MDS functionalities in iQIES. The video tutorials can be found on QTSO and are not mandatory: https://qtso.cms.gov/training-materials/iqies-training-videos
iQIES Service Center
June 8, 2023: 2023 Acute & Post-Acute Care Summit
Location: Renaissance St. Louis Airport Hotel, St. Louis
LeadingAge Missouri, MHA, and ACHE are proud to offer the 4th annual Summit for Acute and Post-Acute Care Providers. This gathering of industry professionals is intended to produce solutions across the care continuum for a collaborative healthcare industry. You’ll hear from top experts in the field on topics such as Acute and Post-Acute relationship modeling, Workforce in Healthcare, Payment Reform, incorporating technology into your healthcare landscape, and the future of healthcare from our keynote speaker.
The Summit is a one-day event that brings together acute and post-acute healthcare industry professionals for education and networking, aiming to improve healthcare delivery. It fosters collaboration and is unique in its approach to education and networking.
May 9, 2023: Veteran’s Benefits
Location: St. Louis County Library – Jamestown Bluffs Branch, Florissant
May 23, 2023: Veteran’s Benefits
Location: St. Louis County Library – Prairie Commons Branch, Hazelwood
May 24, 2023: The Bare Necessities – Nursing in Long-Term Care
June 15, 2023: Residents First Long-Term Care Conference
Location: St. Louis University’s Margaret McCormick Doisy LRC, St. Louis
July 11, 2023: Preventing Financial Fraud
Location: St. Louis County Library – Cliff Cave Branch, St. Louis
July 25, 2023: Preventing Financial Fraud
Location: St. Louis County Library – Jamestown Bluffs Branch, Florissant
The passage of Amendment 3 in 2022, and legalization of adult cannabis use in Missouri created needs, challenges, and opportunities. The Missouri Department of Health and Senior Services (DHSS) is working to ensure Missourians have access to sufficient evidence-based information to make informed decisions about cannabis consumption and exposure, as well as, be knowledgeable about how it affects safety and the public health of all Missourians. We are asking stakeholder to take the survey linked below by April 28, 2023 to help identify what Missouri partners are doing to address cannabis use/misuse, resources utilized, challenges, needs and opportunities to collaborate.
Thank you for your time, interest and information. We look forward to working with you on strategies to prevent cannabis use and misuse and educate Missourians regarding legal cannabis use.
https://missouriwic.iad1.qualtrics.com/jfe/form/SV_d0eClc80miwNmho
We are currently in the planning phase to host in-person provider meetings in all regions this year and are considering the best topics to provide the most beneficial information. We would like to hear from you about what LTC related topics and info you believe would be helpful and educational!
Please take a moment to complete a one-question survey by May 10, 2023 at https://www.surveymonkey.com/r/2C82YVN.
Please see the most frequently cited deficiencies report from the first quarter of 2023.
Vaccines, Treatments and Promising Practices to Improve Resident Outcomes
CMS QI Voices: Improving COVID-19 Outcomes in Nursing Homes Across America, a new audio series produced by the Centers for Medicare & Medicaid Services (CMS), is available for listening at https://qioprogram.org/cmsqivoices.
This audio series is designed to help busy medical directors, administrators and directors of nursing and education keep residents and staff safe with actionable information to increase COVID-19 vaccination and use of available treatments and improve infection prevention efforts in nursing home and long-term care settings.
In a special series of three 15-minute episodes, CMS Chief Medical Officer Dr. Lee Fleisher leads clinical discussions with experts from the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA) Center for Biologics and Research and the Administration for Strategic Preparedness and Response. These episodes cover:
In the remaining five-minute episodes, CMS leaders talk with CMS Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) and the nursing homes they serve to discuss:
The CMS QI Voices: Improving COVID-19 Outcomes in Nursing Homes Across America audio series is available wherever listeners have online access. Nursing home teams may listen at https://qioprogram.org/cmsqivoices or contact LTC@hqi.solutions for more information about the audio series.
Please see the FDA safety announcement on the risk of fluid barrier protection failure of certain Halyard masks and N95 respirators. Feel free to share with healthcare providers.
On April 17, 2023, the Centers for Medicare & Medicaid Services (CMS) will transition to the Internet Quality Improvement and Evaluation System (iQIES) for Minimum Data Set (MDS) record submissions and reports. As part of this transition, the QIES Assessment Submission And Processing (ASAP) system for MDS submissions will be turned off on Thursday, April 13 at 8:00 p.m. ET. Providers should submit completed MDS records prior to 8:00 p.m. ET on April 13 to the QIES ASAP system or wait until 8:00 a.m. ET on Monday, April 17 to submit data in iQIES. Once the transition is complete, all new, modification, or inactivation records must be submitted in iQIES, even if the original record to be corrected was accepted into the QIES ASAP system. Providers are expected to take into account all submission requirements when determining the date that they submit completed MDS records, including but not limited to, submission timeliness, claims processing, and care planning requirements.
MDS submission and records will be available in iQIES beginning Monday, April 17, 2023 at 8:00 a.m. ET. iQIES will be the only system in which MDS data submissions can occur.
What to Expect with the Minimum Data Set (MDS) Transition to iQIES
Please note there are some system-generated reports in the CASPER application that will not be migrated over to the iQIES folders. Users should download and save or print any of these system-generated reports that they wish to retain. For more information on MDS reports, please visit: https://qtso.cms.gov/news-and-updates/what-expect-minimum-data-set-mds-transition-iqies-april-17-2023.
Register for an iQIES Account
Please note that failure to obtain access to iQIES prior to April 17, 2023 will impact your ability to submit MDS records once the migration is complete. For information and instructions to register for an iQIES account, please visit: https://qtso.cms.gov/news-and-updates/action-required-register-iqies-account.
iQIES Service Center
If you have questions or require assistance, please contact the QIES/iQIES Service Center by phone at (800) 339-9313 or send an email. Please note that call volume may be higher than normal during this time.
COMRU will be hosting a webinar/Q&A session regarding the online process and the ending of the COVID 19 waiver via WebEx.
April 24, 2023: Join Meeting Here
Time: 10:00 a.m.
Join by meeting number
Meeting number (access code): 2460 830 8201
Meeting password: 67tMfa2hU6R
Tap to join from a mobile device (attendees only)
+1-650-479-3207,,24608308201## Call-in toll number (US/Canada)
+1-312-535-8110,,24608308201## United States Toll (Chicago)
May 9, 2023: FREE CEU Event
Location: The Meadows at John Knox Village, Lee’s Summit
CEU hours available through the Missouri and Kansas Boards of Nursing Home Administrators.
All attendees will receive a certificate of participation.
The Delta variant quickly became the predominant circulating SARS-CoV-2 strain in the USA during summer 2021. Missouri identified a high number of outbreaks in long-term care facilities (LTCFs) across the state with low vaccination rates among LTCF staff members and poor adherence to mitigation measures within local communities. Ten long-term care facilities in Missouri worked with CDC to evaluate case data to assess disease transmission, vaccination status, and outcomes among residents and staff, including onsite visits to facilities with recent COVID-19 outbreaks in communities with substantial transmission to assess mitigation measures. Attached is a copy of the published findings from that study.
The Mo HealthNet Personal Funds Account Balance Report was updated in March of 2023. Please use the following link to access the updated report when reporting expired residents to the MO HealthNet Division: https://manuals.momed.com/forms/Personal_Funds_Account_Balance_Report.pdf.
Please note, while the MO HealthNet Personal Funds Account Balance Report form states the completed form must be submitted within 60 days of the resident’s death, federal requirements for certified nursing facilities require the notification within 30 days of the resident’s death. Refer to F569 of the State Operations Manual. For state regulations, please refer to 19 CSR 30-88.020 (11).
Also note, the only resident funds that can be withdrawn prior to completing the Personal Funds Account Balance Report is for basic funeral expenses.
Feel free to contact Lynn Gilmore, Lead Auditor, at 573-508-4150 if you have any questions.
Knowledge tests for 1/1/23-4/5/23 show students passed at 64.11%
These areas are below 80%:
*If your students have failed a test, please have your students review their tests so they know what areas that need more attention before retesting.
Skills tests given from 1/1/23-4/5/23 show students passed at 79.05%
Students scored the lowest on the areas below:
NOTE: HEU and Headmaster met with our Test Advisory Panel in March to address some changes in the skills test and knowledge test. These changes will be effective on July 1, 2023 so please check the Missouri Headmaster Website for the most recent version of the Candidate Handbook.
CNA Live Renewals Coming Soon
HEU is excited to announce the “new” process for CNA Renewals as it is close to going “LIVE” on May 1, 2023.
Please email Headmaster at missouri@hdmaster.com if you have not setup your employer profile. This will give the employer the option to verify employment and pay for the renewal for their CNA staff. This process will increase efficiency and time as it is all done electronically for the CNA and the employer. We have included a link to review the process in a “How To Guide” and will be offering several Q & A webinars. Please see below:
On April 17, 2023, the Centers for Medicare & Medicaid Services (CMS) will transition to the Internet Quality Improvement and Evaluation System (iQIES) for Minimum Data Set (MDS) record submissions and reports. As part of this transition, the QIES Assessment Submission And Processing (ASAP) system for MDS submissions will be turned off on Thursday, April 13 at 8:00 p.m. ET. Providers should submit completed MDS records prior to 8:00 p.m. ET on April 13 to the QIES ASAP system or wait until 8:00 a.m. ET on April 17 to submit data in iQIES. Once the transition is complete, all new, modification, or inactivation records must be submitted in iQIES, even if the original record to be corrected was accepted into the QIES ASAP system. Providers are expected to take into account all submission requirements when determining the date that they submit completed MDS records, including but not limited to, submission timeliness, claims processing, and care planning requirements.
Register for an iQIES Account
Please note that failure to obtain access to iQIES prior to April 17, 2023 will impact your ability to submit MDS records once the migration is complete. For information and instructions to register for an iQIES account, please visit: https://qtso.cms.gov/news-and-updates/action-required-register-iqies-account
Outlined below are a few highlights and expectations for the release of the iQIES MDS submission and reporting functionality.
Key Highlights of iQIES
What to Expect for Providers and Vendors
Report Information – QIES/CASPER
Report Information – iQIES
Following completion of the migration, users will be allowed to access and run the user-requested reports in iQIES. User’s access to the reports below will be similar to the access in the CASPER Reporting application, so long as your new HARP role allows access to generate and view reports. Users will only be allowed to run reports for the providers to which they have access.
Below are the report categories/types and each MDS report that is associated to the category/type combination.
Data Availability for iQIES User-Requested Reports
Resident Internal IDs on MDS and SNF QRP Reports
SNF QRP Quality Measure Report Information
The above files can be downloaded from the SNF QRP Measures and Technical Information page on the CMS website: https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/nursinghomequalityinits/skilled-nursing-facility-quality-reporting-program/snf-quality-reporting-program-measures-and-technical-information.
iQIES Service Center
If you have questions or require assistance, please contact the QIES/iQIES Service Center by phone at (800) 339-9313 or send an email. Please note that call volume may be higher than normal during this time.
The draft Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.18.11 is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS 3.0 RAI User’s Manual v1.18.11 will be effective beginning October 01, 2023.
This version of the MDS 3.0 RAI Manual contains substantial revisions related to the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act), which requires that standardized assessment items be collected across post-acute care (PAC) settings. Standardized data will enable cross-setting data collection, outcome comparison, exchangeability of data, and comparison of quality within and across PAC settings. Additionally, the language of the manual has been updated throughout to be gender neutral. Guidance and examples in numerous chapters and appendices have been revised for clarification and to reflect current regulations and best practices. Due to the scope of the revisions, CMS will not issue Replacement Pages for v1.18.11; those wishing to continue using a physical copy of the manual are encouraged to print the new version.
The final Minimum Data Set (MDS) 3.0 Item Sets version v1.18.11 are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS Item Sets v1.18.11 will be effective beginning October 01, 2023.
The DHSS Health Education Unit is conducting Weekly Instructor Info Webinars/Q&A Meet-Ups. These sessions will be held same day and time each week – Tuesdays at 2:00 p.m.
April 11, 2023: Instructor Info Meet Up Meeting
April 18, 2023: Instructor Info Meet Up Meeting
April 25, 2023: Instructor Info Meet Up Meeting
Please see the CNA Registry webpage for past meetings and more information.
If you have questions, please call our office at 573-526-5686.
May 23, 2023: Alzheimer’s Disease and Dementia Care Seminar
Location: The Sarah Community, Bridgeton
Trainer: Madisen Mendez, MOT, OTR/L, MSCS, CDP, CADDCT, CMDCP
The prevalence of dementia is on the rise. Successful dementia care in skilled nursing facilities, residential communities, and the home setting requires an understanding of the disease process, communication techniques, and possible causes of unwanted behaviors in persons living with dementia. The Alzheimer’s Disease and Dementia Care Seminar is a National Council of Certified Dementia Practioners (NCCDP) curriculum and will provide fundamental education on dementia care to enhance the quality of life of those living with cognitive dysfunction and their caregivers. In addition, this course will provide participants with approaches for daily activities, unmet needs, behavioral care, and interdisciplinary support.
REGISTRATION is LIMITED. No Refunds will be given, however substitutions can be made.