Category: Nursing Home Administrators

Missouri DHSS Urges Continued Vaccination as Close Monitoring of Delta Variant Continues

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Missouri is experiencing a rise in individuals contracting the Delta variant (B.1.617.2, first detected in India) of the virus that causes COVID-19, SARS-CoV-2. It was announced by the Centers of Disease Control and Prevention yesterday that the Delta variant has been reclassified as a “variant of concern” in the United States. The Missouri Department of Health and Senior Services (DHSS) has been closely monitoring these developments and has been on the national leading edge of aggressive wastewater testing for variants of concern.

The Delta variant joins the B.1.1.7 (Alpha), B.1.351 (Beta), P.1 (Gamma), B.1.427/B.1.429 (Epsilon) variants circulating in the United States which are already classified as variants of concern.

Deemed highly transmissible, the Delta virus has been already detected in over 70 countries of the world, and is projected to become dominant worldwide. It is also causing more serious illness and hospitalizations among those who have not been vaccinated.

Monitoring the spread of emerging variants in the United States relies on widespread, rapid sequencing. While this national effort is still somewhat limited, it is clear that the variant has become prevalent in communities throughout Missouri. In February, the Missouri Department of Health and Senior Services (DHSS) began testing wastewater samples to look for the presence of these variants. These testing results are displayed in a new layer of the COVID-19 sewershed surveillance StoryMap.

The unpredictability of emerging variants is cause for continuation of infection prevention precautions.

“Our greatest concern in Missouri is areas with lower vaccine uptake,” said Robert Knodell, Acting Director of the Missouri Department of Health and Senior Services (DHSS). “With this variant being easier to spread and possibly causing more severe illnesses among unvaccinated people of all ages, vaccinations are the best way to stop this virus in its tracks.”

This recent rise of the highly transmissible Delta variant underscores the importance of continued testing for COVID-19 of all those with related symptoms, as well as those who have been exposed to the virus but may not have symptoms.

Social distancing and appropriate masking remain important and effective public health countermeasures. Vaccination is the most effective and long-lasting tool for protection from this infection. DHSS continues to encourage anyone age 12 and up to get vaccinated against COVID-19. Get the facts about COVID-19 vaccines and where to get vaccinated at MOStopsCovid.com.

Proposed Changes to the CNA Rules

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The Health Education Unit is excited to announce our new changes to the CNA Rules – COMING SOON!

Along with the new implementation of the new CNA testing process, our rules are being updated and include proposed changes to the curriculum, reciprocity for out of state CNA’s coming to work in Missouri, and the requirement for our instructors to attend a four-hour update training every five years, as well as several others.

We invite you to attend one of our Q and A sessions to learn more about these changes. Our third party test administrator, Headmaster, will also join and be available to answer questions. Please access our website at https://health.mo.gov/safety/cnaregistry/ for log in information.

The scheduled dates and times are listed below:

June 16, 2021: DHSS/D & SDT Headmaster Q & A Webex Meeting
Time: 12:00 p.m.
Meeting number (access code): 177 675 4909 Meeting password: urUBZCPC265

Join from a video system or application
Dial 1776754909@stateofmo.webex.com
You can also dial 173.243.2.68 and enter your meeting number. Tap to join from a mobile device (attendees only)
+1-650-479-3207, 1776754909## Call-in toll number (US/Canada)
+1-312-535-8110, 1776754909## United States Toll (Chicago)

Join by phone
1-650-479-3207 Call-in toll number (US/Canada)
+1-312-535-8110 United States Toll (Chicago)
Global call-in numbers

June 22, 2021: DHSS/D & SDT Headmaster Q & A Webex Meeting
Time: 3:30 p.m.
Meeting number (access code): 177 961 7383 Meeting password: VHvmrBY3Z83

Join from a video system or application
Dial 1779617383@stateofmo.webex.com
You can also dial 173.243.2.68 and enter your meeting number. Tap to join from a mobile device (attendees only)
+1-650-479-3207, 1779617383## Call-in toll number (US/Canada)
+1-312-535-8110, 1779617383## United States Toll (Chicago)

Join by phone
1-650-479-3207 Call-in toll number (US/Canada)
+1-312-535-8110 United States Toll (Chicago)
Global call-in numbers

June 30, 2021: DHSS/D & SDT Headmaster Q & A Webex Meeting
Time: 10:00 a.m.
Meeting number (access code): 177 278 8445 Meeting password: 3fdQsTPs8X2

Join from a video system or application
Dial 1772788445@stateofmo.webex.com
You can also dial 173.243.2.68 and enter your meeting number. Tap to join from a mobile device (attendees only)
+1-650-479-3207, 1772788445## Call-in toll number (US/Canada)
+1-312-535-8110, 1772788445## United States Toll (Chicago)

Join by phone
1-650-479-3207 Call-in toll number (US/Canada)
+1-312-535-8110 United States Toll (Chicago)
Global call-in numbers

DHSS teams up with Missouri Developmental Disabilities Council to launch COVID-19 plain language guide for the disability community

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The Missouri Department of Health and Senior Services (DHSS) along with the Missouri Developmental Disabilities Council released a new resource, the “Missouri Plain Language Guide for People with Disabilities, their Families and Caregivers,” on COVID-19 and the vaccine.

Through this partnership, the new guide will ensure that important information related to COVID-19 and vaccine access is more accessible to people with intellectual and developmental disabilities, and others with disabilities affecting reading, comprehension and other cognitive functions.

“After reading this new Missouri Plain Language Guide, I was very impressed with two very important things: 1) the amount of important and vitally necessary information that it contains; and 2) how plain and understandable the format is, that was used to present it, without diluting any of the valuable information that it conveys to the reader. I believe that this will prove to be a very valuable tool for persons with disabilities and many others,” said Cathy Enfield, Chairperson and Self-Advocate, Missouri Developmental Disabilities Council.

“There is so much information available about COVID-19 and vaccines, that it could be hard to navigate through the information. We value the collaboration with DHSS, to provide accurate information in a plain language format that is accessible to so many who experience disabilities. We look forward to continuing this important work to ensure the disability community has information to make decisions about their health,” said Vicky Davidson, Executive Director, Missouri Developmental Disabilities Council.

People with disabilities, their family members and caregivers have been eligible to receive the COVID-19 vaccine in the earliest phases of Missouri’s vaccine rollout. Currently, any Missourian age 12 and older is eligible to receive the COVID-19 vaccine. Since the beginning of 2021, DHSS and the Missouri Advisory Committee on Equitable COVID-19 Vaccine Distribution have been focused on deploying new strategies and resources to meet the disability community where they are – this new guide is a resource to support Missouri’s disability community and those individuals, family members and caregivers who support them.

“Since day one at DHSS, our goal has been to ensure Missouri’s most vulnerable, people with disabilities and those who support them (i.e., their families, caregivers and disability service providers) were at the front of the line to receive the free vaccine throughout our vaccine roll-out process. Throughout the year, we have also been working to deploy new strategies and resources to meet the disability community where they are. Our new plain language guide is an additional resource for Missourians with disabilities and those who support them,” said Sara Hart Weir, co-chair of the Missouri Advisory Committee on Equitable COVID-19 Vaccine Distribution.

Enfield added, “We simply need information to be supplied in a clear, plain and understandable way. As Chair of the Missouri Developmental Disabilities Council, I am proud of the work that our members and staff did on the document. I applaud their efforts and the efforts of all those who were involved.”

If you or someone you know is unable to visit a COVID-19 vaccination clinic without assistance, please call the COVID-19 Hotline at 877-435-8411 and press option 4 to be routed directly to your local Area Agency on Aging to make a vaccine appointment. You can also register individuals for the vaccine by visiting Missouri’s COVID-19 website, MOStopsCovid.com. COVID-19 Hotline hours of operation are Monday-Friday 7:30 a.m.-5:30 p.m. and Saturday 8 a.m.-2 p.m. (Hotline is open on Saturdays through until June 11.) Individuals are encouraged to call soon to ensure their names are added to the list.

Conversations with Carmen

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June 18, 2021: A Beautiful Day in the Neighborhood
Guest: LaVrene Norton, Action Pact Founder, Executive Leader/CEO

Need help getting everyone out of the doldrums of COVID? Let free the spirit of joy and love – work together to bring back the simple pleasures of home. Create team on the fly. Let music and laughter rock the halls. Wave!

Think Neighborhood. Have a block party.

We begin again with a short presentation on the Artifacts of Culture Change as they can offer us a measurable road map. We will then head down the path to Neighborhood where culture change begins. Where good neighbors work together to enjoy and share the simple pleasures of daily life.

MALA Train the Trainer

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July 7, 2021: 2021 Train the Trainer
September 8, 2021: 2021 Train the Trainer
November 3, 2021: 2021 Train the Trainer

Participants must receive approval in order to attend this workshop. Those wishing to attend must submit the application and necessary paperwork to MALA at least five days prior to the workshop date.

Upon MALA’s review of your application, you will receive an approval/confirmation or denial letter via email.

MALA ALF Assessment Training

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July 26-28, 2021: 2021 ALF Assessment Training

As required by 198.005 RSMo and 19 CSR 30-86.047, residents of Assisted Living Facilities are required to undergo a community based assessment performed by an appropriately trained and qualified individual. This individual must complete a DHSS approved 24-hour training program prior to performing resident assessments. The MALA ALF Assessment Training satisfies this regulatory requirement.

BinaxNOW Recoupment – Ending Friday June 11th

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DHSS will cease recoupment of excess Abbott BinaxNOW cards effective Friday, June 11 – meaning any recoupment requests must be received by 5:00 p.m. on Friday, June 11 in order to be sent a mailing label. As before, we will only accept unopened boxes and box lots that have at least 30 days or more to expiration, please refer to the most recent extension expiry letter from Abbott. After that date, the recoupment form will be removed from the DHSS website.

If your facility has an excess of Abbott BinaxNow Cards, which you are unable to use prior to them expiring, please provide your information on the recoupment form link: https://mophep.maps.arcgis.com/apps/opsdashboard/index.html#/1913bb3c639843c49b74350a4652d750.

SEMA will send you UPS shipping labels and the tests will be sent to the state warehouse for redistribution- so they do not expire before they can be used.

Please note the following:

  • Unless you have specifically ordered the tests from DHSS via an online ordering portal- the tests you are returning were from FEDERAL.
  • SEMA is unable to accept tests that are 30 days or less until expiration date (this can be within the new expiry date). With less than 30 days, they are unable to recoup and redistribute those tests to another user in a timeframe that allows the new user time to incorporate into their testing regimen.
  • Abbott’s guidance for unused kits is that all components of this kit should be discarded as Biohazard waste.

CANCELLING DIRECT SHIPMENTS

  • If there are facilities in your state receiving direct allocations of Abbott Binax NOW that would like to cancel those allocations, please submit the cancellation request to ARDxUSGovernmentSupport@abbott.com. Note: this is a cancellation not a pause. Pausing allocations is not an option. Once received allocations can be transferred to other facilities within the state.

Wanted: COVID-19 Vaccine Champions

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The sooner we’re all vaccinated for COVID-19, the safer we’ll all be. And that is especially true for point of care staff. That’s why the Health Quality Innovation Network (HQIN), in collaboration with the Missouri Nursing Home Advisory Council, is seeking brief statements from the frontline – why your staff members chose to be vaccinated.

Peer-to-peer encouragement can boost vaccine confidence as well as vaccination rates.

Would any of your team members be willing to share their vaccination “story?” All it takes is completing a brief online form and uploading a photo, which could be a selfie, the staff member being vaccinated, or even an image to depict the reason they got vaccinated such as to keep their loved ones and residents healthy.

To participate, simply share the COVID-19 Vaccine Experience Consent form with staff or complete it for them (with their consent).

The collection of powerful impact statements will be developed into posters and social media posts so that we can spread the word, rather than the virus.

Questions? Email HQI.

SLCR Life Safety Code Information Series

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The Section for Long-Term Care Regulation will be releasing a series of Life Safety Code Information. You may also view the entire Life Safety Code document for reference.

Today’s subject is:

Can residents have a microwave in their room?

K324 – Cooking is not allowed in resident rooms. NFPA 19.3.2.5.3 and 19.3.2.5.4
K925 – Cooking appliances cannot be within 15 feet of an area of administration in a resident room.

NFPA 101, 2012 edition:
18/19.3.2.5.2* Where residential cooking equipment is used for food warming or limited cooking, the equipment shall not be required to be protected in accordance with 9.2.3, and the presence of the equipment shall not require the area to be protected as a hazardous area.
18/19.3.2.5.4* Within a smoke compartment, residential or commercial cooking equipment that is used to prepare meals for 30 or fewer persons shall be permitted, provided that the cooking facility complies with all of the following conditions:

(1) The space containing the cooking equipment is not a sleeping room.
(2) The space containing the cooking equipment shall be separated from the corridor by partitions complying with 19.3.6.2 through 19.3.6.5.
(3) The requirements of 19.3.2.5.3(1) through (10) and (13) are met.

Monthly Infection Control and Prevention Webinar Series: What you need to know to keep you, your patients and community safe.

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June 2021 -December 2022 – 2nd Tuesday of each month from 12-1 p.m.: ICP Monthly Webinar Series

June 10 – Inaugural Webinar: Vaccines are Safe – How we know!
Lynelle Phillips, MPH, RN, Assistant Teaching Professor, Department of Public Health, School of Health Professions, Extension Service Nurse Specialist, University of Missouri, Columbia

  • General rules of vaccines
  • FDA approval process and Emergency Use Authorization Use (EUA) process
  • How were we able to get a vaccine to market in such a short time and still cut no corners?
  • Compare the different vaccines – safety and efficacy
  • Is the lesser protection by J&J significant enough to be important? J&J Case Study.

 

July 8 – How do COVID vaccines affect immunity to COVID?
Taylor Nelson, DO, Infectious Disease, Internal Medicine, University of Missouri Health Care, Columbia. Board Certified by the American Board of Internal Medicine/Infectious Disease

  • Natural immunity vs vaccine-induced immunity – which is best?
  • How long does the vaccine protect me?
  • What is Herd immunity and is it reasonable to expect we will ever achieve it?
  • If I’ve had COVID, why get vaccinated?
  • To boost or not to boost?
  • I’m young, isn’t it less risky to take chance with COVID than the vaccine?

 

August 10 – Environmental Health: Air Purification and Quality
Loie Couch, RN, BS, CIC, FAPIC, Infection Prevention Specialist, Barnes Jewish Christian (BJC) Hospital, St. Louis

  • Functions of a ventilation system
  • Benefits and limitations of bi-polar ionization
  • Minimum filtration requirements
  • Apply filtration flexibility on a space-by-space approach
  • Appropriate use of UV light disinfection and accompanying hazards
  • Visible light disinfection and its appropriate use and considerations

2021 Missouri Suicide Prevention Conference

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July 28, 2021: Missouri Suicide Prevention Conference

The Missouri Suicide Prevention Network invites you to join us for our annual conference!

This year’s conference is brought to you by the Missouri Department of Mental Health, Missouri Behavioral Health Council and Community Counseling Center.

Visit us online at www.mospn.org/conference.

The virtual conference will be free of charge, unless you are needing continuing education. Continuing Education (CE) will be $10 per person.

The Missouri Behavioral Health Council has approved this program for up to 6.3 behavioral health continuing education contact hours. MBHC will be responsible for this program and maintain a record of your continuing education hours earned. See agenda for session breakdown.

Continuing Medical Education (CME) is currently pending approval for select sessions. See agenda for those eligible sessions.

Missouri partnerships ensure access to COVID-19 vaccines for homebound residents

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The Missouri Department of Health and Senior Services (DHSS) announced a partnership between the Area Agencies on Aging, local public health agencies, and Emergency Medical Services (EMS) to ensure homebound adults have a streamlined and accessible vaccination experience across the state. Understanding that various communities have already developed a plan for vaccinating homebound individuals in their area, the partnerships established by the State are to merely supplement and allow these efforts to continue at the local level.

COVID-19 vaccination of homebound persons presents unique challenges to ensure the appropriate vaccine storage, temperatures, handling, and administration to ensure safe and effective vaccination.  Both CDC and CMS define homebound persons as those that need the help of another person or medical equipment such as crutches, a walker, or a wheelchair to leave their home, or their medical provider believes that their health or illness could get worse if they leave their home, and they typically do not leave their home. 

The homebound referral process begins with the Area Agencies on Aging who are experts in discerning homebound status. Adults who are homebound and want to be vaccinated in their home can register through their local Area Agency on Aging or through the Missouri Vaccine Navigator registry by indicating they are homebound. Individuals reaching out to the State COVID-19 Hotline seeking vaccination for a homebound individual will be directed to their local Area Agency on Aging.  The homebound individual, their caregiver, family member, or healthcare provider can make the referral. 

The Area Agency on Aging makes contact with the homebound individual to obtain consent and gather the pertinent information to coordinate the vaccination in their home.  In some cases, caregivers and other household members may also be vaccinated at the same time as the homebound individual to prevent vaccine wastage. The Area Agency on Aging turns over the list of registered homebound individuals to their local public health agency or EMS provider who then schedules the in-home appointments. The AAA may also provide the homebound individual with courtesy appointment reminders via phone as many do not have internet or email access. 

The City of St. Louis Department of Health teamed up with the St. Louis Fire Department, Team Rubicon and the St. Louis City Area Agency on Aging to provide their homebound residents COVID-19 vaccination opportunity.

“This program will provide much-needed protection against COVID-19 for clients who may find it difficult to visit a vaccine clinic,” says Dr. Fredrick Echols, Acting Director of Health for the City of St. Louis. “By bringing the vaccine to them, we remove the barrier of travel and ensure these clients are not left behind in the vaccination process.”

[View Photo]  James Thompson, EMS Supervisor, and Mary Sullivan with Team Rubicon vaccinate a homebound resident of St. Louis City.

Kansas City’s homebound vaccination strategy involves a partnership between the Mid-America Region Council (MARC) Area Agency on Aging, the local health departments of Cass, Clay and Platte Counties and Kansas City, as well as multiple EMS and fire districts.

Chief Chip Portz of Central Jackson County Fire District said, “By partnering with our local health department and by taking advantage of reimbursement opportunities, the Central Jackson County Fire Protection District is able to provide this vital community service to a very vulnerable population without using emergency crews who would normally be protecting the rest of our citizens. We use off-duty paramedics in a non-emergency role to ensure our emergency response capacity is not diminished or compromised.”

[View Photo]  Central Jackson County Fire District, Captain Paramedic, Nathan Manley is providing vaccination to a homebound resident.

Lee’s Summit Assistant Fire Chief, Dan Manley, who has been instrumental in regional emergency planning, arranged a vaccine event for MARC Aging and Adult Services staff as well as their community partner who is delivering meals to self-isolating congregate and homebound older adults during COVID.

“Having our staff and volunteers vaccinated protects our most vulnerable homebound residents that we serve,” said Manley.

If you or someone you know is homebound or unable to visit a COVID-19 vaccination clinic without assistance, please call the COVID-19 Hotline at 877-435-8411 and press option 4 to be routed directly to your local Area Agency on Aging to make a vaccine appointment. You can also register homebound individuals for the vaccine by visiting Missouri’s COVID-19 website, MOStopsCovid.com. COVID-19 Hotline hours of operation are Monday-Friday 7:30 a.m.-5:30 p.m. and Saturday 8 a.m.-2 p.m. Individuals are encouraged to call soon to ensure their names are added to the list.  

News Release: State adds five additional language options to Missouri Vaccine Navigator

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The Missouri Department of Health and Senior Services (DHSS) has launched the Missouri Vaccine Navigator in five additional languages for non-English speaking individuals. Already available in English and Spanish, Vaccine Navigator now also allows individuals to register and find vaccination appointments throughout Missouri in Chinese, French, Korean, Portuguese and Russian.

All individuals over the age of 12 are now eligible to get a COVID-19 vaccine in Missouri, regardless of their citizenship. (Pfizer is the only vaccine authorized for those ages 12-17).

Approximately 775,000 individuals are currently registered in Missouri Vaccine Navigator, which is powered by Qualtrics. The system allows individuals to register and schedule an appointment for a COVID-19 vaccine by viewing vaccination events throughout the state.

In addition to helping individuals register for a vaccine, the Missouri Vaccine Navigator will remind registrants when it is time to schedule their second dose. Two of the vaccines currently authorized for use (Pfizer and Moderna) require two doses, and the second dose is critical to ensure individual and community protection.

The Missouri Vaccine Navigator also integrates with ShowMeVax, the state’s immunization database for providers. Vaccination events using the Missouri Vaccine Navigator for scheduling enables  coordinators to quickly load vaccination administration data into the system and avoid cumbersome data entry.

Once an individual is registered with Missouri Vaccine Navigator, the scheduling platform becomes available and can be accessed as often as needed or until vaccination is achieved.

Those with online accessibility issues are encouraged to call the COVID-19 hotline at 877-435-8411 for registration assistance. Language translation and other services are available to callers.

COVID-19 vaccines are completely free for everyone in the U.S. Get the facts at  MOStopsCovid.com.

SLCR Life Safety Code Information Series

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The Section for Long-Term Care Regulation will be releasing a series of Life Safety Code Information. You may also view the entire Life Safety Code document for reference.

Today’s subject is:

What if a sprinkler head gets paint on it or has corrosion?

No one can successfully remove paint or corrosion from a sprinkler head and the facility must replace those sprinkler heads. There is currently not any UL listed paint remover.

NFPA 25, 2011 edition:
5.2.1.1 Sprinklers shall be inspected from the floor level annually.
5.2.1.1.1 Sprinklers shall not show signs of leakage; shall be free of corrosion, foreign materials, paint, and physical damage; and shall be installed in the correct orientation (e.g., upright, pendent, or sidewall).
5.2.1.1.2 Any sprinkler that shows signs of any of the following shall be replaced:

(1) Leakage
(2) Corrosion
(3) Physical damage
(4) Loss of fluid in the glass bulb heat responsive element
(5) Loading
(6) Painting unless painted by the sprinkler manufacturer

5.2.1.1.3 Any sprinkler that has been installed in the incorrect orientation shall be replaced.
5.2.1.1.4 Any sprinkler shall be replaced that has signs of leakage; is painted, other than by the sprinkler manufacturer, corroded, damaged, or loaded; or is in the improper orientation.
5.2.1.1.5 Glass bulb sprinklers shall be replaced if the bulbs have emptied.

Provider Feedback Survey

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The Section for Long-Term Care Regulation is again seeking input from providers we serve. We are asking for your help in identifying areas in our Section where excellent customer service is provided and areas where we need to focus on improving our customer service experience.

Please take a couple minutes to complete our 2021 Provider Feedback Survey by June 30, 2021 at https://www.surveymonkey.com/r/CFY7N9T.

SLCR Life Safety Code Information Series

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The Section for Long-Term Care Regulation will be releasing a series of Life Safety Code Information. You may also view the entire Life Safety Code document for reference.

Today’s subject is:

How often does the facility need to ensure the generator transfers power within 10 seconds?

  1. What information is required for the documentation?
  2. Does it have to be under load?

The facility staff must document a transfer within ten seconds at least annually. This documentation must include all legs with the amperage under load. The load test must last at least 30 minutes, which is in addition to (warm up is not allowed) cool down times. This is not a load bank test, which is available only for diesel generators who cannot meet at least 30% of load.

NFPA 110, 2010 edition:
4.3 Type. The type defines the maximum time, in seconds, that the EPSS will permit the load terminals of the transfer switch to be without acceptable electrical power. Table 4.1(b) provides the types defined by this standard.

New QIPMO Newsletter – May 2021

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The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls – Volume 8, Issue 3.

In this issue:

  • Embracing Diversity in Our Homes
  • Can You See the Light??
  • Just for You: QIPMO Infection Control Manual
  • No-Nose Gang
  • OSHA in tha’ House!
  • Maintaining Life Safety Code Compliance
  • Person-Centered Activities

Please visit QIPMO’s website here for this and other previous newsletters.

Cream of the Crop Webinars

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CE Available for Nurses, Social Workers, Nursing Home Administrators, and pharmacotherapeutics (RX)
We hand selected 12 of our most popular webinars from 2020.
https://web.cvent.com/event/dcf77498-045c-48e7-aa2a-d17a5cd8aa09/summary

Sessions for NHA CE:

Age Friendly Health Systems
John Morley, MD, Professor Geriatrics, St. Louis University Medical School
This session will address recognizing and managing geriatric syndromes. The 4M framework will be included to ascertain specific health outcome goals and care preferences.

Preserving Integrity in Turbulent Times
Cynda Ruston, PhD, RN, FAAN, Anne & George L. Bunting Professor of Clinical Ethics, German Institute of Bioethics/School of Nursing, Professor of Nursing & Pediatrics, John Hopkins University
Listen to a recognized and international leader in nursing ethics, from John Hopkins University. This session will focus on selected sources of moral suffering, consequences of moral suffering, and offers a pathway of moral resilience by restoring integrity.

Medication Considerations in the Elderly During the COVID-Pandemic
Curt Wood, R.PD., BCGP, FASP, Elder Care Pharmacy Consultant, LLC
Medication usage is even more critical in a pandemic as many long-term care communities are experiencing outbreaks of the virus. Ideas on gradual dose reduction and managing chronic diseases will be discussed.

Resiliency: Using Gratitude to Thrive Through Adversity
T.J. Sweet, MHA, Practice Manager, Ellis Administration, University of Missouri Hospital, Columbia
Learn how to use strategies to validate feelings and practical ways to support colleagues when exposed to high stress levels in uncertain times. Learn to thrive despite adversity and maintain a resilient mindset using gratitude.

Reducing Meds – The When, What and How to Minimize Adverse Outcomes
Craig Sever, BS, R.Ph., Clinical Coordinator Eversprings Pharmacy, St. Louis, Missouri
The speaker will provide insight on how to pharmacologically assess the most reducible meds and develop an appropriate reduction strategy for older adults.

Leadership Development Academy for LTC Leaders

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Join us for the MU Leadership Development Academy for Nurse Leaders and Nursing Home Administrators in Long-term Care. We know that Long-term Care can be challenging. With an 11 year proven track record, hundreds of graduates and life-changing testimonials, this leadership course is designed for busy LTC professionals, all while earning 50 hours of CE credit.

The academy has been proven to increase leadership skills and improve confidence, which will help to create a working environment that encourages teamwork and quality improvement.

NO COST for RNs and NHAs from Skilled Nursing Facilities in Missouri (excludes Veterans Administration facilities).
The complimentary option is available to Missouri SNFs since the support for this academy is provided by CMP funds designated for Missouri SNFs.

More Information: https://extension.missouri.edu/programs/nursing-outreach/enhanced-leadership-development-academy.

COVID-19 Testing and other Necessary COVID-19 Related Invoices – Important Update: Please Read!

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ALFs, ICFs, and RCFs that have billed for “other” costs as of 5/3/2021 may continue to submit “other” necessary COVID-19 related invoices through June 30, 2021. All “other” invoices (as of 5/3/2021) submitted by ICFs, ALFs, and RCFs must include a new signed addendum.

SNFs may continue to bill for “other” necessary COVID-19 related invoices through June 30, 2021.

All Long-Term Care facilities (SNFs, ICFs, ALFs, and RCFs) may continue to submit testing invoices until further notice.

Due to time constraints, please do not wait until the last minute to submit these invoices.

The web portal can be found here: https://apps.dss.mo.gov/LongTermCareCovid19Invoices/

CMS Memo QSO-21-19-NH: Interim Final Rule – COVID-19 Vaccine Immunization Requirements for Residents and Staff

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Interim Final Rule – COVID-19 Vaccine Immunization Requirements for Residents and Staff

CMS has issued QSO-21-19-NH, which outlines the Interim Final Rule – COVID-19 Vaccine Immunization Requirements for Residents and Staff. This rule establishes Long-Term Care (LTC) Facility Vaccine Immunization Requirements for Residents and Staff. This includes new requirements for educating residents or resident representatives and staff regarding the benefits and potential side effects associated with the COVID-19 vaccine, and offering the vaccine. Furthermore, LTC facilities must report COVID-19 vaccine and therapeutics treatment information to the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN). Please read through the memo carefully for facility actions and effective dates.

See the memo or visit https://www.cms.gov/files/document/qso-21-19-nh.pdf for complete details.

CMS Social Media Campaign – Community Champions

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On May 5, 2021, as a part of CMS’ ongoing COVID response efforts to support the long term care community, CMS debuted their first social media video highlighting staff, also referred to as Community Champions, who moved from being initially uncertain about receiving the COVID-19 vaccine to accepting the vaccine – and encouraging their peers to do the same.

Throughout the COVID-19 pandemic, staff in nursing homes have been providing ongoing care to our nation’s most vulnerable. This social media campaign is intended to help increase vaccine acceptance amongst long-term care staff.

SLCR Life Safety Code Information Series

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The Section for Long-Term Care Regulation will be releasing a series of Life Safety Code Information. You may also view the entire Life Safety Code document for reference.

Today’s subject is:

           What kind of documentation should a facility provide to the surveyor when on a fire watch?

Most facilities have one fire watch policy. If a facility has one policy, then the policy must have all the items in Chapter 15 within NFPA 25, 2011 edition. If the facility has two separate policies, the sprinkler system fire watch policy is required to include all the items in Chapter 15.

NFPA 25, 2011 edition:
Minimum Requirements
15.1.1.1 This chapter shall provide the minimum requirements for a water-based fire protection system impairment program.
15.1.1.2 Measures shall be taken during the impairment to ensure that increased risks are minimized and the duration of the impairment is limited.
Impairment Coordinator
15.2.1 The property owner or designated representative shall assign an impairment coordinator to comply with the requirements of this chapter.
15.2.2 In the absence of a specific designee, the property owner or designated representative shall be considered the impairment coordinator.
Tag Impairment System
15.3.1 A tag shall be used to indicate that a system, or part thereof, has been removed from service.
15.3.2 The tag shall be posted at each fire department connection and the system control valve, and other locations required by the authority having jurisdiction, indicating which system, or part thereof, has been removed from service.
Impaired Equipment
15.4.1 The impaired equipment shall be considered to be the water-based fire protection system, or part thereof, that is removed from service.
15.4.2 The impaired equipment shall include, but shall not be limited to, the following: Sprinkler systems, Standpipe systems, Fire hose systems, Underground fire service mains, Fire pumps, Water storage tanks, Water spray fixed systems, Foam-water systems, Fire service control valves
Preplanned Impairment Programs
15.5.1 All preplanned impairments shall be authorized by the impairment coordinator.
15.5.2 Before authorization is given, the impairment coordinator shall be responsible for verifying that the following procedures have been implemented:

(1) The extent and expected duration of the impairment have been determined.
(2) The areas or buildings involved have been inspected and the increased risks determined.
(3) Recommendations have been submitted to management or the property owner or designated representative.
(4) Where a required fire protection system is out of service for more than 10 hours in a 24-hour period, the impairment coordinator shall arrange for one of the following:

(a) Evacuation of the building or portion of the building affected by the system out of service
(b) An approved fire watch
(c) Establishment of a temporary water supply
(d) Establishment and implementation of an approved program to eliminate potential ignition sources and limit the amount of fuel available to the fire

(5) The fire department has been notified.
(6) The insurance carrier, the alarm company, property owner or designated representative, and other authorities having jurisdiction have been notified.
(7) The supervisors in the areas to be affected have been notified.
(8) A tag impairment system has been implemented. (See Section 15.3.)
(9) All necessary tools and materials have been assembled on the impairment site.

Emergency Impairments
15.6.1 Emergency impairments shall include, but are not limited to, system leakage, interruption of water supply, frozen or ruptured piping, and equipment failure.
15.6.2 When emergency impairments occur, emergency action shall be taken to minimize potential injury and damage.
15.6.3 The coordinator shall implement the steps outlined in Section 15.5.
15.7 Restoring Systems to Service
When all impaired equipment is restored to normal working order, the impairment coordinator shall verify that the following procedures have been implemented:

(1) Any necessary inspections and tests have been conducted to verify that affected systems are operational. The appropriate chapter of this standard shall be consulted for guidance on the type of inspection and test required.
(2) Supervisors have been advised that protection is restored.
(3) The fire department has been advised that protection is restored.
(4) The property owner or designated representative, insurance carrier, alarm company, and other authorities having jurisdiction have been advised that protection is restored.
(5) The impairment tag has been removed.

The Resident Advocate Newsletter – May 2021

Posted on

The May 2021 Resident Advocate is now available.

The Resident Advocate provides:

  • Information on residents’ rights and care issues
  • News and updates on national policy
  • Self-advocacy tips for obtaining person-centered, quality care

This issue includes updates on the coronavirus disease (COVID-19) and suggestions for staying engaged and advocating for yourself to continue to receive the care you deserve. This issue also features an article on COVID-19 prevention tips and ideas to stay connected with friends and family during isolation.

This newsletter is a great resource to share with long-term care residents. Nursing home staff, long-term care Ombudsman programs, family members, and other advocates are encouraged to forward this newsletter to residents or print and share copies with residents. Download this issue or past issues from this webpage.