Category: Nursing Home Administrators

Conversations with Carmen

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November 15, 2019: Shedding Light on Dementia for Family, Friends and Care Givers
Guests: Linda Bump, MPH, RLD

Continuing the conversation on how we can stay in relationship, even when we must “give care” as a family member, friend or caregiver.

In this show, we’ll discuss approaches to support daily activities from self-care, to eating, to pursuing leisure.

In our last conversation, we detailed the five human needs of comfort, identity, inclusion, attachment and occupation. This show will have a special focus on the human need of occupation and will discuss specific ways and techniques to help persons living with dementia continue as much of their normal, daily occupation as possible.

Pioneer Network’s Hot Topics: Culture Change in Action

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November 21, 2019: Creating Daily Pleasures in Outdoor Spaces: Making It Happen in All Seasons
Guide: Maggie Calkins, PhD, EDAC, Ideas Institute

Panelists: Betsy Miller, Director of Resident Services & Hilary Boucher, Life Enrichment Manager, White Horse Village, Newtown Square, PA and Barbra Hileman, Activity Director, Garvey Manor & Our Lady of the Alleghenies Residence, Hollidaysburg, PA

For you and me, spending time outdoors is a normal part of life, and something we miss when weather and circumstances keep us indoors for extended periods of time. But for residents living in nursing homes and assisted living communities, and even for elders living in their own homes, opportunities to enjoy outdoor living are often rare, even in ideal weather, but certainly when conditions are less than ideal due to cold, heat, snow or rain.

In this webinar, Maggie Calkins, will share WHY being able to enjoy time outdoors is important and HOW caregivers and families can support making it happen. She will discuss the health benefits of spending time outdoors in terms of stress, mood, concentration, sleep and more. She will also explore the differences in designing for active and passive use of outdoor spaces and share creative ideas for non-traditional outdoor elements, from green houses to hydroponic gardening to fishing, golfing and yerts.

And then team members from two Communities will share stories of how they are making it happen, how outdoor living is a part of life for the residents in their homes.

Pioneer Network’s Hot Topics: Culture Change in Action  (Free Webinar)

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December 19, 2019: This Holiday Season, Give the Gift that Keeps Giving
Guide: Brian LeBlanc, Marketing and Public Relations Executive

Join us for a conversation about how to make the holidays the best they can be not only for persons living with dementia, but for their Care Partners and for each of us.

Brian will share his thoughts on things like: what are some of the most meaningful gifts you can give; how can holiday traditions have a positive effect on individuals; and what are well-intentioned things that people do during the holidays that add to the stigmatization created around elders and those living with dementia.

SNF QRP Threshold Noncompliance Messages

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CORMAC used to send out informational messages to SNFs that were not meeting the SNF QRP APU threshold on a quarterly basis ahead of each submission deadline. Swingtech will now send out these messages. If SNFs signed up for these messages with CORMAC they do not need to sign up again, but anybody who newly signs up for these messages will need to send their request to QRPHelp@singtech.com and must include email addresses they wanted these messages to go to along with the facility name and CMS Certification Number (CCN).

Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Deadline

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The submission deadline for the SNF Quality Reporting Programs (QRP) is approaching. MDS data for April 1 – June 30 (Q2) of calendar year (CY) 2019 are due with this submission deadline. All data must be submitted no later than 11:59 p.m. Pacific Standard Time on November 18, 2019.

As a reminder, it is recommended that providers run applicable CASPER reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.

Swingtech sends informational messages to IRFs, LTCHs, and 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.

Payroll-Based Journal (PBJ) Deadline

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The submission deadline for PBJ is approaching. PBJ data for 7/1/19 through 9/30/19 is due on November 14, 2019. CMS uses PBJ data to determine each facility’s staffing measure on the Nursing Home Compare tool on Medicare.gov website, and calculate the staffing rating used in the Nursing Home Five Star Quality Rating System. Once a facility uploads their data file, they need to check their final Validation Report, which can be accessed in the Certification and Survey Provider Enhanced Reporting (CASPER) folder, to verify that the data was successfully submitted. CMS also strongly recommends that nursing homes run the following CASPER reports to review the accuracy and completeness of the data that they have entered: 1700D Employee Report, 1702D Individual Daily Staffing Report, and/or 1702S Staffing Summary Report. In addition, facilities should be running the MDS Census reports that are also available in CASPER to verify that their census is accurate.

More information about PBJ can be found on the CMS webpage www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html.

CMS Memos Released

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CMS Memo: QSO-20-01-NH: Consumer Alerts added to the Nursing Home Compare website and the Five Star Quality Rating System

Memorandum Summary

  • Abuse Indicator – CMS is updating the Nursing Home Compare website to make it easier for consumers to identify facilities with instances of non-compliance related to abuse.
  • Consumer Alert for Oregon Nursing Homes – CMS will be adding a consumer alert on the Nursing Home Compare website for all Oregon facilities indicating that incidents of abuse may not be reflected on the Nursing Home Compare This action is in response to a recommendation by the Government Accountability Office (GAO).

 

CMS Memo: QSO-20-02-NH: Updates to the Nursing Home Compare website and the Five Star Quality Rating System

Memorandum Summary

  • CMS is removing the quality measures related to residents’ reported experience with pain from the Nursing Home Compare website and the Five Star Rating System.
  • We are also advising providers we will be updating the thresholds for quality measure ratings, according to the plan introduced in CMS Memorandum QSO-19-08-NH, in which the thresholds will be updated every six months. The first update will take place April 2020.
  • We are listing the dates the Nursing Home Compare website and the Five Star Rating System will be updated over the next few months.

 

In addition, the Technical User Guide has also been updated on the following website: www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/FSQRS.html.

MLN Workshops

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Practice Gratitude: Find Joy

October 16, 2019: Cape Girardeau
October 24, 2019: Columbia
October 29, 2019: Poplar Bluff
October 30, 2019: Kirksville

 

Awaken Customer Loyalty

October 22, 2019: Chillicothe
November 5, 2019: St. Louis
November 6, 2019: Columbia

 

Leadership: Eliminating Road Blocks on the Path to Success

October 29, 2019: Kansas City
November 12, 2019: Springfield
November 14, 2019: St. Louis

Updated PDPM DLL Package (V1.0003 FINAL) Available October 7, 2019

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A revision to the PDPM DLL Package (V1.0003 FINAL) was posted, and the previous version (V1.0002 FINAL) was removed. This version corrects four bugs that were identified after the V1.0002 release. The package contains updated test files and documentation.

QTSO Memo #2019-065 (dated October 4, 2019) contained information related to issues with version 1.0002 (FINAL) of the PDPM DLL Package, and noted that an updated version would be released today (Monday, October 7, 2019).

Version 1.0003 of the PDPM DLL package is now available on the CMS MDS Webpage at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIMDS30TechnicalInformation.html.

If you have any questions concerning this information, please do not contact the QTSO Help Desk:

SNF PDPM Assessments and Grouper Update

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CMS is aware of issues with the latest PDPM DLL Package (V1.0002 FINAL). We are targeting to release an updated version on Monday, October 7, 2019, which corrects the identified grouper discrepancies.  SNF providers should continue to follow the Resident Assessment Instrument (RAI) requirements which include, but are not limited to, establishing assessment reference dates for OBRA or PPS assessments that are required/scheduled, including the PDPM Transitional Interim Payment Assessments, assessing residents, and coding the applicable MDS assessments.  As per the RAI requirements, assessments should be completed within 14 days and recorded in Z0500. Late submission payment penalties do not apply under the SNF PPS.  We will work with providers to ensure that timely payments are made. We will continue to share updates as they become available. In the meantime, providers should not hesitate to contact us.  For questions regarding PDPM please send inquiries to pdpm@cms.hhs.gov  for information technology questions please send emails to MDSTechIssues@cms.hhs.gov.  Please contact your state Medicaid agency for questions related to the Other State Assessment (OSA) and Medicaid payment.

Public Comment Announcement for 82.030

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The following proposed rulemaking is published for public comment in the Missouri Register effective October 1, 2019:

  • 19 CSR 30-82.030 Assessment of Availability of Beds.

While this particular regulation set is being rescinded under the SLCR rules, facilities still have to comply with following Certificate of Need regulatory citations regarding the criteria and standards for assessment for the availability of beds:

  • 19 CSR 60-50.450
  • 197.318.1, RSMo.

This rule only outlined the procedures the SLCR was to follow when determining for the Missouri Health Facilities Review Committee whether or not a need existed in a particular locale for additional Medicaid certified beds. Additionally, the Certificate of Need Program (CON) has established its own regulations and procedures for the criteria in determining approval of long-term care beds in varying localities. Furthermore, the SLCR provides information to the CON program upon request.

Please see the Public Comment Notice for details.

Error Message 3616b on the MDS 3.0 NH Final Validation Report

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CMS posted the following information to their MDS 3.0 Technical Information webpage on 10/2/19:

  • A new version of RUG-IV has been applied to the MDS ASAP system. Effective Sunday, September 29, 2019, the ASAP will evaluate all RUG-IV HIPPS codes using version 1.04. This version is backward compatible and will evaluate assessments with all target dates before or after October 1, 2019. To avoid receiving the ASAP system warning message -3616b, please update the RUG-IV version number to “1.04” to submit your HIPPS code.

Optional State Assessment (OSA)

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There is a new item, A0300A Optional State Assessment, that asks “Is this assessment for state payment purposes only?” The State of Missouri is not a case mix state so we do not require the Optional State Assessment (OSA), however, there may be some HMOs or replacement plans which ask you to complete the OSA for payment purposes. You will not submit these OSA assessments to the QIES ASAP system. You must contact the specific HMO or replacement plan to find out what they require.

Interim Payment Assessment (IPA)

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The IPA is an optional PPS (Medicare Part A) assessment. However, the switch over from RUG-IV to PDPM requires a “transitional” IPA in order for SNFs to bill Medicare for days in October if the resident was admitted to the SNF for their Med A stay prior to 10/1/19 . To set up an IPA assessment, including the “transitional IPA”, you will need to do the following:

  • Code item A0300 Optional State Assessment “Is this assessment for state payment purposes only?” as “0. No”;
  • Code item A0310A Federal OBRA Reason for Assessment as “99. None of the above”;
  • Code item A0310B PPS Assessment as “08. IPA – Interim Payment Assessment”;
  • Code item A0310E “Is this assessment the first assessment (OBRA, scheduled PPS, or Discharge) since the most recent admission/entry or reentry?” as “0. No”;
  • Code item A0310F “Entry/discharge reporting” as “99. None of the above”.

MU Gerontology Clinical Update

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December 5-6, 2019: 30th Annual Gerontology Clinical Update
Location: Peachtree Catering and Banquet Center Ballroom, Columbia

This gerontology conference is two days of evidence-based and application-oriented educational programming built on current literature, suggestions from past participants and hot topics suggested by the conference planning committee. The topics for the conference were determined by experienced gerontology nurses from hospitals, LTC, rehabilitation, home and community health, as well as gerontology nursing faculty, a nursing home administrator, social worker and LTC facility surveyors. Every effort was made to translate the latest evidence into practical and useful knowledge for the gerontology professional.

Keynote Speakers
December 5, 2019: Martin J. Schreiber, Alzheimer’s Caregiver, Ambassador, Former Governor of Wisconsin
Keynote Address:  My Two Elaines

December 6, 2019: Gerda Saunders, PhD, Author, Salt Lake City, UT
Keynote Address: The Disappearing Self

October is Residents’ Rights Month

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Residents’ Rights Month is held during the month of October to celebrate and focus on awareness of dignity, respect, and the value of long-term care residents. This year’s theme is “Stand for Quality” – to emphasize the importance of standing for quality in all aspects of residents’ experiences – quality care, quality of life, quality of services, and quality choices.

Missouri’s Long-Term Care Ombudsman Program “Stands for Quality Care” for all residents of long-term care homes. Celebrate “Residents’ Rights Month” in October!

Conversations with Carmen

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October 18, 2019: Shedding Light on Dementia for Family, Friends and Care Givers – 2nd in series on creating a good life for persons living with dementia
Guests: Megan Hannan, MS and Linda Bump, MPH, RLD

How can we stay in relationship with the people we love who are now living with dementia?

Consider:

    • Listening and being present.
    • Appealing to strengths and abilities.
    • Experiencing even a small success.

These are things that help any of us have a better moment, hour or day, and often help persons living with dementia feel heard, included, competent and less isolated. That can be huge!

We invite staff, families and friends of persons living with dementia to join us for this “illuminating” conversation. We’ll discuss the five basic human needs: comfort, inclusion, identity, occupation and attachment, and how understanding those can help us be present and in relationship with persons living with dementia. We’ll also talk about simple communication techniques and approaches that have been shown to help ease agitation or confusion.

For this show, we encourage communities to invite family members and friends of your residents living with dementia, to join you for this webinar. Make it a party!

For those who support someone living at home with dementia, gather family and friends together for this webinar.

As always, registration for the webinar allows you to attend the live show and/or to watch the recorded show. Learn at your convenience!

New MDS 3.0 RAI Manual Released

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On September 18, 2019 CMS released the MDS 3.0 RAI Manual v1.17.1, effective October 1, 2019. This version of the MDS 3.0 RAI Manual incorporates clarifications to existing coding and transmission policy; it also addresses clarifications and scenarios concerning complex areas. Since the preliminary release of the manual on May 20, 2019, changes have been made to clarify which assessments swing bed providers must complete; the definition of the “interruption window” for interrupted Part A-covered stays; the coding of item I0200B; and changes related to group therapy policies, as well as other corrections. Please see the document titled “MDS 3.0 RAI Manual v1.17.1 Replacement Manual Pages and Change Tables_October 2019” posted in the Related Links section at the bottom of the CMS MDS 3.0 RAI Manual page located at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/MDS30RAIManual.html.

MC5 Fall Roadshow – Restorative Sleep: Lessons Learned, Barriers Encountered, Successes Achieved

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October 22, 2019: Restorative Sleep: Lessons Learned, Barriers Encountered, Successes Achieved
Location: Orlando’s Event Center, Maryland Heights

October 29, 2019: Restorative Sleep: Lessons Learned, Barriers Encountered, Successes Achieved
Location: St. Joseph Medical Center, Kansas City

Restorative Sleep: Lessons Learned, Barriers Encountered, Successes Achieved

Presenters: Dave Walker, BSE, LNHA and Mendy Wibbenmeyer

The Restorative Sleep Vitality Program (RSVP) was an 18-month grant program sponsored by MC5. Thirty (30) skilled homes from across the state started this project and this presentation will explain some of the lessons learned, barriers encountered, and successes achieved. The goal of the program was to create a sleep culture for elders by promoting active engagement during the day and restful restorative sleep at night. This presentation will explain how sleep and lack of sleep affects a person’s 24-hour day, and will give participants some practical tips and strategies to create a Sleep Culture for their own residents. Staff from one of the collaborative homes will share their own personal experience.

This presentation will teach you the importance of Restorative Sleep by learning to identify and implement at least ten interventions to re disturbances to nighttime sleep. You will also discover the negative affect of fragmented sleep on the human body. Participating homes will share their insight and discuss how implementing Restorative Sleep as changed their culture. You will learn to apply this knowledge and make it work for your environment!

APLISOL® Inventory Replenished

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NTCA has learned that the FDA has removed APLISOL® from its current shortage listing. APLISOL® is now listed on the CBER-Regulated Products: Resolved Shortages webpage.

In response to a call from NTCA, the manufacturer of APLISOL®, Par Pharmaceutical Companies Inc., stated that all geographic markets/wholesalers throughout the US should have adequate inventory now. In another call, Sanofi confirmed that Tubersol® is still in allocation.

Conversations with Carmen

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September 20, 2019: The Validation® Method – Moving Beyond Therapeutic Lies and Redirection
Host & Presenter: Carmen Bowman

Learn how the Validation® method developed by Naomi Feil gives a means for successfully communicating with persons with dementia, something desperately needed by them, their caregivers and family members. Validation replaces the outmoded and person-devaluing methods of redirection, diversion, reality orientation, and the therapeutic lie. Validation teaches how to “exquisitely listen,” empathize, “move into” the disoriented person’s world and validate feelings. Using Validation® boosts self-esteem, builds trust and rapport and often eliminates the person’s need to live in the past by creating a warm and welcoming present. Learn about the basic Validation® techniques and the potential they hold to help persons living with dementia, even when there is a history of trauma.