New Section for Long-Term Care Regulation Assistant Administrator

New SLCR Assistant Administrator

The Section for Long-Term Care Regulation is pleased to announce Tracy Niekamp will be joining the Section as the Assistant Administrator. As many of you know, Tracy worked in a management capacity for SLCR until a couple of years ago when she became the Licensure and Certification Manager for the Department of Mental Health. Tracy’s experience both here and at the Department of Mental Health will be invaluable to the Section. Tracy’s first day with SLCR will be December 18, 2017.

AHRQ Releases TeamSTEPPS

AHRQ Releases TeamSTEPPS 2.0 to Improve Patient Safety in Long-Term Care

AHRQ has updated its TeamSTEPPS® training for long-term care facilities. Now called TeamSTEPPS 2.0 for Long-Term Care, the curriculum updates have improved the usability and flow of materials, added training scenarios to reflect health care issues in long-term care settings, and added a new measurement module to help teams track progress. The revisions also bring this version of the TeamSTEPPS “train-the-trainer” curriculum in line with changes made to TeamSTEPPS 2.0 for hospital-based teams. Users may download and/or print all the free TeamSTEPPS 2.0 for Long-Term Care materials for training in any post-acute or long-term care facility.

TMF QIN Nursing Home Quality Improvement Spotlight on….

Nursing Home Training Sessions: Clostridium difficile Part Two – Strategies to Prevent, Track and Monitor C. difficile

This nursing home training session provides strategies to prevent and track incidence and prevalence of Clostridium difficile (C. difficile) infections in nursing homes. Click on the links below to take the training and receive nursing contact hours.

The session is one of a six-part series supporting nursing homes in implementing antibiotic stewardship as well as in preventing and managing C. difficile infections. (2.0 Nursing Contact Hours Available)

Clostridium difficile Part Two – Strategies to Prevent, Track and Monitor
Continuing Education Information: Nursing Home Online Training Series (PDF)

MC5 Restorative Sleep Vitality Program (RSVP)

MC5 Restorative Sleep Vitality Program (RSVP)

MC5 is seeking 30 SNF communities to participate in an 18-month program to restore restful sleep to residents and elders. The Restorative Sleep Program seeks to promote active engagement during the day and restful restorative sleep at night.

MC5 will utilize Empira’s Restorative Sleep program, which was developed from evidence-based sleep hygiene research studies and consultation with subject matter experts. Using cutting-edge practices to enhance residents’ sleeping and waking patterns, Restorative Sleep has created new best practices outlining how all 24 hours of the day impact residents’ sleep quality.

Enrolling in this program will include commitment to implementing a multi-pronged approach including clinical, operational, and environmental interventions and solutions to create a culture of restorative sleep.

Please visit www.momc5.com  for more details including the application to participate in the MC5 Restorative Sleep Vitality Program.

TMF QIN Nursing Home Quality Improvement Spotlight on….

Nursing Home Training Session: Clostridium difficile Part One – Clinical Overview

This nursing home training session provides information on the etiology, transmission, risk, signs, symptoms and treatment of Clostridium difficile infection. Click on the links below to take the training and receive nursing contact hours.

The session is one in a six-part series to support nursing homes in implementing antibiotic stewardship as well as in preventing and managing Clostridium difficile infections. (2.4 Nursing Contact Hours Available)

Nursing Home Training Session: Clostridium difficile Part One – Clinical Overview
Continuing Education Information: Nursing Home Online Training Series (PDF)

TMF QIN Nursing Home Quality Improvement Spotlight on….

Nursing Home Training Session: Antibiotic Stewardship

This nursing home training session provides information on the concept and practical aspects of antibiotic stewardship, the core elements of a long-term care antibiotic stewardship program and the need for a community-based approach. Click on the links below to take the training and receive nursing contact hours.

The session is one in a six-part series to support nursing homes in implementing antibiotic stewardship as well as preventing and managing Clostridium difficile infections. (2.1 Nursing Contact Hours Available)

Nursing Home Training Session: Antibiotic Stewardship
Continuing Education Information: Nursing Home Online Training Series (PDF)

MU Enhances Leadership Development Academy (ELDA)

ELDA – November 2017-May 2018

A professional development certificate program for RNs, NHAs and Social Workers using a proven curriculum to improve leadership behaviors with a combination of face-to-face meetings and two webinars. Offered over 7 months, it features an innovative and evidence-based curriculum with a strong focus on application to practice and peer consultation.

This will be the last time the ELDA will be taught in a face-to-face format. If you prefer to learn in a live classroom, be sure to enroll now. Beginning in Spring/Summer 2018, we are pleased and excited to offer the ELDA in a mostly online format. You will receive a separate mailing on this option.

For more information, including the brochure and registration, please visit nursingoutreach.missouri.edu/lda.aspx.

Licensure and Certification Fees

Licensure and Certification Fees

Over the past several months the Licensure and Certification Unit has received an influx of checks from providers that come in with applications, bed/status/name changes, and/or changes of operator/owner. All checks and money orders must be mailed to the Fee Receipts Unit with the facility name indicated on them. Please send all fees to the Fee Receipts Unit at:

Department of Health & Senior Services
Section for Long Term Care Regulation
Fee Receipts
920 Wildwood Drive
P.O. Box 570
Jefferson City, MO  65102

Additionally, please indicate the check number on the application or other documents sent to the Licensure and Certification Unit. Please contact the Licensure and Certification Unit with any questions at 573-526-8508 or ltcapplication@health.mo.gov. Thank you!

TMF QIN Nursing Home Quality Improvement Spotlight on….

Antibiotic Resistance: How It Happens and Strategies to Decrease the Spread of Resistance

This nursing home training session provides a foundation of information about antibiotic resistance and opportunities for improving appropriate antibiotic use. It also includes strategies toward reducing resistance.

The session is one in a six-part series to support nursing homes in implementing antibiotic stewardship as well as preventing and managing Clostridium difficile infections. (1.3 Nursing Contact Hours Available)

Antibiotic Resistance: How it Happens and Strategies to Decrease the Spread of Resistance
Continuing Education Information: Nursing Home Online Training Series (PDF)

Clarification – Notice Before Transfer or Discharge Requirements

Notice Before Transfer or Discharge Requirements:

CMS clarification of 42 CFR §483.15(c)(3)(i) which requires facilities to send a copy of the notice of transfer or discharge to the Office of the State Long-Term Care Ombudsman. www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-17-27.pdf.

TMF QIN Nursing Home Quality Improvement Spotlight on….

Nursing Home Training Session: Exploring Antibiotics and Their Role in Fighting Bacterial Infections

This nursing home training session provides information on the basics of antibiotics, their functionality, potential risks and side effects, general considerations for usage and prescribing and an introduction to why using antibiotics appropriately is important.

This session is the first in a six-part series to support nursing homes in implementing antibiotic stewardship as well as preventing and managing Clostridium difficile infections. (1.5 Nursing Contact Hours Available)

Nursing Home Training Session: Exploring Antibiotics and their Role in Fighting Bacterial Infections
Continuing Education Information: Nursing Home Online Training Series (PDF)

TMF QIN Nursing Home Quality Improvement Spotlight on….

International Infection Prevention Week: Oct. 15-21

During International Infection Prevention Week – help break the chain of infection by educating health care professionals, administrators, legislators and consumers about the importance of preventing infections and improving outcomes. Click on the following links for more information and resources about promoting infection prevention in long-term care.

Infection Prevention and You in Long-Term Care
APIC: Infection Prevention in Long-Term Care Fact Sheet (PDF)
CDC: Hand Hygiene in Health Care Settings
CDC: Infection Prevention Tools for Long-Term Care

TMF QIN Nursing Home Quality Improvement Spotlight on….

Reducing Antipsychotic Medication Use 

Engaging residents in their care and providing treatment alternatives assists in reducing the unnecessary use of antipsychotics. Click on the following links to learn more about reducing the use of antipsychotic medications.

Reducing Antipsychotic Drug Use in Long-Term Care Settings (Video)
Create Connect: Creative Activity Workbook
QAPI: Mood/Behavior Symptom Log (Microsoft Word)

Conversations with Carmen

Conversations with Carmen

October 20, 2017:  Improving the Dining Experience for Residents – Honoring Choice, Exceeding Regulations
Guest Presenter:  Suzanne Quiring, RD, CDM, SuzyQ Menu Concepts

Want to provide a great dining experience, preferences and choice – and be in compliance with new CMS requirements? Learn how to work within budget & time restrictions, tackle cold food, high food waste, endless food preference lists issues and how to move away from tray and pre-plate service to self-determined meal delivery that honors resident choice while saving money. Photos, real examples and many ideas will be shared to help communities implement practical culture change ideas with the confidence of the literature, best practices and federal requirements to back them up.

For more details, including times and full registration, please visit events.r20.constantcontact.com/register/eventReg?llr=aievf5bab&oeidk=a07eenu4xaq26132c77.

CMS PowerPoint Presentation: 2017 RAI User’s Manual Provider Updates

CMS PowerPoint Presentation: 2017 RAI User’s Manual Provider Updates

A PowerPoint presentation that highlights the major changes to the October 1, 2017 version of the RAI Manual has been posted to the CMS MDS webpage at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursinghomeQualityInits/MDS30RAIManual.html. The presentation can be found as #6 in the Related Links section at the bottom of this webpage. Please note that the presentation provides an overview of the major changes but not all of the changes to the manual. Providers should also review the RAI Manual Change Tables and the manual itself to understand all of the changes.

MU Enhances Leadership Development Academy (ELDA)

MU Enhances Leadership Development Academy (ELDA)

November 2017-May 2018

A professional development certificate program for RNs, NHAs and Social Workers using a proven curriculum to improve leadership behaviors with a combination of face-to-face meetings and two webinars. Offered over 7 months, it features an innovative and evidence-based curriculum with a strong focus on application to practice and peer consultation.

This will be the last time the ELDA will be taught in a face-to-face format. If you prefer to learn in a live classroom, be sure to enroll now. Beginning in Spring/Summer 2018, we are pleased and excited to offer the ELDA in a mostly online format. You will receive a separate mailing on this option.

For more information, include brochure and registration, please visit nursingoutreach.missouri.edu/lda.aspx.

Influenza Vaccination Requirements

Influenza Vaccination Requirements

There has been legislation passed in the last couple years regarding influenza vaccination requirements.  Homes should be implementing these requirements as applicable.

198.053.  Assisted living facilities, notification of posting of latest Vaccine Informational Sheet. — No later than October first of each year, in accordance with the latest recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, each assisted living facility, as such term is defined in section 198.006, shall notify residents and staff where in the facility that the latest edition of the Vaccine Informational Sheet published by the Centers for Disease Control and Prevention has been posted. Nothing in this section shall be construed to require any assisted living facility to provide or pay for any vaccination against influenza, allow the department of health to promulgate any rules to implement this section, or cite any facility for acting in good faith to post the Vaccine Informational Sheet.

198.054.  Influenza vaccination for employees, facilities to assist in obtaining. — Each year between October first and March first, all long-term care facilities licensed under this chapter shall assist their health care workers, volunteers, and other employees who have direct contact with residents in obtaining the vaccination for the influenza virus by either offering the vaccination in the facility or providing information as to how they may independently obtain the vaccination, unless contraindicated, in accordance with the latest recommendations of the Centers for Disease Control and Prevention and subject to availability of the vaccine. Facilities are encouraged to document that each health care worker, volunteer, and employee has been offered assistance in receiving a vaccination against the influenza virus and has either accepted or declined.

S&C Memo: 17-43-ALL: Quality and Certification Oversight Reports (QCOR) Website Launch

S&C Memo: 17-43-ALL: Quality and Certification Oversight Reports (QCOR) Website Launch

New Website Platform and Data System: The Centers for Medicare & Medicaid Services (CMS) is releasing information related to the new QCOR website in an overarching initiative for increased transparency.

Please see the full memo at www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-17-43.html?DLPage=1&DLEntries=10&DLSort=2&DLSortDir=descending.

New MDS 3.0 RAI Manual Posted

New MDS 3.0 RAI Manual Posted

CMS posted the MDS 3.0 RAI Manual v1.15 on their website on 8/31/17, which will be effective October 1, 2017. The new Manual can be found in the Related Links Section at the bottom of the following CMS website www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-instruments/NursingHomeQualityInits/MDS30RAIManual.html

The Related Links section at the bottom of this page contains:

  1. MDS 3.0 RAI Manual v1.15 October 1, 2017
  • A Single PDF file of the entire RAI manual for use as an electronic version with bookmarks that you can click on to take you to each section of the manual.
  1. MDS 3.0 RAI Manual v1.15 and Change Tables October 1, 2017
  • Traditional zip files of the RAI manual and the change tables that crosswalk the changes made to this year’s manual. Note: This is the same material as the first item above, except there are separate files for each chapter or subchapter.
  1. MDS 3.0 RAI Manual v1.15 Replacement Manual Pages and Change Tables October 1, 2017
  • Replacement pages for this year’s manual changes for those that want to just update their existing paper based manual with the pages that have changed. It also includes the change tables that crosswalk the changes made to this year’s manual.
  1. MDS Forms (Item Sets) v1.15.1 October 1, 2017
  • Two folders separate the v1.15.1 MDS forms (MDS item sets) into those used in long term care facilities (SNFs and NFs) and those used in swing bed facilities.