COVID and Flu A/B Test Kits

  • ALERT: DHSS 30-Day Pause of PPE and Test Kit Shipping Operations on January 31, 2023

DHSS will pause shipping operations on January 31, 2023 for up to 30 days to complete inventory and transition warehouse operations to a new platform. Orders for PPE and Flow Flex Antigen Test Kits will need to be placed prior to January 27, 2023 for shipment on January 30, 2023. Please ensure your last order will cover PPE and Antigen Test Kit needs through March 1, 2023. During the pause, orders will not be processed or shipped. However, once shipping resumes March 1, 2023, PPE and Antigen Test Kits will be shipped daily upon approval and order processing.

 

  • FREE COVID-19/Flu A&B TEST KITS

DHSS is now offering free lifeSign Status COVID-19/Flu A&B Test kits to long-term care facilities.  These testing supplies are currently in limited supply, therefore, LTC facilities should continue to use COVID-19 antigen testing supplies as indicated. Orders may be placed now. Shipping will begin on Tuesday, January 17, 2023.

Application for Status COVID-19/Flu A&B Test Kits

When to use Flow Flex COVID-19 antigen test kit VS Status COVID-19/Flu A&B Test kit:

  1. Use Flow Flex for residents with known COVID-19 exposure
  2. Use Flow Flex for residents during the facility COVID-19 outbreak, or high COVID community level
  3. Use Status test kit if COVID exposure is unknown or unlikely
  4. Use Status test during the facility influenza outbreak, or high influenza activity in the community
  5. Do not use Status test for COVID detection if patient symptomatic for more than 5 days

Long Term Care Facilities must add to the facility’s CLIA certificate:

Adding lifeSign Status COVID-19/Flu A&B Test kits to Your CLIA Test Menu

The CLIA program has developed an email template that you can copy and paste, fill in the blanks, and email to CLIA@health.mo.gov to update your test menu to include lifeSign Status COVID-19/Flu A&B.

Email Subject line: Add COVID-19 Testing to existing CLIA Certificate for [FACILITY NAME]

Lab/Facility Name:

 

Existing CLIA Waived Lab #:

 

Lab Director Name:

 

Which COVID-19/ SARS-CoV-2 Waived Test system added?
Check [X] all that may apply.

[    ] Abbott BinaxNOW COVID-19 Ag Card
[    ] Acon FlowFlex
[    ] Quidel Sofia 2 SARS-CoV-2 Antigen assay
[    ] Becton Dickinson Veritor™ Plus Antigen test kit
[    ] Abbott ID Now
[ X ] OTHER Waived test(s) approved by FDA EUA (specify below): lifeSign Status COVID-19/Flu A&B Test kits

As the Laboratory Director or administrator/owner’s agent of record for the CLIA facility holding a Waived Certificate identified above, I wish to append my facility’s existing CLIA# to include additional testing for COVID-19. I attest that my facility will provide reasonable assurances that:

  1. All testing personnel for COVID-19 will be provided adequate and documented training
  2. All Manufacturer’s Instructions for Use (IFU) will be strictly adhered to

All tests results (both positive and negative) will be reported to the proper public health entities under federal and state requirements. See MO DHSS link regarding reporting: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/how-to-report-lab-results.php

 

 

Reporting Positive Influenza Results

As a reminder, all influenza results must be reported on a weekly basis, in aggregate, to your LPHA using the Laboratory-Confirmed Influenza Weekly Worksheet for Reporters.

For additional information about influenza, including Missouri’s reporting rules, please see https://health.mo.gov/living/healthcondiseases/communicable/communicabledisease/cdmanual/pdf/Influenza.pdf or contact MO DHSS, Bureau of Communicable Disease and prevention at (573) 751 -6113.

 

Reporting Positive COVID-19 Tests

Facilities performing their own COVID-19 testing (antigen testing) must report positive results through one of the following portals:

  1. Missouri Disease Reporting Online Portal (MODROP)
  2. In bulk via HL7 or CSV file using the DHSS- Electronic Lab Reporting process
  3. National Healthcare Safety Network (NHSN) or the Association of Public Health Laboratories (APHL) Informatics Messaging Services (AIMS) Platform.

Facilities using an external laboratory (PCR testing) must enter positive case information into MODROP.

The Missouri Disease Reporting Online Portal (MODROP). MODROP can be accessed directly from https://modrop.health.mo.gov/ or by using the existing ECD-1 link at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/case-reporting.php and selecting the MODROP button.

NOTE: The recommended browser for use of MODROP is Google Chrome. Other browsers may cause issues with MODROP.

Facilities will need to register for a MODROP account the first time they use the new portal. MODROP allows reporting of only COVID-19 cases. Reports of other reportable conditions may be faxed to 573-751-6417.

If you have any questions or encounter any issues utilizing MODROP or for questions about HL7 or CSV reporting, please reach out to the EpiTrax Help Desk via e-mail at epitrax@health.mo.gov.

Please see the FAQ and thank you for your efforts to provide complete and accurate COVID-19 data to public health.

TB Testing

There has been confusion regarding whether the IGRA (T-SPOT) blood test is acceptable for residents of LTC facilities. There was a revision to state statute 199.290 in 2013 that allows for the use of IGRA for healthcare facility workers. However, a revision was not made to 19 CSR 20.100, which states residents must be tested using the two-step TST.

We received clarification from DCPH that residents can be tested using the IGRA blood test, which is in alignment with CDC guidelines. DCPH staff indicated they are looking at revisions to 19 CSR 20-20.100 but did not give a timeframe on when this might occur. This means IGRA is acceptable for residents and staff. Our TB Flowsheets reflect this on our website (https://health.mo.gov/seniors/nursinghomes/providerinfo.php).

LEGISLATION NOTICE UPDATE: Compassionate Care Visitation Act (191.1400, RSMo.)

House Bill (HB) 2116 (merged with Senate Bill 710) known as the “Compassionate Care Visitation Act” and “No Patient Left Alone Act” became law on August 28, 2022. This legislation requires a health care facility (HCF) defined as a hospital, hospice, or long-term care facility to allow a resident, patient, or guardian of such, to permit in-person contact with a compassionate care visitor during visiting hours. A compassionate care visitor may be the patient’s or resident’s friend, family member, or other person requested by the patient or resident. The compassionate care visitation is a visit necessary to meet the physical or mental needs of the patient or resident, including end-of-life care, assistance with hearing and speaking, emotional support, assistance with eating or drinking, or social support. Section 191.1400, RSMo, outlines the provisions for the Compassionate Care Visitation Act.

As a result of this legislation and by January 1, 2023, the Department of Health and Senior Services (DHSS) is required to develop informational material for patients, residents, and their legal guardians regarding the provisions of the Compassionate Care Visitation Act. HCF’s are required by statute to make this informational material accessible upon admission or registration and on the primary website of a HCF.

Compassionate Care Visitation GuidanceThis handout developed by the DHSS is to be used by a HCF to meet the required informational material requirement. The handout is posted to the following webpages:

You can review the Compassionate Care Visitation Act statute 191.1400, RSMo, in its entirety at https://revisor.mo.gov/main/OneSection.aspx?section=191.1400&bid=51115&hl.

Health Education Unit Updates

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 – every Tuesday at 2:00 pm.

Please see the link to join these weekly meetings provided on our CNA Registry webpage (in the announcements towards the bottom of the homepage).

If you have questions, please call our office at 573-526-5686.

CDC Health Advisory – Treatment of Influenza With Reduced Availability of Oseltamivir

Please see the CDC Health Advisory, number 482, dated 12-14-2022 entitled, “Interim Guidance for Clinicians to Prioritize Antiviral Treatment of Influenza in the Setting of Reduced Availability of Oseltamivir.” Should you have any questions, please contact the Missouri Department of Health and Senior Services’ Bureau of Communicable Disease Control and Prevention at 573-751-6113.

Facility Reported Incidents (Self-Reports)

The Section for Long Term Care Regulation (SLCR) has developed two new forms for all long-term care providers to utilize when reporting Facility Reported Incidents. Providers are not required the use these forms. However, the forms will be especially helpful for certified facilities to ensure they have met the reporting requirements under F609 for the Initial Report and the Follow-Up Investigation Report.

The FRI Initial Reporting Form can be sent to the Adult Abuse and Neglect Hotline fax number (listed on the form) or to the regional office.

The FRI Follow-Up Investigation Form will be sent directly to the regional office.

**Please note: Information sent via email is not secure unless it is encrypted. Sending the FRI Initial Reporting Form to the fax number at the Adult Abuse and Neglect Hotline or the regional office will ensure the information is secure.

Reporting Positive COVID-19 Tests

Facilities performing their own COVID-19 testing (antigen testing) must report positive results through one of the following portals:

  1. Missouri Disease Reporting Online Portal (MODROP)
  2. In bulk via HL7 or CSV file using the DHSS- Electronic Lab Reporting process
  3. National Healthcare Safety Network (NHSN) or the Association of Public Health Laboratories (APHL) Informatics Messaging Services (AIMS) Platform.

Facilities using an external laboratory (PCR testing) must enter positive case information into MODROP.

The Missouri Disease Reporting Online Portal (MODROP). MODROP can be accessed directly from https://modrop.health.mo.gov/ or by using the existing ECD-1 link at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/case-reporting.php and selecting the MODROP button.

NOTE: The recommended browser for use of MODROP is Google Chrome. Other browsers may cause issues with MODROP.

Facilities will need to register for a MODROP account the first time they use the new portal. MODROP allows reporting of only COVID-19 cases. Reports of other reportable conditions may be faxed to 573-751-6417.

If you have any questions or encounter any issues utilizing MODROP or for questions about HL7 or CSV reporting, please reach out to the EpiTrax Help Desk via e-mail at epitrax@health.mo.gov.

Please see the FAQ and thank you for your efforts to provide complete and accurate COVID-19 data to public health.

Personal Protective Equipment

Missouri has limited PPE reserves to assist in filling critical needs and prioritize healthcare providers providing direct care to confirmed or suspected COVID patients. Note requests should only be submitted after all normal supply chains, including the Missouri COVID Supply Solution, have been exhausted and you have a supply of twenty-one days or less on hand as the quantities and types of PPE available through the state are limited.

https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/ppe.php

Free COVID-19 Antigen Test Kits

DHSS offers TWO different types of rapid antigen test kits. DHSS offers ACON Flow Flex antigen test kits under the state CLIA waiver for testing in congregate care settings (In-Office) by testing personnel. DHSS also offers iHealth antigen test kits for At-Home testing.

Rapid Antigen Test Kit Application Portal (arcgis.com)

Long Term Care Facilities must make sure the ACON Flow Flex are added to the facility’s CLIA certificate:

Adding ACON Flow Flex to Your CLIA Test Menu

The CLIA program has developed an email template that you can copy and paste, fill in the blanks, and email to CLIA@health.mo.gov to update your test menu to include ACON Flow Flex.

Email Subject line: Add COVID-19 Testing to existing CLIA Certificate for [FACILITY NAME]

Lab/Facility Name:

 

Existing CLIA Waived Lab #:

 

Lab Director Name:

 

Which COVID-19/ SARS-CoV-2 Waived Test system added?
Check [X] all that may apply.

[    ] Abbott BinaxNOW COVID-19 Ag Card
[    ] Acon FlowFlex
[    ] Quidel Sofia 2 SARS-CoV-2 Antigen assay
[    ] Becton Dickinson Veritor™ Plus Antigen test kit
[    ] Abbott ID Now
[    ] OTHER Waived test(s) approved by FDA EUA (specify below):

As the Laboratory Director or administrator/owner’s agent of record for the CLIA facility holding a Waived Certificate identified above, I wish to append my facility’s existing CLIA# to include additional testing for COVID-19. I attest that my facility will provide reasonable assurances that:

  1. All testing personnel for COVID-19 will be provided adequate and documented training
  2. All Manufacturer’s Instructions for Use (IFU) will be strictly adhered to

All tests results (both positive and negative) will be reported to the proper public health entities under federal and state requirements. See MO DHSS link regarding reporting: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/how-to-report-lab-results.php

 

Long-Term Care/Hospice Coordination of Care Form and Training Video

After three years of collaboration, review, discussion, and hard work, the Long-Term Care/Hospice Coordination of Care form and training video are complete, and available. The collaboration on this project was wonderful and we are so thankful to all of the partners who assisted and offered input.

The Bureau of Home Care and Rehabilitative Standards has a link to the form as well as more information on their Hospice web page. There is also a link via HQIN for an educational video featuring examples of health care personnel implementing the Long-Term Care & Hospice Coordinated Task Form Tool.

Long Term Care and Hospice Coordination of Care Form
Video – Long Term Care & Hospice Coordination of Care

Revised Reporting Requirements for Facility Reported Incidents

As noted in the CMS memo QSO-22-19-NH Revised Long-Term Care Surveyor Guidance: Revisions to Surveyor Guidance for Phases 2 & 3, Arbitration Agreement Requirements, Investigating Complaints & Facility Reported Incidents, and the Psychosocial Outcome Severity Guide, CMS revised the guidance in Chapter 5 and related exhibits of the State Operations Manual (SOM) to strengthen the oversight of nursing home complaints and Facility Reported Incidents (FRIs). Beginning October 24, 2022, nursing homes will be required to submit the following information:

FRI – Initial Report

When reporting FRIs to the state agency, nursing homes must provide as much information as possible, to the best of its knowledge at the time of submission of the report, so the state agency can initiate action necessary to oversee the protection of nursing home residents. Initial reports must be reported immediately but not later than two hours if the allegation is abuse or the incident resulted in serious bodily injury, or not later than 24 hours if the allegation is not abuse or the incident did not result in serious bodily injury. “Serious bodily injury” means an injury involving extreme physical pain; involving substantial risk of death; involving protracted loss or impairment of the function of a bodily member, organ, or mental faculty; requiring medical intervention such as surgery, hospitalization, or physical rehabilitation; or an injury resulting from criminal sexual abuse.

Information to include in the initial report:

  • Facility name, address, and contact information of the reporter (including email address and after hours phone number if not in the facility);
  • Type of allegation (physical abuse, sexual abuse, mental/verbal abuse, deprivation of goods and services by staff, neglect, misappropriation of resident property or exploitation, injury of unknown source, suspected crime);
  • Date and time when staff became aware of the incident, name of staff person to whom the information was reported, and name of person who made the allegation;
  • Date and time administrator was notified of the incident and by whom;
  • Alleged victim(s) name, date of birth, and current location;
  • Alleged perpetrator(s) name, position, contact information;
  • When and where the incident occurred and names of any witnesses;
  • Brief description of the incident;
  • Describe any type of injury (bruise, scratch, laceration, puncture wound, fracture, bleeding, redness on the skin, etc.);
  • Describe any changes in resident behavior indicating a change in the resident’s normal baseline (crying, expressions or displays of fear, cowering, anger, withdrawal, difficulty sleeping, etc.);
  • Describe all steps taken to immediately ensure protection of resident(s), such steps could include:
  • Immediate assessment of the alleged victim and provision of medical treatment as necessary;
  • Evaluation of whether the alleged victim feels safe and if he/she does not feel safe, taking immediate steps to protect the resident, such as a room relocation and/or increased supervision;
  • Immediate notification to the alleged perpetrator’s (if a resident) and/or the alleged victim’s physician and the resident representative when there is injury, a significant change in condition or status, and/or a need to alter treatment significantly;
  • If the alleged perpetrator is facility staff, removal of the alleged perpetrator’s access to the alleged victim and other residents and assurance that ongoing safety and protection is provided for the alleged victim and other residents;
  • If the alleged perpetrator is a resident or visitor, removal of the alleged perpetrator’s access to the alleged victim and, as appropriate, other residents and assurance that ongoing safety and protection is provided for the alleged victim and other residents;
  • Other measures the facility is taking to prevent further potential abuse, neglect, exploitation, and misappropriation of resident property.
  • Notification to law enforcement (if applicable), including date/time, agency name, report number, and name/title of person who reported to law enforcement;
  • Other agencies notified (Ombudsman, Adult Protective Services), including date/time and agency name.

Follow-up Investigation Report

Within five business days of the incident, the facility must provide in its report sufficient information to describe the results of the investigation, and indicate any corrective actions taken if the allegation was verified. It is important that the facility provide as much information as possible, to the best of its knowledge at the time of submission of the report. The facility should include any updates to information provided in the initial report and the following additional information, which should include, but are not limited to, the following:

  • Additional/updated information (any additional outcomes to the resident(s) such as physical or mental harm, whether it was reported to the resident’s representative);
  • Steps taken to investigate the allegation including a summary of interview(s) with the resident/responsible party, witnesses, alleged perpetrator, other residents in contact with the AP, staff responsible for oversight and supervision of residents and the AP;
  • If available, include summary of hospital/medical progress notes, discharge summaries, law enforcement reports, and death reports;
  • Provide a brief conclusion of the investigation and indicate if the findings were verified, not verified, or inconclusive and how this was determined;
  • Provide in detail all corrective actions taken;
  • Describe any action(s) taken as a result of the investigation or allegation;
  • Describe the plan for oversight of implementation of corrective action, if the allegation is verified;
  • As a result of a verified finding of abuse, such as physical, sexual or mental abuse, identify counseling or other interventions planned and implemented to assist the resident;
  • If systemic actions (e.g., changes to facility staffing patterns, changes in facility policies, training) were identified that require correction, identify the steps that have been taken to address the systems;
  • If the allegation was reported to law enforcement or another state agency, where applicable and if available, what is the status or provide conclusions of their investigation.
  • Name of the facility individual primarily responsible for conducting the investigation;
  • Name of person submitting report, date and time of submission, and contact number/email address.

Please note: We are in the process of developing forms for initial reporting and for follow-up reporting that all Missouri LTC homes (including state-licensed only) will be able to utilize for FRIs. We will release these forms at a later date and will also schedule a webinar to discuss this information. Please review the memo in its entirety and reach out to your regional office with any questions.

https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/revised-long-term-care-surveyor-guidance-revisions-surveyor-guidance-phases-2-3-arbitration

Administrator License Renewals for 2023 and Forward

Administrators due to renew in 2023 and forward are required to complete all required continuing education (CE) clock hours in-seat or can complete a maximum of half of the total required hours through online continuing education programs (web-based, teleconference, self-study and webinar).

 Refer to the “License Renewal Checklist” on the website https://health.mo.gov/information/boards/bnha/.

 Please contact the Board of Nursing Home Administrators with any questions or concerns at BNHA@health.mo.gov.

COMRU Online Application

We are aware that some providers are experiencing issues with the link to the COMRU online application. We apologize for this inconvenience. Please first try the following alternative link to see if this will work to access the online application:  https://redcapdrlltc.azurewebsites.net/redcap/surveys/?s=RNMP48LRWY.

If this link does not work, please contact COMRU at COMRU@health.mo.gov for assistance. 

COMRU Update

Beginning October 3, 2022, the Level 2 determination letters will be sent from Bock Associates instead of COMRU. The Level 2 determination letter will continue to be uploaded to the online application. If you have any questions regarding the change in the determination letter, please contact COMRU at 573-522-3092 (option #4).

Please ensure the processed online application and Level 2 screening has been printed/saved for your records. COMRU will begin purging the online system in October, so all Skilled Nursing Facilities (SNF) will need to have copies of these documents prior to them being deleted.

News Release: $10 million in ARPA funding for Missouri RCFs and ALFs

Missouri residential care and assisted living facilities licensed with the Missouri Department of Health and Senior Services (DHSS) are now eligible for reimbursement for COVID-19-related expenses through the American Rescue Plan Act (ARPA). $10 million of this federal funding has been allocated for reimbursement.

Providers may seek reimbursement for expenses incurred and/or business interruption costs directly related to preparing, preventing and responding to the COVID-19 pandemic. The funds will compensate expenses incurred between April 1, 2021 and March 31, 2022. Expenses eligible for reimbursement include:

  • Payroll costs.
  • Training and orientation.
  • Operational supplies.

“Missouri’s residential care and assisted living facilities had some of the most challenging situations to navigate throughout the pandemic, from infection control management to workforce and equipment shortages,” said Paula Nickelson, DHSS acting director. “This reimbursement opportunity will allow facilities to recover from the unprecedented challenges the past two and a half years have presented so they can focus on providing care to some of Missouri’s most vulnerable.”

DHSS created two portal guidance documents to assist operators with registering online and navigating the portal. Operators will need to register on the MO ARPA portal before they can apply. An application checklist and FAQs can be found on moarpa.mo.gov.

A link has also been posted under the Information for Long-Term Care Facilities/COVID webpage at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/professionals.php#collapseSix.

Funding Opportunity for Residential Care and Assisted Living Facilities

The Missouri Department of Health and Senior Services (DHSS) is excited to announce a reimbursement opportunity available to Residential Care Facilities (RCF) and Assisted Living Facilities (ALF). Beginning, September 1, 2022, operators may apply for reimbursement for expenses incurred between April 1, 2021 and March 31, 2022, directly related to preparing, preventing, and responding to the COVID-19 pandemic.

If you operated a residential care facility or assisted living facility licensed with DHSS between April 1, 2021 and March 31, 2022, you are eligible for reimbursement for allowable expenses.

Before operators can complete an application for reimbursement:

  1. Operators must be registered as a vendor with the State of Missouri and must have provided their Federal Employer ID Number (FEIN) to DHSS.
  2.    If not already registered, complete the Vendor Input Form located here. Completed forms must be sent to the Office of Administration by fax at 573-526-9813 or by mail to PO Box 809, Jefferson City, MO 65102.
  3. The address used in registering as a vendor must be the same address used on the reimbursement application. Be sure to register only the operating entity and not all individual facilities owned by the same company.
  4. Email registered name and FEIN to LTCARPAReimbursements@health.mo.gov.

For your convenience, you will find a Frequently Asked Questions and an Application Checklist attached to this communication. These documents can also be found online at https://moarpa.mo.gov/required-forms-program-application-instructions/ under Operators of Residential Care / Assisted Living Facilities.

Funding for this initiative has been made available through the American Rescue Plan Act (ARPA). Missouri’s ARPA funding opportunities are located here: https://moarpa.mo.gov/available-funding-opportunities/.

ARPA Funds FAQ 2022 0829 final
ARPA Funds Checklist 2022 0829 final

CNA Instructor 4-Hour Update Training Requirement – Due 8/31/22

As of 12/30/21, the new CNA regulations require the CNA instructor to take a four-hour update training every five years. Please see below the regulatory language:

19CSR-84.010 (15)(C)

Any instructor who has not completed the required four (4) hour update training by August 31, 2022, and every five (5) years thereafter shall be removed from the department-approved list of instructors. If removed from the department’s list, the instructor shall attend and successfully complete the Nursing Assistant Instructor Workshop in order to be reinstated to act as an instructor

All current instructors who have not taken the instructor 4 hour update training by August 31, 2022, will be removed as a CNA Instructor from the registry.

*The four hour update training is still required to be completed by August 31, 2022 even if you have recently taken the Train the Trainer course (unless the four hour update training was included) to become a CNA instructor.

If you have any questions, please contact the Health Education Unit at CNARegistry@health.mo.gov or call us at 573-526-5686.

COVID-19 Boosters – Customizable Package Encourages Staff, Residents, Families and Visitors to Share Their “Why”

Health Quality Innovation Network (HQIN), the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Missouri, recently released a new tool in the fight against COVID-19.

The Vaccine Champion Social Media Package can help your facility boost vaccine confidence by encouraging staff, residents, families and visitors to share their “why” for getting the COVID-19 vaccine. The customizable package includes pages you can print and display for staff, residents, families and visitors to add their reason for getting vaccinated. It includes instructions and suggestions to promote their positive messages on social media channels.

Download the package and customize it for your team to help spread the word, rather than the virus.

DHSS Supply Chain Assessment Survey

Missouri DHSS is conducting a survey to assess healthcare supply chain integrity and is requesting your input. The survey is designed to assess the current status of the healthcare supply chain while also capturing lessons learned from the COVID-19 pandemic. As part of the Hospital Preparedness Program, we are required to complete a supply chain assessment to examine supply chain vulnerabilities to guide future planning efforts. The information collected will also help statewide assets and stockpile realignment with respect to location, number and contents of caches, as well as to identify gaps for future investments.

This survey is 52 questions and divided into 5 sections: facility information, background information, preparedness, purchasing/operations, and future planning. It is recommended that facilities have emergency preparedness staff and procurement staff work together to complete the survey. Thank you in advance for participating in this collaborative effort regarding the healthcare supply chain.

https://survey123.arcgis.com/share/e9b6ec9e7bcd4aaeb3ee1755aecb8075

The survey will close COB August 5, 2022.

Medicaid Spend-Down Limit Changes

Effective 07/01/22, the Medicaid Resource (Spend-Down) Limit increased to $5,301.85. Please see the link https://dssmanuals.mo.gov/wp-content/uploads/2022/06/mhabd-appendix-j.pdf.

Please note that for Medicaid/Medicare certified facilities, F569 states the facility must notify each resident/legal guardian that receives Medicaid benefits when the amount in the resident’s account reaches $200 less than the SSI resource limit. This means certified facilities should notify the resident/legal guardian when the resident’s personal funds are $5,101.85 or higher.

Feel free to contact Lynn Gilmore, Lead Auditor, at 573-508-4150 if you have any questions.

Discharge Letters

Do Your Facility’s Discharge Letters Have the Right Contact Information for the Appeals Unit?

Failure to provide the appropriate appeal contact information can result in the appeals unit setting aside a discharge. Requests for a discharge hearing are required to be sent to:

Department of Health and Senior Services Appeals Unit
P.O. Box 570
912 Wildwood Drive 3rd floor
Jefferson City, Missouri 65102-0570
Phone: (573) 522-1699
Fax (573) 751-0247
Email: DHSS.Appeals@health.mo.gov

Discharge regulations can be found here: https://s1.sos.mo.gov/cmsimages/adrules/csr/current/19csr/19c30-82.pdf.

American Rescue Plan Act (ARPA) Funding Opportunity for RCF and ALF

The Department of Health and Senior Services (DHSS) is excited to announce an upcoming reimbursement opportunity available to Residential Care Facilities (RCF) and Assisted Living Facilities (ALF). Through Missouri’s State Fiscal Recovery Funds, operators may seek reimbursement for expenses incurred directly related to preparing, preventing, and responding to the COVID-19 pandemic.

DHSS will begin accepting applications for reimbursement on September 1, 2022. In the coming weeks, additional details about the reimbursement process, reimbursement amounts, eligible expenses, and supporting documentation will be provided. Our goal is to simplify this process for facility administrators as much as possible.

In preparation of the launch of the application, you are urged to take steps now to prepare. If you operate an RCF or ALF and are interested in this funding opportunity, please ensure you are registered as a vendor to receive payment from the State of Missouri. Before operators can complete an application for this opportunity, they must register as a vendor with the state’s financial system – SAM II. If the operating entity is already registered as a vendor with the State of Missouri, you do not need to re-register.

The SAM II registration Vendor Input Form can be found at https://oa.mo.gov/sites/default/files/vendor_input_ach_eftd.pdf. The completed Vendor Input Form must be sent directly to the Office of Administration by fax at 573-526-9813 or by mail to Office of Administration/Accounting, PO Box 809, Jefferson City, MO 65102.

Operator Tips in Registering as a Vendor with the State of Missouri:

  • Be sure to register only the legal operating entity and not all individual facilities owned by the same operating entity.
  • Be sure the address used in the State’s financial system is the same address that will be used as the operator’s address on the application and any accounts payable documentation.

We will keep you updated with more information regarding the RCF/ALF funding opportunity via this listserv.

Funding for this initiative has been made available through the American Rescue Plan Act (ARPA). Missouri’s ARPA funding opportunities are located here: https://moarpa.mo.gov/available-funding-opportunities/.