The Section for Long-Term Care Regulation, Region 2 Office in Poplar Bluff will be moving to a new address on May 27, 2020. Please note only the address is changing. The phone and fax numbers will remain the same.
Section for Long-Term Care Regulation, Region 2 Office
1903 Northwood, Suite 4
Poplar Bluff, MO 63901
Phone: (573) 840-9580
Fax: (573) 840-9586
Please review the updated CMS guidance – COVID-19 Emergency Declaration Blanket Waivers & Flexibilities for Health Care Providers (PDF) including the waiver for Paid Feeding Assistants. The waiver now allows training to be conducted in 1 hr. vs. 8 hrs. However, the content for the training remains the same.
Please refer to our website for the content: https://health.mo.gov/safety/cnaregistry/feedassistant.php.
Questions regarding this waiver should be directed to CNARegistry@health.mo.gov.
Community testing events serve the residents of the county where the event is being held. DHSS is partnering with local health departments and health care providers to offer these events, and different communities will be reached at different times. Also, some events may not require you to be a resident of the county where an event is taking place. If you are not a resident of a county currently holding a community testing event, you can continue to check back at the link as new sites will be added as events are planned. Please review the information or check your local health departments social messaging for more information.
Click this link to access the information: https://dcphdo02redcap.azurewebsites.net/redcap/surveys/?s=FAMNRL3LF7.
Here is list of currently scheduled community testing opportunities.
This NEW dashboard contains tons of COVID-19 data that the public can review at will. Cases by county info is still included and is expanded to show daily % increase in cases, 7-day % increase in cases and number of new cases over the last 14-days. In addition, the dashboard includes information on testing, demographics, deaths and hospitalizations.
The link to the dashboard is http://mophep.maps.arcgis.com/apps/MapSeries/index.html?appid=8e01a5d8d8bd4b4f85add006f9e14a9d.
Please see the FEMA Fact Sheet regarding PPE packages for nursing homes.
These guidelines describe implementation steps to help limit the spread of infection when a staff member or resident develops COVID-19 in your facility. The guidance can be found under the Long Term Care Facilities Link at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/professionals.php#collapseSix. The title of document is COVID-19 LTCF Guidance.
** Please review the document as there are important changes to the guidance, including facility-wide testing upon identification of a positive case and routine follow-up testing.
Many long-term care facilities have begun reporting COVID-19 data into the CDC’s NHSN Long-term Care Component. In an effort to have a more complete representation of COVID-19 data for the State of Missouri, we are asking facilities who are not yet reporting to consider reporting data through the CDC’s NHSN Module and those facilities that are currently reporting to begin sharing their data (conferring rights) with DHSS. In order to share the data you enter into the CDC’s NHSN site, you must join the “Missouri Group” within NHSN and select the option to “Confer Rights”.
Once you have completed the NHSN enrollment process and received your acceptance notification from NHSN, you can login to the NHSN site to:
How do I join the Missouri Group and confer rights to the department?
NHSN website provides instructions – https://www.cdc.gov/nhsn/pdfs/groups-startup/JoinGroup-current.pdf.
The document is titled: NHSN Data Sharing: Joining a Group and Accepting the Confer Rights Template.
Please use the following information to join the Missouri group:
Group ID: 20503
Use password: MHIRS29
DHSS is also encouraging facilities to report each day. This will allow more accurate and timely data that could be used for increased allocation of resources for facilities that start to see increased cases, rather than responding up to a week later when outbreaks are identified.
Please see attached order requiring all congregate living facilities to report positive polymerase chain reaction (PCR) test results on one or more residents or one or more staff members, who physically worked at such facility within fourteen days prior to testing positive, within 24 hours. Congregate living facilities include residential care facilities, assisted living facilities, intermediate care facilities and skilled nursing facilities.
See this guidance for specific reporting details.
In an effort to expand the PPE reserves and simplify the PPE process, the state has created a new COVID-19 webpage dedicated to be a one-stop shop for all information related to PPE. The PPE webpage will provide Missouri’s latest information and resources in three categories including how to access PPE, guidance for use and optimization for maintaining your PPE supply for the duration of the COVID-19 epidemic.
You can use this website to access the PPE marketplace, too.
Also, NEW to this website and to the state is the State PPE Reserves option.
Missouri has limited PPE reserves to assist in filling these critical needs and will 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 (aka Missouri PPE Marketplace), have been exhausted and you have a supply of fourteen days or less on hand as the quantities and types of PPE available through the state are limited. Use this link https://survey123.arcgis.com/share/35c0d11050b04a809028d2caf9fd45fd?portalUrl=http://mophep.maps.arcgis.com to access the PPE Request Form. You will receive an automatically generated email notifying you of receipt of your request. Requests will be evaluated in the order in which they are received. If your request is approved, either in full or partially, you will receive an electronic notification upon shipment. If denied, you will receive an electronic verification of the decision.
PPE options for Non-profits and Governmental Entities
Because we know many of you continue to struggle with obtaining PPE items, we wanted to make sure you are aware that not-for-profit entities may purchase items from Missouri Vocational Enterprises (MVE). MVE operates through Missouri’s Department of Corrections and produces and sells a number of items. MVE may sell these items to any state agency, local government entities, or any not-for-profit agency.
MVE has a variety of janitorial supplies, personal products (soap, toilet tissue, etc.), laundry supplies, and disinfectant supplies. Most of these items can be found on the MVE website (https://docservices.mo.gov/mve/products/consumables/consumable.html). In addition, MVE has recently begun selling certain PPE items including cloth face coverings, isolation gowns, and hand sanitizer (gallon jugs). These items are not listed on their website at this time but information is attached or below. PPE items are being prioritized to state agencies but may also be purchased by local government and not-for-profit entities as supplies are available. For awareness, DMH has received cloth face coverings and hand sanitizer but have not yet received our order for isolation gowns. As with all PPE, some items are more readily available then others.
If you have a need for these items, we would encourage not-for-profit providers to explore all avenues to obtain needed items, including those available through MVE. You can visit their website to see items available and details for the ordering process. To order cloth face masks, isolation gowns, or sanitizer, you may need to call and speak with their customer service staff, they are very helpful – contact numbers can be found on the website. Again, only not-for-profit entities, state agencies, and local government entities may purchase items from MVE.
Finally, in regards to hand sanitizer, it is available in one gallon jugs only. The price per gallon is $20. Orders are limited to 100 gallons per order and no more than one order per week. The product number is F-617 Hand Sanitizer.
We hope this information is helpful to you. Thank you so much for all you do and are doing to provide care and services to our vulnerable populations.
The Department of Health and Senior Services would like to notify Missouri health care providers of changes in guidance due to expanded COVID-19 testing availability within the state. The testing landscape has shifted significantly in the past eight weeks, and through partnerships with private laboratories, we encourage testing of both symptomatic and asymptomatic individuals. DHSS does not need to approve testing when performed outside of the State Public Health Laboratory.
See the attachment or visit this link to read this full guidance: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/pdf/mo-pcr-testing-update-providers.pdf.
See the attachment or visit this link to read this in full: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/pdf/serological-testing-quick-facts-providers.pdf.
Below is a communication to providers around billing for COVID 19 testing. This includes information for billing Medicaid and for testing and treatment of the uninsured. DHSS is working on guidance to assist homes in determining the best way to obtain facility-wide testing for their communities. Further guidance will be forthcoming.
At this time, DHSS is continuing to follow the guidelines from the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services related to restricting visitors in long term care homes. On 4/27/20, our Department Director, issued an order continuing the current restrictions on visitors in long term care homes. We know that these restrictions are incredibly hard on residents, families and friends- however- we have also seen the devastation that COVID-19 can quickly bring in a long term care home- both in small counties and large cities. https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/pdf/economic-reopening.pdf. We are closely monitoring the situation at state and federal levels. We are hopeful families and residents will soon be united face to face. Until then, we encourage you to assist family in communicating with their loved ones virtually, via FaceTime or Skype. Non-essential services, including beauty shop should also be restricted. DHSS has posted guidance for Community Integration for adults 65 and older and other high risk populations. These tools will assist you in helping individuals to reintegrate into the community, once the restrictions have been lifted.
The Department of Health and Senior Services (DHSS) posted to the website on 5/5/2020 a presentation showing the multiple data points to inform Missouri’s COVID-19 response. Included in this data, but not limited to the below, is:
Here is the link to this data.
https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/pdf/analytics-update.pdf.
Please see the Advisory Message and Fact Sheet from FEMA about PPE packages for nursing homes with details and contact information.
Goes into effect at 12:01 a.m., Monday, May 4, 2020
Statewide Stay-at-Home Order still applies until then.
We have received several questions regarding the impact the Economic Reopening Order has on long-term care communities. The order addresses long-term care communities, specifically in paragraph #3 of the order, which states, “In accordance with the guidelines from the President, the CDC, and the Centers for Medicaid and Medicare Services, people shall not visit nursing homes, long-term care facilities, retirement homes, or assisted living homes unless to provide critical assistance or in end-of-life circumstances. Elderly or otherwise vulnerable populations should take enhanced precautionary measures to mitigate the risks of contracting COVID-19.”
The guidance below issued by the Department on March 13th and March 17th continues to be in place.
LTC Memo
LTC Leaving Facility
CMS has created a process to enable states to approve requests for communicative technology that meet CMS parameters. The parameters are detailed in the instructions portion of the application template (below). This template and process will reduce the amount of time for approval of CMP funds for technology that allows residents to engage in virtual social and telehealth visits as restrictions have been placed on visitors to prevent the spread of COVID-19.
The application is for nursing homes certified to participate in Title 18 and Title 19 of the Social Security Act. We encourage companies that operate more than one home to complete one application for all certified homes to the extent possible. This will reduce the number of applications and will help expedite the approval process.
Applications should be submitted to slcr@health.mo.gov. Questions regarding the application process may be sent to this address as well.
Once an application is approved, SLCR will contact each applicant to explain the payment process.
COVID-19 Application Template Final
COVID-19 Application FAQ
SLCR has issued guidance for the implementation of state waivers related to tuberculosis testing for employees and staff. Please read through this important guidance.
Questions regarding these waivers should be directed to RegulationUnit@health.mo.gov.
Please see the attachments below for details.
Intermediate Care and Skilled Nursing Facilities – Testing for Tuberculosis 4-23-20
TB Testing – 85.042-27- 4-23-20
The Department of Health and Senior Services issued a news release today explaining “Increased testing capacity allows Missouri to expand criteria for patient testing”.
The full press release is available here https://health.mo.gov/news/newsitem/uuid/912934b4-fa13-408b-a9b7-627db5c1c1e1/increased-testing-capacity-allows-missouri-to-expand-criteria-for-patient-testing.
Also, great news, as of yesterday almost 400 providers had signed up for Missouri PPE Marketplace. Remember to access that source through the Department of Economic Development’s website https://ded.mo.gov/.
Thanks so much for everyone who has entered information. This will inform the PPE need across the state as well as help identify new suppliers and manufacturers of PPE. Remember you have to use Edge, Chrome, Firefox, or Opera as your Internet browser. Also, we have heard that emails to complete the registration are going to junk or spam email folders. This is being addressed, but please check those folders if you have started the registration process and have not gotten your email.
**Special Note for Multi-Facility Organizations**
If you are part of a larger organization and would like to submit a request as one corporate entity instead of each facility, please email supplysolution@ded.mo.gov to make a request to register as one corporation. You will be required to put a Missouri facility address in the registration.
SLCR has issued guidance for the implementation of state waivers related to Fire Safety and Emergency Preparedness Standards for Residential Care and Assisted Living Facilities. Please read through this important guidance.
Questions regarding these waivers should be directed to RegulationUnit@health.mo.gov.
Please see the attachments below for details.
RCF ALF 86.022 Waiver Implementation Guidance 4-23-2020
Residential Care and Assisted Living Facilities 4-23-20
The Department of Health and Senior Services has issued waivers related to physical plant requirements:
Questions regarding these waivers should be directed to RegulationUnit@health.mo.gov.
Please see the attachment below for details.
Physical Plant Requirements for Intermediate Care Skilled Nursing Residential Care and Assisted Living Facilities 4-22-20
On April 21, 2020, CMS issued a COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers, which extends the PASRR approval through the end of the emergency declaration.
Effective April 2, 2020 and through the end of the Federal Emergency Declaration, certified Skilled Nursing Facilities and Intermediate Care Facilities will continue to follow the process outlined in the PASRR 1135 Waiver Implementation 4-22-20 for new admissions into Medicaid-certified beds.
Questions regarding this process should be directed to COMRU@health.mo.gov.
In the past few weeks Missouri has seen an increasing spread of COVID-19 from population centers to more rural communities. This is concerning as rural areas tend to have more limited access to health care and populations that are older and have more chronic health conditions. During this time that we all have a role in protecting our communities and limiting the spread of this disease. Whether you have COVID 19, are a caregiver of an individual with COVID 19 , or just going out in public places, there are actions that you should be taking.
See the tip sheet for more information.
The Treasury Department says that the first recipients of stimulus checks have been given to taxpayers that have already filed their 2019 (or 2018) tax returns and have provided direct deposit information to the IRS.
The stimulus money should be treated the same way as the Circuit Breaker Checks/Rent Rebate Checks. Stimulus money should be used for the resident’s current or foreseeable needs.
In order for the facility to recoup the funds, the facility must have:
Please keep in mind:
Feel free to contact Lynn Gilmore, SLCR Sr. Auditor, at Lynn.Gilmore@health.mo.gov or 573-508-4150 if you have any questions.
SLCR has issued guidance for the implementation of state waivers related to adult day care programs. Please read through this important guidance.
Questions regarding these waivers should be directed to RegulationUnit@health.mo.gov.
Please see the attachments below for details.
ADC Waiver Implementation Guidance 4-22-20
Adult Day Care Requirements 4-22-20