Category: SLCR Guidance

Resident Funds

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Resident Funds

Question: When a resident who receives a monthly personal allowance from Social Security is discharged from a facility, should the facility send all of the resident’s funds with the resident or back to Social Security?

Answer: The facility should keep detailed records, which will assist the facility in determining what funds should be returned to Social Security. Only Social Security funds need to be returned to Social Security based on secure.ssa.gov/apps10/poms.nsf/lnx/0200603140. Not all funds in the resident trust fund account need to be returned to Social Security, such as birthday money, workshop earnings, money from family, etc.

The amount of SSA conserved funds may also be turned over to the beneficiary or the new payee. Social Security does grant exceptions when a resident needs the Social Security funds for their next stay. The facility must call Social Security in advance to request the exception. Once Social Security approves the exception, the facility may give all funds to the resident.

Third Party Liability Account Balance Form

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Third Party Liability Account Balance Form

Facilities must submit the Personal Funds Account Balance Report (TPL Form) to MO HealthNet for any expired resident that was a MO HealthNet participant; or was a recipient of aid, assistance, care, services; or if the resident had money expended on his/her behalf by the Department of Social Services. This does not apply to discharged residents.

If a resident had no personal funds remaining at the facility, in any account, with whatever title the account may be known when they expired, then a TPL form does not need to be sent.

Certified facilities must submit the TPL Form within 30 days of expiration, while state licensed facilities must submit within 60 days of expiration.

The TPL form can be found at manuals.momed.com/forms/Personal_Funds_Account_Balance_Report.pdf.

2018 Annual Provider Meetings – Updated

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2018 SLCR Annual Provider Meetings

October 2, 2018: Region 2 Agenda
Location: Drury Plaza Hotel Cape Girardeau Conference Center, Cape Girardeau

October 3, 2018: Region 7 Agenda
Location: Holiday Inn St. Louis SW – Route 66, St. Louis

October 10, 2018: Region 5 Agenda
Location: Quality Inn & Suites, Hannibal

October 11, 2018: Region 6 Agenda
Location: Capitol Plaza Hotel & Convention Center, Jefferson City

October 23, 2018: Region 1 Agenda
Location: Oasis Hotel and Convention Center, Springfield

October 24, 2018: Region 3 Agenda
Location: Adams Pointe Conference Center, Blue Springs

October 25, 2018: Region 4 Agenda
Location: Red Lion Hotel, St. Joseph

Please see the updated information regarding our 2018 Annual Provider Meetings below. 

**Earn up to 5.25 CEUs (depending on the session(s) attended).
***Advanced registration is not necessary. There is no cost to attend any of these meetings.

2018 Annual Provider Meetings Flyer    

Handouts – These handouts attached will not be provided at the meeting so please print them and bring them with you.
Resident Funds
Protective Oversight-What Does That Really Mean
Opioid Crisis, “Talk About It”
Ombudsman (The things we do)
Complaint by the Numbers 2.0-A look at FY18 Complaints
Home Health and Hospice/Discharge Updated 10/10/18
Meet the Engineers
LTC Survey Process (One Year Later)
Life Safety Code Updates

Nursing Facility Level of Care Stakeholder Meetings – Postponed

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Nursing Facility Level of Care Stakeholder Meetings – Postponed

In an effort to properly address the feedback received in previous stakeholder meetings, the August 21, 2018 Nursing Facility Level of Care (LOC) Stakeholder Meeting has been postponed until further notice.

The Department received over 500 comments concerning the proposed Nursing Facility LOC system. The Department wants to ensure all feedback is properly analyzed.

Further information regarding future meetings will be announced.

New QIPMO Newsletter – August 2018

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New QIPMO Newsletter – August 2018

The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls – Volume 5, Issue 4.

In this issue:

  • Wanted: RN Coverage
  • The Revolving Door of MO Nursing Home Administrators
  • CPR – Let’s Do It or NOT
  • Alzheimer’s and Dementia
  • Resources for Infection Control
  • Caring for a Resident with a Pacemaker
  • Committees? Tasks?

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

Nursing Facility Level of Care Stakeholder Meetings

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Nursing Facility Level of Care Stakeholder Meetings

For those of you unable to attend, we encourage you to review the presentations below.

NFLOC Stakeholder PPT (June 25, 2018)
NFLOC Stakeholder PPT (July 13, 2018)

**Also, the August 2nd meeting has been rescheduled for August 21 at the Governor’s Office Building in Jefferson City. Please see the updated flyer here.

Provider Feedback Survey

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Provider Feedback Survey

The Section for Long-Term Care Regulation is seeking input from long-term care providers. We are asking for your help to identify 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 Provider Feedback Survey at www.surveymonkey.com/r/7TWRHGG by June 30, 2018.

CMS Fire Safety Information

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CMS Fire Safety Information

CMS provided updated Fire Safety information for distribution to surveyors and providers. Please see the information here.

Note: Missouri’s state regulation for implementation of an approved fire watch in a SNF is more stringent than the federal regulations.  Facility’s must comply with state requirements:

19 CSR 30-85.022(11) (E) requires: When a sprinkler system is to be out of service for more than four (4) hours in a twenty-four- (24-) hour period, the facility shall immediately notify the department and the local fire authority and implement an approved fire watch in accordance with NFPA 101, 2000 edition, until the sprinkler system has returned to full service. I/II

Administrator Licenses Expire June 30, 2018

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Administrator Licenses Expire June 30, 2018 – RENEW NOW

Administrator licenses expiring June 30, 2018 are up for license renewal. License renewal notifications were sent via email to the email address on file. Please note that once the renewal is complete, an electronic license will be issued via email. The Board office no longer mails paper licenses.

Please visit the Missouri Board of Nursing Home Administrator’s web page for the renewal instructions and renewal application at http://health.mo.gov/bnha. Remember to notify the Board office at BNHA@health.mo.gov with changes in your contact information, especially the email address.

LPN Licenses Expire May 31, 2018

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LPN Licenses Expire May 31, 2018 – RENEW NOW

Approximately 25,000 renewal postcards were mailed to LPNs in early March. The postcard contains online renewal instructions. You must either renew online or with a paper renewal. If you did not receive your postcard or need a paper renewal, complete this form and email, mail or fax it to our office. It takes 3-4 business days after your renewal is received before your license is renewed. You will not receive a license card. Go to www.nursys.com and enroll yourself in e-Notify as a Nurse in order to receive notification when your license is actually renewed. As an added benefit, you will also receive license renewal reminders and notification of any changes to your license or discipline status by enrolling yourself in this free service.

Influenza

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Influenza

During a recent call with CMS, they advised SLCR of some important items found on surveys to share with surveyors and providers.

Influenza A and B have been reported in LTC facilities across the state. A reminder that when you are dealing with the flu and other diseases, you want to make certain staff and residents have access to equipment to keep them safe and healthy. This includes knowing when to use soap and water and when alcohol-based hand sanitizers can be used.

Check out the information from Centers for Disease Control and Prevention: www.cdc.gov/handwashing/pdf/hand-sanitizer-factsheet.pdf. Ensure the hand sanitizers used in your facility contain at least 60% alcohol in order to kill organisms.

Priming Insulin Pens

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Priming Insulin Pens

During that same call, CMS also reported they have observed a lack of staff priming insulin pens, prior to each use and after changing the needle. If insulin pens are not primed to remove the air from the needle and cartridge, residents may not get the correct amount of insulin. Manufacturer instructions include directions related to this.

There are many different tools and resources online. We found one from Becton-Dickinson that can be found here: www.bd.com/resource.aspx?IDX=10256.

Emergency Protocol Reminder

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Emergency Protocol Reminder

This protocol provides the telephone numbers corresponding to the region in which your home is located if you experience a loss in a necessary service that has the potential to affect resident safety or well-being. You are encouraged to contact the regional office main office telephone number during normal business hours as survey staff carry the cell phone and may be conducting a survey or inspection during working hours and may not answer immediately.

Remember – this protocol is not to be used to self-report incidents normally reported to the Elderly Abuse and Neglect Hotline.

Please see the attached Emergency Protocol for complete directions. The document and information is also available anytime at ltc.health.mo.gov/safety-emergency.

2018 Annual Provider Meetings

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Section for Long-Term Care Regulation’s 2018 Annual Fall Provider Meetings

It’s a new year and your 2018 Provider Meetings are already taking shape! The Quality Assurance and Education Unit staff are currently in the planning phase and are considering the best topics to provide the most beneficial information.  We would like to hear from you about what LTC related topics you believe would be helpful, informative, and ‘worth the drive.’ If you’ve also been thinking- “Gee I wish they would do a presentation on…….,” then you are invited to be on our planning team! Please forward your suggestions to:

Carla.Jennings@health.mo.gov 
Kristi.Luebbering@health.mo.gov 
Steven.Vest@health.mo.gov 

CMS Memo: S&C 18-04-NH: Temporary Enforcement Delays for Certain Phase 2 F-Tags and Changes to Nursing Home Compare

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CMS Memo: S&C 18-04-NH: Temporary Enforcement Delays for Certain Phase 2 F-Tags and Changes to Nursing Home Compare

  • Temporary moratorium on imposing certain enforcement remedies for specific Phase 2 requirements: CMS will provide an 18 month moratorium on the imposition of certain enforcement remedies for specific Phase 2 requirements. This 18 month period will be used to educate facilities about specific new Phase 2 standards.
  • Freeze Health Inspection Star Ratings: Following the implementation of the new LTC survey process on November 28, 2017, CMS will hold constant the current health inspection star ratings on the Nursing Home Compare (NHC) website for any surveys occurring between November 28, 2017 and November 27, 2018.
  • Availability of Survey Findings: The survey findings of facilities surveyed under the new LTC survey process will be published on NHC, but will not be incorporated into calculations for the Five-Star Quality Rating System for 12 months. CMS will add indicators to NHC that summarize survey findings.
  • Methodological Changes and Changes in Nursing Home Compare: In early 2018, NHC health inspection star ratings will be based on the two most recent cycles of findings for standard health inspection surveys and the two most recent years of complaint inspections.

Please see the full memo and details at www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-18-04.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending.

New Section for Long-Term Care Regulation Assistant Administrator

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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.

Licensure and Certification Fees

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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!