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.

Submitting Exceptions & Second Business Requests

The Regulation Unit has established an email account that providers can now submit all their requests to one email address: RegulationUnit@health.mo.gov. Providers are to begin utilizing this email as soon as possible.

The instructions for submitting the Exceptions and Second Business requests have both been updated. Please see those instructions below.

Instructions for Exception Request (updated 09/06/22)
Instructions for Second Business Request (updated 09/06/22)

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/.

2022 Annual SLCR Provider Meeting

August 24, 2022: Region 6
Location: Capitol Plaza Hotel & Convention Center, Jefferson City

September 1, 2022: Region 5
Location: Quality Inn & Suites, Hannibal

September 7, 2022: Region 4
Location: Stoney Creek Hotel & Conference Center, St. Joseph

September 8, 2022: Region 3
Location: Adams Pointe Conference Center, Blue Springs

September 15, 2022: Region 2
Location: Drury Plaza Hotel Cape Girardeau Conference Center, Cape Girardeau

October 5, 2022: Region 1
Location: Oasis Hotel and Convention Center, Springfield

October 12, 2022: Region 7
Location: Crowne Plaza St. Louis Airport, Bridgeton

The 2022 Updated Provider Meeting Agenda is now available. Please see the flyer for location details.

 

2022 Handouts
1. COMRU Online Application
2. CNA Testing and Renewal Process
3. LTC Regulatory Interpretive Guidance Update
4. Missouri Medicaid Case Mix
5. Section Update
6. Mental Health First Aid – Oct 12 2022
7. Mental Health Care & Crisis Planning For Nursing Facilities
8. ARPA Funding
THE ARTIFACTS OF CULTURE CHANGE 2.0

New Release: Heat and Humidity can be a Dangerous Combination

(JEFFERSON CITY, MO) – The Missouri Department of Health and Senior Services (DHSS) urges Missourians of all ages to take precautions as heat and humidity rise to dangerous levels.

Heat-related illnesses often affect the very young, the elderly and the chronically ill, but summer temperatures can also take a toll on healthy young and middle-aged adults.

In 2021, 18 people died from heat exposure in Missouri, ranging in age from 35-105 years. Half of the deaths occurred among those between the ages of 35-64.

During prolonged periods of high temperatures, using air conditioning – either at home or by seeking shelter in a local cooling center – is the best preventive measure.

“Heat and humidity can place a lot of stress on the body,” said DHSS Acting Director Paula Nickelson. “Heat exhaustion can come on suddenly, with little warning, and lead to heatstroke which becomes a very dangerous situation.”

During excessive heat, Nickelson urges Missourians to check on friends and neighbors, especially those who are elderly and chronically ill. To report a senior citizen or an adult with disabilities who is in need of assistance due to the heat, call the state’s toll-free abuse and neglect hotline at 1-800-392-0210, or make a report online.

Medications can impair a body’s response to heat, making them more vulnerable to the heat.

There are a number of steps individuals can take to stay cool including:

  • Wear appropriate clothing – wear lightweight, light-colored, loose-fitting clothing.
  • Stay cool indoors – stay in air-conditioned places as much as possible. Find a local cooling center.
  • Stay hydrated – drink plenty of fluids regardless of your activity level, and do not wait to until you are thirsty. Avoid sugary and alcoholic beverages; these actually cause you to lose body fluids.
  • Schedule outdoor activities carefully – try to plan outdoor activity for morning or evening hours when the temperature is coolest.
  • Pace yourself – reduce exercise or physical activity during the hottest part of the day, and take frequent breaks in the shade or in an air-conditioned place.
  • Wear sunscreen – sunburn affects your body’s ability to cool down and can make you dehydrated.
  • Prepare your home – change air conditioner filters, cover windows that receive morning or afternoon sun with drapes or shades, and make sure you have portable fans if necessary.

Knowing the signs and symptoms of heat related illness and how treat them is also important. Signs of heat exhaustion may include muscle cramps; heavy sweating; cold, pale and clammy skin; dizziness; headache; nausea or vomiting; and fainting or passing out. If you think you or a loved one are experiencing heat exhaustion, you should stop physical activity move to a cool place – preferably air-conditioned, loosen clothing, and sip cool water. Seek medical attention immediately if you are throwing up, your symptoms get worse or symptoms last longer than one hour.

Signs of heat stroke may include high body temperature (103°F or higher); hot, red, dry or damp skin; fast, strong pulse; headache; dizziness; nausea; confusion; or loss of consciousness. If you think you or a loved one are experiencing heat stroke you should call 911 immediately. Heat stroke is a medical emergency. Move the person to a cool place – preferably air-conditioned. Help lower the person’s body temperature with cool cloths or a cool bath until medical personnel arrive. Do not give the person anything to drink.

For more information regarding heat-related illness and prevention, visit the websites of DHSS or the CDC.

 

Emergency Protocol for Facilities
The Emergency Protocol was developed in 2007 for communication between long-term care homes and the Section for Long-Term Care Regulation (SLCR), in the event a disaster occurs that results in a loss of a necessary service (electricity, water, gas, telephone, etc.). This protocol was established to streamline communication so that homes can focus on what is most important – the safety and well-being of the residents.

This protocol (Emergency Protocol Handout for Facilities) provides the cellular telephone number corresponding to the region in which your home is located if you experience a loss in a necessary service – for instance Air Conditioning – 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.

Provider Feedback Survey

The Section for Long-Term Care Regulation is again seeking input from providers we serve. We are asking for your help in identifying 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 2022 Provider Feedback Survey by June 30, 2022 at https://www.surveymonkey.com/r/72PRNZY.

COVID-19 Testing Reimbursement and Supplies

COVID-19 TESTING REIMBURSEMENT ENDING JUNE 15, 2022:
The last day to submit COVID-19 testing invoices for reimbursement via the DSS invoice portal is June 15, 2022. After June 15, 2022, the portal will be closed and no other testing invoices will be accepted.

Additional Testing Resources:
Free Antigen Testing Supplies
The Missouri Department of Health and Senior Services (DHSS) continues to have an adequate supply of free ACON Flow Flex rapid antigen tests all Long Term Care Facilities may apply to receive. Full details regarding the product, CLIA requirements, standing physician orders, and the Rapid Antigen Test Kit Application can be found here: https://ltc.health.mo.gov/archives/15339.

2022 SLCR Annual Provider Meetings

We are currently in the planning phase to host in-person provider meetings in all regions this year and are considering the best topics to provide the most beneficial information. We would like to hear from you about what LTC related topics and info you believe would be helpful and educational!

Please take a moment to answer complete a short questionnaire by May 31, 2022 at https://www.surveymonkey.com/r/9287QZQ.

New Changes coming in May for the COVID-19 Module Surveillance Pathways and Weekly HCP & Resident COVID-19 Vaccination Module

There will be various revisions to the LTCF COVID-19 Module surveillance pathways and COVID-19 Vaccination Modules for residents and healthcare personnel in the upcoming NHSN May release. CDC will be conducting training webinars next month. Please attend a training session to learn how data entry forms will change and receive instructions for accurate reporting. Below are a few changes you will see starting next month in the COVID-19 Module surveillance pathways.

NHSN COVID-19 Module Surveillance Pathway Forms will be Revised
New Changes Coming in May!!

What are the main changes?

Simplifications

  1. REMOVAL of Supplies and PPE Pathway
    1. Users will no longer need to report data to this pathway
  2. The Resident Impact and Facility Capacity Pathway (RIFC) and the Staff and Personnel Impact Pathway will have several data elements removed:
    1. COVID-19 test type
    2. Vaccine manufacturer (RIFC only)
    3. COVID-19 re-infections
    4. Other respiratory illness
    5. Testing performed and time for receiving results

Possible Additions

  1. Expand vaccination status options for boosters.
  2. Include simplified PPE shortage question.

How should I prepare for the upcoming changes?

  • Review ALL E-mail communication from NHSN
  • Attend COVID-19 Module trainings
  • Review the TOIs to assist with reporting elements
  • Update your CSV files as applicable
  • Templates will be updated on the COVID-19 webpage in May

How can I learn more?
CDC will be conducting training webinars in May. More information on these webinars will be shared in the coming weeks, so stayed tuned!

If you have questions, please send an e-mail to NHSN@cdc.gov with ‘COVID-19 Surveillance Pathway Forms’ in the subject line. Below are the changes that will also take place in the COVID-19 Vaccination Module starting next month.

 

NHSN Weekly COVID-19 Vaccination Cumulative Summary Forms will be Revised
New Changes Coming in May!!

What are the main changes?

Simplifications

  1. COVID-19 vaccination data will no longer be reported by vaccine manufacturer for questions on primary vaccine series and additional/booster doses.
  2. Questions on vaccine supply will be removed.
  3. Completing monthly reporting plans for COVID-19 vaccination modules in the Long-Term Care Facility Component will no longer be required. Instead, upon saving or uploading data, users will agree to the following:
    1. The data reported are consistent with definitions outlined in NHSN surveillance protocols (including tables of instructions and frequently asked questions).
    2. The data will be sent to the Centers for Medicare and Medicaid Services (CMS) to fulfill CMS quality reporting requirements (when applicable).

Additions

  1. Adding a note at the top of form specifying that data can be submitted by completing the questions on the data collection form or by using the new event-level COVID-19 vaccination forms.
  2. Adding a question for facilities to report the cumulative number of individuals who are up to date with COVID-19 vaccination.
  3. Adding two fields to question #4 to report the cumulative number of individuals who received only one booster dose and two or more booster doses of COVID-19 vaccine (Note: For residents only)

How should I prepare?
Facilities should develop or update data tracking mechanisms to collect weekly COVID-19 vaccination data on residents and healthcare personnel for the additional questions.

Tip: Using the new event-level COVID-19 vaccination forms in NHSN’s Long-Term Care Facility Component can simplify the tracking and reporting of data on multiple booster doses and up to date status.

How can I learn more?
CDC will be conducting training webinars in May. More information on these webinars will be shared in the coming weeks, so stayed tuned so you can register for the sessions.

If you have questions, please send an e-mail to NHSN@cdc.gov with ‘COVID-19 Vaccination Data Reporting’ in the subject line.

Reporting of Positive COVID-19 Cases – Changes Effective Monday, April 18th

Effective April 18, 2022, the existing Electronic COVID-19 Case Reporting System (ECD-1) will be disabled. This system will be replaced by 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.

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

  • MODROP
  • In bulk via HL7 or CSV file using the DHSS- Electronic Lab Reporting process
  • 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.

We are excited for this change and elimination of duplicate reporting of positive cases! 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. The EpiTrax Help Desk e-mail account is monitored from 8AM-5PM CST Monday-Friday.

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

CNA Renewals/Work Updates

Note: The requirement to renew the CNA certification every 24 months is not a new regulation; however, the process to renew has been updated and a fee has been added.

**Please see this link for information on how to renew.

When a CNA passes the final examination, the individual’s name is placed on the CNA active registry. For nurse aide certification to remain active, CNAs are required to submit documentation (e.g., pay stubs, W-2, letter from employer, etc.) of their work in nursing or nursing related services for at least one (1) day (e.g. eight (8) hours) within each twenty-four- (24-) consecutive month time-period. Documentation shall be submitted to the department approved third party test administrator and a fee will be assessed for each renewal.

  • If you are a CNA needing to renew your certification and work in a facility: Log into your profile in TMU and enter your employment under the employment tab, upload your documents for proof of 8 hours of work and then pay the required fee. After the fee is processed, you will show active on the registry.
  • If you are a CNA needing to renew your certification with out of state employment: Log into your profile and select “out of state employment” and send an email from your employer with name, date of birth, employment dates and hours worked to missouri@hdmaster.com.
  • If you are CNA working private duty: Log into your profile in TMU and select private duty from a drop down menu. You will need to process the payment then email the proof of work documents to missouri@hdmaster.com. After work is confirmed, your certification will show active on the registry.
  • If you are a facility wanting to pay for multiple CNA’s renewal: You will need to fill out the form Employer Renewal Payment. If you have additional questions please email them at missouri@hdmaster.com or call at 800-393-8664 and ask for the Missouri team.