Category: SLCR Guidance

SLCR Life Safety Code Information Series

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The Section for Long-Term Care Regulation will be releasing a series of Life Safety Code Information. Please see the entire document for reference.

Today’s subject is:

The Life Safety Code requires a facility with a generator to manually exercise all breakers and itemize all of the electrical panels used for the generator.

    1. How often does this need to occur?
    2. Does the facility have to have to follow the same procedure for all panels, even if they are not connected to the generator?

The LSC requires annual inspection and annual testing on all electrical panels attached to the generator unless the manufacturer’s guide states otherwise.

This only applies to the panels the generator utilizes (which will include the panels used for the Life Safety branches).

NFPA 99, 2012 edition:
6.4.4.1.2.1* Circuit Breakers. Main and feeder circuit breakers shall be inspected annually, and a program for periodically exercising the components shall be established according to manufacturer’s recommendations.
A.6.4.4.1.2.1 Main and feeder circuit breakers should be periodically tested under simulated overload trip conditions to ensure reliability.

Updated DHSS Visitation Guidance

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The guidance incorporates the new visitation guidance recently released by CMS as well previous guidance related to reopening, beauty and barber shop services, communal dining and group activities, and resident outings. In addition to updates to the visit guidance, several updates have been made in other areas as well, so please review carefully for the most up-to-date guidance. All prior guidance documents have been removed from the DHSS LTC COVID-19 webpage and replaced with this document.

Clarification on CMS Visit Guidance related to County Positivity Rates – CMS has provided clarification on this language in the visit document: Facilities should allow indoor visitation at all times and for all residents (regardless of vaccination status), except for a few circumstances when visitation should be limited due to a high risk of COVID-19 transmission (note: compassionate care visits should be permitted at all times). These scenarios include limiting indoor visitation for: Unvaccinated residents, if the nursing home’s COVID-19 county positivity rate is >10% and <70% of residents in the facility are fully vaccinated.

SLCR received questions regarding whether the county positivity rate of >10% referred to the actual positivity rate or to those counties designated as “red”. CMS has stated that the CDC’s county percent test positivity characterization methodology (color-coded system) may be used to determine how visitation should be implemented. Using the color-coded system, facilities in the “red” category should limit visitation for unvaccinated residents if <70% of residents in the facility are fully vaccinated.

Please note: both criteria need to be met before a facility should limit indoor visitation for unvaccinated residents – county positivity rate is >10% and <70% of residents in the facility are fully vaccinated.

SLCR Life Safety Code Information Series

Posted on

The Section for Long-Term Care Regulation will be releasing a series of Life Safety Code Information.

Today’s subject is:

Does Life Safety Code allow candles in a certified facility?

Facilities may not use candles with wicks for décor. If a facility chooses to use candles as décor, the candle shall not have a wick, and the wick must be pulled out. It is not acceptable to have the wick cut flush to the candle.

Facility staff may use lit candles for a birthday celebration, but facility staff must continually supervise the candles while lit.

If a facility uses candles for religious purposes, these lit candles must be supervised 24/7 or be in a different occupancy with a 2-hour wall that separates it from the rest of the facility. The facility has the option to utilize an electric candle when it is not possible or practical to supervise the lit candles.

Please feel free to reach out to your regional office with any questions.

Nursing Home Visitation – COVID-19 (QSO 20-39, REVISED 3/10/2021)

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Yesterday- CMS, in conjunction with the Centers for Disease Control and Prevention (CDC), updated visitation guidance with emphasis on the importance of maintaining infection prevention practices, given the continued risk of COVID-19 transmission. The new guidance includes the impact of COVID-19 vaccination. DHSS will be updating its guidance as well and it will be consistent with the CMS guidance. Facilities certified for Medicare and Medicaid are required to follow the CMS memo. All long-term care communities (SNF, ICF, ALF and ICF) may utilize the CMS guidance until the DHSS guidance is updated. CMS hosted a Stakeholder Discussion today regarding the new guidance. A transcript of the session will be uploaded to CMS’ website on 3/12/20 at: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts.

Key Changes include:

  • Facilities should allow indoor visitation at all times and for all residents (regardless of vaccination status), except for a few circumstances when visitation should be limited due to a high risk of COVID-19 transmission (note: compassionate care visits should be permitted at all times).
  • CMS and CDC continues to recommend facilities, residents, and families adhere to the core principles of COVID-19 infection, including physical distancing (maintaining at least 6 feet between people). This continues to be the safest way to prevent the spread of COVID-19, particularly if either party has not been fully vaccinated. However, they acknowledge the toll that separation and isolation has taken. They also acknowledge that there is no substitute for physical contact, such as the warm embrace between a resident and their loved one. Therefore, if the resident is fully vaccinated, they can choose to have close contact (including touch) with their visitor while wearing a well-fitting face mask and performing hand-hygiene before and after. Regardless, visitors should physically distance from other residents and staff in the facility.
  • Provides guidance to describe how visitation can still occur when there is an outbreak, but there is evidence that the transmission of COVID-19 is contained to a single area (e.g., unit) of the facility.
  • Notes that compassionate care visits and visits required under federal disability rights law should be allowed at all times, for any resident (vaccinated or unvaccinated).
  • States that while visitor testing and vaccination can help prevent the spread of COVID-19, visitors should not be required to be tested or vaccinated (or show proof of such) as a condition of visitation.

Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination

CDC has released new guidance, related to vaccinated individuals and the need to quarantine in LTCF. The Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination guidance can be used by LTCF. In using this guidance, long-term care communities should carefully think about how they will determine if the person has had prolonged close contact with someone who was positive.

“Quarantine is no longer recommended for residents who are being admitted to a post-acute care facility if they are fully vaccinated and have not had prolonged close contact with someone with SARS-CoV-2 infection in the prior 14 days.”

https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-after-vaccination.html

 The revised guidance is attached.

National Long-Term Care Administrator’s Week

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March 22, 2021 marks the one year anniversary of the first known COVID positive resident identified in a long-term care facility. So much has happened in 365 days. Each of you know better than anyone else what a humbling, scary, frustrating, and grief stricken year it has been. You also know that this past year has also created deep bonds between your administrative teams, personal moments of strength that you did not know were possible, and moments of humanity and deep kindness that still make you speechless. It is a year that has reminded us of the importance of family, friends, and our health. This week is National Long-Term Care Administrator’s Week. There is no better time for all of us in the Section for Long-Term Care Regulation to share with you our appreciation of each and every one of you. We are thankful for your leadership, kindness, and support of others during the most extraordinary time of our professional lives. We are thankful for your partnership and for the partnership of our long-term care associations who worked tirelessly alongside with us. Thank you for all you have done to protect health and keep the residents of long-term care in Missouri safe.

Missouri DHSS COVID-19 Healthcare Provider PPE Needs Assessment

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Over the past 12 months, the State of Missouri Department of Health and Senior Services (DHSS) and the Missouri State Emergency Management Agency (SEMA) have been providing personal protective equipment (PPE) at no cost through our Strategic National Stockpile (SNS) program to healthcare providers in order to protect staff and patients during the COVID-19 pandemic. PPE supply chains have been disrupted due to many factors, but have begun to normalize. In order to determine future operations and sustainment of the Missouri DHSS PPE Request System and PPE Reserve, we are conducting a survey to assess the current state of the healthcare personal protective equipment (PPE) supply chain from the perspective of our healthcare providers.

This survey is being directed to those agencies and organizations that have been working with individual providers and individual providers. We are particularly interested in responses from smaller rural and independent facilities, clinics, and healthcare providers who have had the most difficulty obtaining PPE resources. We ask that the survey be completed by March 24, 2021.

Survey Link: https://www.surveymonkey.com/r/9YCHYVP.

Long-Term Care Facilities and Visitation

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As we anxiously await guidance from CDC and CMS on changes, they will recommend and/or require of long-term care communities related to testing, visitation, quarantine, etc. – a reminder that homes should use previous visitation guidance to support opening up their communities to visitors. This week, the CMS spreadsheet of county positivity rates shows MO with 63 green, 49 yellow and 3 red counties. Homes in green and yellow counties should allow visitation according to the core principles of COVID-19 infection prevention and facility policies, if they are not in outbreak status. As soon we receive updated guidance, we will communicate the information via the long-term care facility listserv. Keep in mind DHSS has issued guidelines- not regulatory requirements related to visitation. You know your long-term care community and can best assess and make a plan to help residents reconnect with loved ones based on their wants/needs, availability of PPE, staffing, etc.

Additional guidance related to frequent questions we receive:

 

COVID recovered in past 3 months

If a resident has tested positive and has recovered (no longer on transmission based precautions) in the past 90 days, CDC guidance states they do not need to quarantine or get tested again for up to 3 months as long as they do not develop symptoms again. https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html Homes can use this guidance in developing policies related to visitation and quarantine for residents as well to help expand visitation within their communities and to allow residents to resume some normalcy in their routines.

For residents that have had COVID in the past 3 months and are off of transmission based precautions, they would not need to quarantine if they left for a home visit or went out for dinner- based on CDC guidance for quarantine. We encourage facilities, families and residents to continue to use the infection control practices outlined in the attached memo. Even though someone has had COVID- we do not know a lot about reinfections and those measures (mask, social distancing, and good hand hygiene) help protect from influenza as well.

 

Home Visits and Outings

If a resident chooses to leave the facility to visit family or for an outing, we recommend nursing homes use the recommendations from the holiday leave guidance when they return to the nursing home:

  • Screen and increase monitoring for signs and symptoms.
  • Test a resident for COVID-19 if signs or symptoms are present or if a resident or their family reports possible exposure to COVID-19 while outside the nursing home. A nursing home may also opt to test residents without signs or symptoms if they leave the nursing home frequently or for a prolonged length of time, such as over 24 hours. For more information on testing guidelines, see CMS memorandum QSO-20-38-NH.
  • Place the resident on transmission-based precautions (TBP) if the resident or family member reports possible exposure to COVID-19 while outside of the nursing home, or if the resident has signs or symptoms of COVID-19 upon return. Please note that residents and loved ones should report to the nursing home staff if they have had any exposure to COVID-19 while outside of the nursing home.
  • Consider placing residents on Transmission Based Precautions BP if they were away from the nursing homes for more than 24 hours.

https://www.cms.gov/files/document/covid-facility-holiday-recommendations.pdf

https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/pdf/ltcf-holiday-guidance.pdf

 

Vaccination and Infection Control measures

At this time, there are still many questions unanswered regarding vaccination that make infection control changes uncertain right now. Current CDC can be found here: https://www.cdc.gov/vaccines/covid-19/toolkits/long-term-care/index.html.

Vaccination is one important tool (not the only) in our tool belt to address COVID-19 infections. Vaccinating healthcare personnel and residents is essential to helping prevent individuals (who may not be able to recover) from getting COVID-19. For long-term care facilities, vaccinations are vital to protecting healthcare capacity. Staff who are sick cannot work and provide the necessary case and services to residents to ensure their health and safety.

The toolkit includes some helpful information for staff and residents/loved ones regarding the vaccine as well.

https://www.cdc.gov/vaccines/covid-19/toolkits/long-term-care/downloads/answering-staff-questions.pdf

https://www.cdc.gov/vaccines/covid-19/toolkits/long-term-care/downloads/answering-residents-loved-ones-questions.pdf

 

Visitation Guidance 9-22-20
CMS Memo – Nursing Home Visitation – COVID-19

Regulation Update Notice

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The proposed rule for 19 CSR 30-91.010 Authorized Electronic Monitoring in Long-Term Care Facilities was published in the Code of State Regulations on January 29, 2021. The official new rule can be found on the Office of the Secretary of State’s website at: http://www.sos.mo.gov/adrules/csr/current/19csr/19csr.asp.

The rule is located under Division 30 in Chapter 91. The effective date for the rule will be February 28, 2021.

If you have any questions regarding implementation of the rules, please contact the Section for Long-Term Care Regulation at 573-526-8524.

**Winter Weather Planning**

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Snow and ice are a mainstay of Missouri winter weather. Because of the variety of weather conditions as well as other events, facilities must have an emergency preparedness plan and be ready to act in an emergency to ensure they are to adequately prepared to meet the needs of patients, clients, residents, and participants during disasters and emergency situations. Here are a few things to consider in examining your emergency preparedness plan, specifically as it relates to snow, ice, and power outages.

  • If there is a loss of the primary power, how will the facility ensure adequate temperatures of the facility will be maintained during the emergency situation?
  • Is the plan feasible?
    • Plan for the worst. Most events do not occur on a sunny Tuesday afternoon and the plan should account for things such as poor weather, road conditions, weekends/holidays, evenings, staff ability to travel to work, and other obstacles that may cause issue during the actual emergency.
  • Are staff knowledgeable of the plan and have access to what is needed in order to implement the plan?
    • Phone numbers, contact persons, contracts.
  • Do staff know what to do during an emergency and know who is in charge? If the administrator is not onsite, who is in charge and does that person know all their duties?
    • This may be the DON, but it may also be a charge nurse (or another designated onsite staff) if the event happens in the “middle of the night”. Depending on when the administrator or someone higher up on the order of succession can arrive at the facility, that person (i.e. night charge nurse) may be in charge for an extended amount of time.
  • Is the plan detailed enough?
    • Is there a detailed plan that describes when the residents will evacuate during an emergency? If loss of power, does the plan instruct the staff to start the evacuation prior to the point when the facility is below appropriate air temperatures and to maximize their safety during travel? What is the distance to the emergency evacuation site? What types of roads do they have to traverse, such as “side roads”, bridges, or interstates; all of these roads can have their challenges. Does the facility have more than one contracted emergency site?
      • Is it likely that emergency events will also impact the surrounding areas? It is also possible that the evacuation site may be so far away, residents may not be able to get there when road conditions are less than optimal. Does the contracted site meet all the criteria to allow the residents to shelter in place at that location?
    • Is there a contract for transportation and will that transportation be able to get the residents to and from their current location to the contracted emergency location in a snow/ice storm? If the services have other contracted uses, such as school buses, will they be available at 3:00 P.M. on a school day or can they get drivers at 3:00 A.M. on a Wednesday?
  • Does the facility have a generator?
    • Is there enough fuel, a contract to get more fuel, and a list of what it does and does not operate?
      • Facilities (and the staff in charge) need to know in advance, what their generator will operate. At a minimum, this listing must include whether it runs: Life safety equipment (such as E-lights and fire alarm system(s)), magnetic door locks/door alarms (where applicable for safety), HVAC systems, cooking systems, what outlets residents and staff will be able to be use, and computer equipment/Wi-Fi (if electronic medical records (EMR) are utilized).
      • This list needs to be detailed so staff will know specifically what items will and will not work during a power outage. Many generators will run every second or third ceiling light for emergency lighting, but not all lights in the facility will work during a power outage. This needs to be listed so all staff will know that information.
  • If a facility does not have a generator, what are the plans when it may not be easily able to evacuate due to poor road conditions or other factors that may prohibit a smooth transition from a facility to another location?
    • If the facility plans to have a generator delivered during a loss of power, does the facility have a contract with the generator company to deliver one to them? This contract should include the size of the generator that the facility will need in order to ensure the safety and care needs of the residents are met during the emergency.
      • The building will need to be wired and ready to accept the generator in advance. The facility will not be able to install a generator during the emergency event unless the wiring for the generator has already been completed.
  • Facilities must maintain at least their fire safety equipment (E-lights, fire alarm, sprinkler system, range hood (if any cooking occurs), food, water, heating and cooling, and sewage disposal to shelter in place.
    • There must be a plan of how this will be achieved, emergency supplies, the detailed list of what the generator will run, and any contracts that will be needed during the emergency to ensure these services can continue during the emergency event.
      • Sometimes trucks will not be able to run regular schedules and it may take several days before the facility can get their first delivery after an emergency starts; depending on the extent and severity of the disaster.
  • A power outage may be as simple as a blip, may last for hours, or may last for days – depending on the extent of the power grid damage and when the crews can access the problem(s).
    • The facility needs a plan of when, how, and where they will evacuate if they cannot provide at least the components of the previous bullet point.

During a disaster is the least ideal time to learn an emergency plan will not work or to search for a contracted service. All contracted services including, but not limited to, transportation, fuel needs, evacuation location, food, and water needs to be in the emergency plan. The emergency preparedness team needs to consider and plan all services and contract prior to an actual emergency. During an emergency, it may be very difficult or impossible to get a contracted service due to volume of request, road conditions, and/or other factors.

If your facility experiences a loss of a necessary service (electricity, water, gas, phone, etc.), contact SLCR via the Regional Office emergency phone line and keep them informed of their status. If, for some reason, the facility cannot contact SLCR staff through the regional office phone number, you should contact the hotline. The emergency protocol is attached. When you call, be prepared to answer to the following:

Facility name

Census, including staff assessment of current needs of the residents and monitoring of the ill.

Contact person and emergency contact number that is not the facility main line.

Has the facility called the fire department and central monitoring company if phones, alarm systems are down?

Generator: Y/N

    • If yes, what equipment does the generator serve (fire alarm, HVAC systems)?
    • If yes, amount of fuel onsite and/or system for delivery? How long will fuel last?
    • If no, what is fire watch plan?
    • If no, how will the facility ensure resident needs are met, including maintenance of room temperatures in a safe manner?
      • Obtain generator- is the home set up to receive generator power once delivered? Estimated time for delivery? Estimated time when generator power will be established.
      • Evacuation- Where is facility relocating to, distance from facility, transportation to get there, staffing, sufficient supplies/medications, how will the facility ensure resident needs are met, including maintenance of room temperatures in a safe manner (does the location have a functional emergency generator?) If relocating to a SNF – will the home be over capacity? Is there sufficient beds/space in the receiving facility to house the extra residents?
    • Documentation may be requested, including:
      • If evacuated, a list of residents and were they went
      • Room temperature logs
      • Fire watch documentation

Thank you for preparing in advance and keeping us informed!

Reimbursement for COVID-19 Outbreak Testing and Other Necessary Expenses – Deadline Extended to March 31, 2021

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All LTC facilities (SNF-ICF-RCF-ALF) may submit for reimbursement of outbreak testing through March 31, 2021.

All Skilled Nursing Facilities may invoice for other necessary COVID-19 expenditures up to a maximum cap of $345 per licensed bed. The previous cap of $303, which originally expired on December 30, 2020, has been extended to March 31, 2021 and the cap increased to $345 which is a $42 per licensed bed increase. Facilities cannot bill for expenses that have been previously invoiced.

All other facilities may submit invoices for other necessary COVID-019 expenses up to the previous existing cap of $330/licensed bed, which originally expired on December 1, 2020 and has been extended to March 31, 2021. Facilities cannot bill for expenses that have been previously invoiced.

If any facility previously submitted for reimbursement and did not get reimbursed up to the cap, they can submit for additional reimbursement up to the cap. If you have previously submitted invoices for reimbursement that meets or exceeds the cap, please do not resubmit those items. They are being re-reviewed at this time.

Please see this link for the portal and other additional information: https://apps.dss.mo.gov/LongTermCareCovid19Invoices/.

PUBLIC NOTICE

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The Department of Health and Senior Services, Section for Long Term Care Regulation (SLCR) is soliciting public comments on the below proposed rulemaking. The proposed rulemaking will be published in the February 16, 2021 Volume 46, Number 4 of the Missouri Register at http://www.sos.mo.gov/adrules/moreg/moreg.asp.

  • 19 CSR 30-81.030 Evaluation and Assessment Measures for Title XIX Recipients and Applicants

NOTE: The public comment period will be from February 16 – March 18, 2021. The Department will be accepting comments during the comment period by mailing the comments to Steve Bollin, Director of the Division of Regulation and Licensure, PO Box 570, Jefferson City, MO 65102-0570 or by emailing to RegulationUnit@health.mo.gov.

The proposed rule can be reviewed on our website at: https://health.mo.gov/about/proposedrules/.

Standing Order to Administer BinaxNOW Rapid Antigen Test By Licensed Long-Term Care Facilities

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Dr. Randall Williams has signed a standing order for Long-Term Care Facility staff to receive Abbott BinaxNow testing at the facility they work in to ensure timely testing and isolation of positive employees who are caring for Missouri’s most vulnerable residents, the elderly and disabled. Long-term care facilities should continue to obtain orders for residents through resident personal physicians or facility medical director/physician.

Standing Order – BinaxNOW – LTCF – Symptomatic or Asymptomatic 1-12-21

Submission Deadline for SNF COVID-19 Related Expenses – Extended through 12/30/20

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The submission deadline for SNF “other” necessary COVID 19 related expenditure invoices has been extended through 12/30/2020.  There has been no change testing invoices – the deadline for all facility types to send testing invoices to the state is still 12/30/2020.

Beginning December 18, 2020, the following will appear on the main web application page:

Important update: Please read!

All long term care facilities (SNF, RCF, ALF, ICF) have until 12/30 to submit “testing” invoices.

Skilled Nursing Facilities may resume submitting “other” necessary COVID-19 related expenditures until 12/30.

If you represent a SNF and you already submitted items that were not approved because you were over your allocated cost cap, please do not resubmit those items. Those are being re-reviewed at this time. Only submit new expenses since 12/01 and/or items not previously submitted.

In order to process all LTC invoices in a timely fashion and meet deadlines, it is imperative that facilities submit complete invoices with all the required information and documentation. This includes:

    • The federal tax ID number
    • Invoice to the State with a unique invoice number not already used
    • Invoice/bill from the vendor who provided services/supplies
    • Full address of the facility
    • Signatures on all forms requiring signature
    • Detailed explanation of how the expenditure is COVID-related
    • Signed attestation if one has not already been uploaded to the State

If required documentation is not submitted, your invoice may not be approved.

Federal Pharmacy Partnership for Long-Term Care Program – IMPORTANT INFORMATION FROM CVS AND WALGREENS

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For those communities that chose CVS or Walgreens for the Federal Pharmacy Partnership for COVID-19 Vaccine Program, CVS and Walgreens have started communicating with communities about the program. The information from both pharmacies can be found below. It is imperative that you follow the guidance and direction from CVS or Walgreens when your community receives this information. This will be key to your vaccination clinics running smoothly.

CVS

Walgreens COVID19 Vaccine – What To Expect Guide
Walgreens Facility Tip Sheet
Walgreens LTCF Welcome Email Body

If you have not been contacted, communication will likely continue over the next week. If your facility DID indicate CVS or Walgreens but have not heard from them yet, they you should go to the CVS or Walgreens website and fill out the contact information for your facility. CVS and Walgreens are still working through contacting all the communities assigned to them.

Please make sure the point of contact listed when you registered for the vaccine program is aware the call and/or email from the pharmacies will be coming.  Also, please continue to check your junk or spam folders if you have not been contacted by a pharmacy.

Information regarding this program is developing rapidly.  Please watch for further messages as information is available.

COVID-19 Reporting

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As testing in long-term care (LTC) facilities has expanded with the addition of point-of-care testing kits in recent months, the state has likewise expanded the avenues through which data is collected. Given the additional modes of entry for COVID-19 data, the Missouri Department of Health and Senior Services wants to offer clear guidelines for facilities so they can correctly and accurately submit data regarding their residents and staff.

Please see the Reporting Memo for long-term care facilities, adult day care programs, and ICF-IIDs.

COVID-19 LTC Bed Availability Portal

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Reminder: After submitting your initial survey, you should have received a confirmation email which provided you a link to update your survey each day (instead of submitting a new survey). Multiple surveys for your facility show up twice on the map with different bed numbers. This makes it difficult to know which totals are current. Please use the link emailed to you after your initial submission to edit your facility bed availability. Please do not submit an “initial” submission more than once.

The healthcare continuum is increasingly becoming strained with the number of positive cases across the state. This portal has been established to improve communication across the care continuum to assist in ensuring Missourians have access to the right care in the right setting. We are asking all long-term care communities to complete this brief survey each day by 9:00 AM beginning Wednesday, November 25th in order to identify available beds for potential admissions. Participation in the bed availability survey is voluntary. The survey may be accessed at https://arcg.is/1rjKy8. Once the initial submission is completed, each submitter will receive a link in order to update the bed availability information. If information does not change from day to day, the submitter can simply update the date and submit – the prior day’s information will populate.

The survey information will populate an accompanying dashboard that will be available to hospitals to use as a tool in finding placement for those patients who would be best served in a long-term care setting. This dashboard may be accessed at https://mophep.maps.arcgis.com/apps/opsdashboard/index.html#/f1e0745f93fe46b482d8ff4585f821bf.

To view instructions on utilizing the dashboard, click on ‘Instructions’ under the map for information.

COVID-19 LTC Bed Availability Portal

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The healthcare continuum is increasingly becoming strained with the number of positive cases across the state. This portal has been established to improve communication across the care continuum to assist in ensuring Missourians have access to the right care in the right setting. We are asking all long-term care communities to complete this brief survey each day by 9:00 AM beginning Wednesday, November 25th in order to identify available beds for potential admissions. Participation in the bed availability survey is voluntary. The survey may be accessed at https://arcg.is/1rjKy8. Once the initial submission is completed, each submitter will receive a link in order to update the bed availability information. If information does not change from day to day, the submitter can simply update the date and submit – the prior day’s information will populate.

The survey information will populate an accompanying dashboard that will be available to hospitals to use as a tool in finding placement for those patients who would be best served in a long-term care setting. This dashboard may be accessed at https://mophep.maps.arcgis.com/apps/opsdashboard/index.html#/f1e0745f93fe46b482d8ff4585f821bf.

 

To view instructions on utilizing the dashboard, click on ‘Instructions’ under the map for information.

CDC Guidance and Updates

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The CDC has issued the following guidance:

Testing and Management Considerations for Nursing Home Residents with Acute Respiratory Illness Symptoms when SARS-CoV-2 and Influenza Viruses are Co-circulating

https://www.cdc.gov/flu/professionals/diagnosis/testing-management-considerations-nursinghomes.htm

  1. This guidance summarizes practices that should be considered when SARS-CoV-2 and Influenza viruses are found to be co-circulating based upon local public health surveillance data and testing at local healthcare facilities. While these considerations are specific to care of residents residing in nursing homes, some practices could be adapted for use in other long-term care settings (e.g. assisted living facilities).

 

The following COVID Healthcare IPC guidance has been updated:

  1. Guidance for SARS-CoV-2 Point-of-Care Testing
    1. This update includes minor revisions to the FAQ section.

Free COVID-19 testing opportunities available throughout Missouri

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The State of Missouri continues to host community testing events throughout the state each week.

Missourians can register for these events currently scheduled at health.mo.gov/communitytest and also continue to check back for future opportunities to be tested at an event nearby.

Missouri residency is the only requirement; individuals do not have to live in the county in which they are tested, and they do not have to be experiencing symptoms. Any Missouri residents who wish to be tested with a self-administered nasal swab to determine if they have an active COVID-19 infection can do so at the specified sites in each region at no cost to the individual.

County

Location

City

Dates

Times

Madison

Cherokee Pass Volunteer Fire Department

Fredericktown

November 21

11AM – 3PM

Montgomery

Old Settlers Picnic Grounds

New Florence

November 21

11AM – 5PM

Howell

Lybyer Enhanced Technology Center

West Plains

November 30

11AM – 5PM

Saline

Saline County Health Department

Marshall

November 30

9AM – 5PM

Crawford

Cuba Knights of Columbus Hall

Cuba

December 1

12PM – 6PM

Clay

First United Methodist Church

Kearney

December 1

10AM – 6PM

Platte

Platte County Resource Center

Kansas City

December 2

10AM – 6PM

Greene

Ozark Empire Fairgrounds

Springfield

December 3-4

Dec. 3: 9AM – 7PM
Dec. 4: 7AM – 4PM

Gentry

Stanberry City Hall

Stanberry

December 4

11AM – 5PM

Jasper

Ozark Christian College

Joplin

December 5

10AM – 4PM

Buchanan

Aquatic Center

St. Joseph

December 5

8AM – 4PM

Register for testing at:
www.health.mo.gov/communitytest
or call (877) 435-8411

 

Surge Testing

Additionally, the U.S. Department of Health and Human Services (HHS) has also announced free COVID-19 surge testing that will continue each week in the following:

Columbia (Mondays, 10 a.m.-5 p.m.)
Branson (Tuesdays, 10 a.m.-5 p.m.)
St. Louis (Tuesdays and Wednesdays, 9 a.m.-5 p.m.)
Cape Girardeau (Thursdays, 10 a.m.-6 p.m.)
Lee’s Summit (Thursdays, 10 a.m.-6 p.m., and Fridays, 10 a.m.-5 p.m.)

Testing at these locations is available to individuals 5 years and older – including those experiencing symptoms; those who believe they may have been exposed to someone with COVID-19 coronavirus; and anyone who is worried about possibly having the virus. Individuals seeking testing do not need to be a resident of the community where these testing sites are located. Individuals under 18 years old must have a parent or legal guardian present to consent to testing.

Testing is expected to continue at the following locations for the remainder of this year. Individuals are encouraged to pre-register online at DoINeedaCovid19Test.com.

More information regarding COVID-19 in Missouri can be found at health.mo.gov/coronavirus.

Point of Care Antigen Reporting

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Effective Friday, November 13, 2020, Long-Term Care Facilities (SNF, ICF, ALF and RCF) that are reporting point of care antigen testing results into the NHSN portal, no longer need to duplicate that reporting via the DHSS secured file transfer.

At this time, DHSS asks that long-term care facilities report all positive staff and resident results, for POC and PCR testing, via the Electronic COVID-19 Case Reporting portal to ensure timely notification to DRL and DCPH for outbreak assistance.

DHSS is working on comprehensive guidance for all long-term care communities related to reporting requirements. If you have any questions related to this, please contact tracy.niekamp@health.mo.gov.

Free COVID-19 testing opportunities available throughout Missouri

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The State of Missouri continues to host community testing events throughout the state each week.

Missourians can register for these events currently scheduled at health.mo.gov/communitytest and also continue to check back for future opportunities to be tested at an event nearby.

Missouri residency is the only requirement; individuals do not have to live in the county in which they are tested, and they do not have to be experiencing symptoms. Any Missouri residents who wish to be tested with a self-administered nasal swab to determine if they have an active COVID-19 infection can do so at the specified sites in each region at no cost to the individual.

County

Location

City

Dates

Times

Dunklin

Dunklin County Health Department

Kennett

November 14

9AM – 1PM

St. Louis County

Edger M. Queeny Park

St. Louis

November 17

8AM – 5PM

Callaway

54 Country

Fulton

November 17

10AM – 6PM

St. Louis County

Hazelwood Community Center

Hazelwood

November 18

8AM – 5PM

Marion

Hannibal Inn & Conference Center

Hannibal

November 18

12PM – 6PM

St. Louis County

Kennedy Recreation Center

St. Louis

November 19

8AM – 3PM

Butler

Whitely Park

Poplar Bluff

November 20

12PM – 6PM

Pettis

MO State Fairgrounds Sheep Barn

Sedalia

November 20

11AM – 5PM

Madison

Cherokee Pass Volunteer Fire Department

Fredericktown

November 21

11AM – 3PM

Montgomery

Old Settlers Picnic Grounds

New Florence

November 21

11AM – 5PM

Register for testing at:
www.health.mo.gov/communitytest
or call (877) 435-8411

 

Surge Testing
Additionally, the U.S. Department of Health and Human Services (HHS) has also announced free COVID-19 surge testing that will continue each week in the following:

Columbia (Mondays, 10 a.m.-5 p.m.)
Branson (Tuesdays, 10 a.m.-5 p.m.)
St. Louis (Tuesdays and Wednesdays, 9 a.m.-5 p.m.)
Cape Girardeau (Thursdays, 10 a.m.-6 p.m.)
Lee’s Summit (Thursdays, 10 a.m.-6 p.m., and Fridays, 10 a.m.-5 p.m.)

Testing at these locations is available to individuals 5 years and older – including those experiencing symptoms; those who believe they may have been exposed to someone with COVID-19 coronavirus; and anyone who is worried about possibly having the virus. Individuals seeking testing do not need to be a resident of the community where these testing sites are located. Individuals under 18 years old must have a parent or legal guardian present to consent to testing.

Testing is expected to continue at the following locations for the remainder of this year. Individuals are encouraged to pre-register online at DoINeedaCovid19Test.com.

More information regarding COVID-19 in Missouri can be found at health.mo.gov/coronavirus.

Outbreak Testing Data Reporting Changes

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Effective Friday, November 6, 2020, Long Term Care Facilities no longer need to submit the “Long Term Care Facility COVID-19 Testing Spreadsheets” to record outbreak testing via the Redcap portal. Rather than submitting individual resident and staff data to the Section for Long-Term Care Regulation, LTCF will use the same portal (the title will change to Long Term Care Facility COVID-19 Outbreak Testing Data Reporting) to report basic data elements for each testing cycle to include:

  • Facility identifying data
  • Date outbreak testing occurred
  • # of residents tested
  • # of staff tested

https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/professionals.php#collapseSix

For questions regarding outbreak testing and reporting, please contact your SLCR regional office  https://health.mo.gov/seniors/nursinghomes/pdf/LongTermCareRegions.pdf or tracy.niekamp@health.mo.gov.