COMRU Update

During the Summer of 2024, COMRU implemented several enhancements to the online application system. To test the effectiveness of those enhancements, on September 1, 2024, COMRU began reviewing newly submitted applications as well as reviewing applications submitted prior to September 1.

COMRU is current with reviewing newly submitted applications and has made significant progress in reviewing applications submitted prior to September 1. Only applications submitted July 22 to August 31, 2024, are pending review. COMRU expects to have all applications submitted prior to September 1 reviewed by the end of the calendar year.

Please note: Applications returned to the submitter for correction will be deleted from the online application system if corrections are not made and resubmitted to COMRU within 60 days. he submitter may access the online application at any time to check the status of a pending application. Training on how to check the status of an application can be located on COMRU’s webpage (Under Trainings/WebEx Training – Level One Online Form Feb 2024).

 

Tips and Reminders

  • All attachments to the online application must be in PDF format – please do not include web links. Applications including web links will be returned for correction. All application documents are scanned by COMRU for retention purposes; web links are not stable and cannot be scanned.
  • For Level 1 applications, attachments should be a limited number of pages and only include the information requested. For example, if an applicant is in the hospital, the submitter must either type in the date/reason for hospitalization or attach a hospital H&P that includes this information. The entire H&P from the hospital is not necessary – only those pages that include the date/reason for hospitalization are required.
  • Please review all diagnoses for the applicant including those on the diagnosis list and those listed in any other attachments and answer the application questions accordingly. The most common errors related to diagnoses are:
    • Section D, Question 6: Does the individual have a diagnosis of Major Neurocognitive Disorder (MDNC), i.e., dementia or Alzheimer’s?
    • Section E, Question 2a: Does the individual have a suspected diagnosis or history of an Intellectual Disability/Related Condition?

Many applications have one of these diagnoses listed and this question is answered “no” when the answer should be “yes”. When the question is marked “yes” follow-up questions populate; marking “no” results in an incomplete application which will be returned for correction.

For additional information and answers to frequently asked questions, please review the online training posted on the COMRU webpage.

COMRU PASRR and Level of Care Orientation Training

The Central Office Medical Review Unit (COMRU) has scheduled monthly orientation training to review the requirements of the Pre-Admission and Resident Review (PASRR) and Nursing Facility Level of Care (LOC) application process. These on-line trainings will be one-hour in length and hosted by Ammanda Ott, RN Supervisor for COMRU. Each training is limited to 50 individuals, so register soon!

Webinar series registration link: https://stateofmo.webex.com/webappng/sites/stateofmo/webinar/webinarSeries/register/cc01ce6f1d64435db3a716b6c489bf51

Upcoming Training Dates/Times

November 5, 2024: 11:00 am
December 10, 2024: 11:00 am
January 14, 2025: 11:00 am
February 11, 2025: 11:00 am
March 11, 2025: 11:00 am

 

Why We Are Conducting These Trainings?
• The LOC/PASRR process is complex and can be overwhelming if individuals do not receive sufficient training. We want to make it easier for you!

• Approximately 50% of applications are returned for corrections. This results in delays to the review and approval process – which directly impacts Medicaid payment to nursing facilities and can result in prolonged hospital stays.
• COMRU receives an average of 30-40 calls per day – many of the answers to the questions asked are contained in information accessible online. A decrease in phone calls will allow additional time for COMRU to review pending applications.

Training Agenda
• Overview of the PASRR and LOC requirements.
• Review of the application process from application submission to approval, including recent enhancements made to the online application system.
• Review of common errors that result in the application being returned for correction.
• Discussion of critical information needed to determine whether the application triggers for a Level 2 evaluation and the impact to the nursing facility and hospital.

Who Should Attend
• Individuals who are new to completing the LOC/PASRR application.
• Individuals who want a refresher of the requirements.

Benefits of Attending
• Familiarity with the process and information included online to assist with completing the application.
• Decrease in returned applications and reduction of processing times.

Prior to attending, please review both on-line trainings (New LOC Webex Training Oct 2021 and Level One Online Form Training Feb 2024) located on COMRU’s webpage https://health.mo.gov/seniors/nursinghomes/pasrr.php.

Please see the flyer

CNA Training Reimbursement Opportunity for SNFs

Did you know… skilled nursing facilities can receive reimbursement for CNA training?

The Health Education Unit hosted a webinar along with Mo HealthNet to provide information regarding the amount of reimbursement, instructions related to the submission and important data to consider for reimbursement.

Didn’t get to attend? No problem, watch it now!

For questions, contact the Health Education Unit at 573-526-5686 or email at CNARegistry@health.mo.gov.

Infection Prevention and Control Office Hours

Sessions Begin on September 18 at 12 p.m. ET

Register now to join free virtual Infection Prevention and Control Office Hours, which address topics concerning respiratory virus season.

The focus will be on COVID-19 and strategies to decrease transmission among nursing home residents and staff. This series is tailored specifically for long-term care facilities, providing valuable support in areas such as COVID-19 prevention, immunization strategies and strategies to stay healthy. These sessions will help you discover ways to enhance care for both residents and staff.

Please see this flyer for details and registration

Healthcare Quality and Worker Safety Information from CDC

Exciting News! CORHA Launches Newly Redesigned Website – CORHA, The Council for Outbreak Response: Healthcare-Associated Infections (HAIs) and Antimicrobial-Resistant Pathogens (AR) (CORHA) has recently launched a newly redesigned website. The new site offers enhanced features and expanded information to improve user experience, accessibility, and functionality.

 

Long-Term Care Webinar: 2024-2025 Respiratory Virus Season Updates – Please join CDC’s Division of Healthcare Quality Promotion (DHQP) on Monday, September 16, 2024, at 1 p.m. EDT for an overview of the latest respiratory virus vaccination recommendations, testing and treatment guidance, and infection prevention strategies. Long-term care facility residents are often at high risk of respiratory infections and severe disease due to respiratory viruses. A combination of interventions can protect residents and staff health during respiratory virus season.

Register: https://cdc.zoomgov.com/webinar/register/WN_H4-bbiGEQyOCaP7YUT8Jng

 

ICYMI: CDC and AMA Respiratory Virus Season latest information – During the event, speakers from CDC, including CDC Director Dr. Mandy Cohen, provided important updates on protecting patients and others against influenza, COVID-19, and RSV. Updates included:

  • Emerging immunization issues, as well as recommendations and resources for providers.
  • Reminders about treatments available for patients at increased risk of severe COVID-19 illness.

Preview of new HHS vaccination education campaign – Risk Less. Do More.

Antimicrobial Stewardship for LTCF

NEW FREE RESOURCE

The Healthcare-Associated Infections/Antimicrobial Resistance (HAI/AR) Program has created a free antimicrobial stewardship playbook made for long-term care facilities (LTCF). This playbook includes background information on the state of antimicrobial stewardship in LTCF in Missouri and includes 17 ready-to-use tools and templates to help with antimicrobial stewardship efforts within your facility. Please share this playbook with anyone in your facility that is involved with antimicrobial stewardship activities and efforts.

A link to the playbook is provided here: https://health.mo.gov/professionals/antibiotic-stewardship/pdf/asp-playbook-ltc.pdf.

A link to the MODHSS LTC Antimicrobial Stewardship webpage is provided here: https://health.mo.gov/professionals/antibiotic-stewardship/tools-ltc.php.

Also of news, the HAI/AR program now has an antimicrobial stewardship pharmacist on staff to help answer questions, provide educational content, and help collaborate with antimicrobial stewardship projects and initiatives within your facilities, along with all healthcare facility types in the state. This can also be a great opportunity to participate in a free, non-regulatory assessment of your stewardship program efforts to try and meet antimicrobial stewardship requirements.

If you are interested in hearing more about this, or have questions about healthcare-associated infections, Candida auris, or other multidrug-resistant organisms, please reach out to the DHSS HAI/AR program for more information.

HAI/AR Program Contact Information
Phone: 573-751-6113

Email: HAI_Reporting@health.mo.gov

COVID-19/Flu Test Kits

DHSS has a limited quantity of Acon FloFlex home test and plenty of COVID/Flu combo clinical tests available for request at the following link for LTCF. Requests for Acon FlowFlex are currently limited to one case of 300 tests per request.

Application Site: https://www.arcgis.com/apps/dashboards/52138a04a74e448284e6280770d722ad

Questions related to COVID? The ICAR team can help. ICAR Project | Nursing Home Help

2024 NHSN Annual Training Platform is now Open

The NHSN Annual Training platform is now open! You can now register, access all pre-recorded videos for viewing and start preparing for our live presentations starting July 23, 2024, at 9:00 am EST.

We are officially 1 week away. Log in today to view videos and download slide decks for live sessions. Please note that the pre-recorded sessions kicked off July 15, 2024 and the live virtual training starts next Tuesday, July 23, 2024, at 9:00AM EST.

You can log in to gain access and review the sessions at your convenience.

Click here https://2024nhsntraining-pac.vfairs.com/ to register and confirm your attendance.

We hope that you are getting excited because we are excited and ready!

“See” you soon!

The NHSN Team

HQIN: Simple Strategies for Summer Emergency Preparedness

 
July 2024

Simple Strategies:
Summer Emergency Preparedness

Emergency preparedness is important in every season, but it is especially important in the summer. Summer storms, tornadoes and hurricanes often come with damaging winds and rain, and have similar preparations even though they occur in different areas of the country.
 

In This Newsletter:

Learning Opportunities

 
Extreme Heat
Across the nation we have been experiencing heat waves. Extreme temperatures can negatively affect people, especially populations like nursing home residents. Both staff and residents must take necessary precautions to prevent complications related to excessive heat. Nursing home residents are among the most vulnerable to heat exhaustion and heatstroke.
 
Some suggested interventions for your facility may include the following:

  • Establish a facility protocol with guidance from the medical director about when outdoor activities can/should occur. If residents must be out, such as for transport to medical appointments, etc. be sure they are dressed appropriately for extreme temperatures and be sure to pack them with hydration materials. 
  • Alert staff to monitor residents for the signs and symptoms of heat exhaustion and heatstroke. Notify the resident’s physician of such observations and obtain medical services as needed.
  • Request clinical pharmacist monthly reviews to highlight potential medications that might create higher risks. Review resident medications and identify those that may cause residents to become more susceptible to harm from heat and sunlight.
  • Assure that facility policies and procedures for heat emergency situations are current, complete and staff are trained.
  • Monitor temperatures in care areas and resident rooms.
  • Monitor residents’ choice of clothing to ensure it is appropriate in extreme temperatures. Loose-fitting, light-colored cotton clothing is best to allow the skin to breathe.
  • Help decrease temperatures by closing window blinds and turning off unneeded lights in the daytime.
  • Assist residents to maintain adequate fluid intake. In addition to water, consider popsicles, Jell-O, sherbet and juices to keep residents hydrated.
  • When outside, encourage residents to sit in shaded areas and to use sunscreen.
  • Close windows, doors and blinds during the daytime and open them at night after the outside temperature cools sufficiently.

Check out the following resources to take proactive steps in ensuring you stay cool, hydrated and recognize signs and symptoms of heat-related illness:

Extreme heat should be treated as a major weather emergency, just like an extreme storm and the possibility of power outages. Now is the time to pull out the facility emergency and disaster plans, ensure they are up to date, and be sure staff are educated about what to do.

 
Safe Temperatures in Nursing Homes
There are regulations requiring long-term care facilities to maintain safe temperatures.

F-Tag 584 pertains to comfortable and safe temperature levels in nursing homes. According to the regulation, facilities initially certified after October 1, 1990, must maintain an air temperature range of 71°F to 81°F. Ensuring a comfortable environment is crucial for residents’ well-being, minimizing susceptibility to hypothermia or hyperthermia.

Residents with a history of dehydration, cardiovascular disease or pulmonary disease are particularly susceptible to heat-related illnesses and complications. All staff should be aware and monitor for signs, symptoms and consequences of heat exhaustion, heatstroke and heat cramps.

Use this NHICS response guide as a checklist to ensure tasks are addressed and completed regarding severe weather.

 
Power Outages
Nursing homes across the country may experience power outages for various reasons. Many of these reasons are centered on natural disasters, such as hurricanes and tornadoes. Electrical interruption may also be caused by failing systems, such as electrical grid brownouts or blackouts. When nursing homes lose power, especially for extended periods of time, disaster can strike.

How can nursing homes prepare for the possibility of a power outage? The Federal Emergency Management Agency (FEMA) has published guidelines to facilitate the preparation process.

Among the preparation steps, FEMA recommends:

  • Analyzing risks, particularly those systems and components that can interfere with the ability to deliver care when power outages occur.
  • Identifying specific at-risk residents, such as those receiving temperature-stabilized medications or who may need power-operated support systems.
  • Securing temporary power support, including the use of generators.
  • Setting up redundant cooling systems for food supplies and medications, including off-site or temporary refrigeration facilities.
  • Establishing a maintenance and resupply chain for emergency power systems.
  • Establishing a plan to access resident records during power outages.
  • Establishing communication with organizations like emergency services, local or state health departments, emergency management agencies and evacuation shelter facilities.
  • Enhanced staff training to develop emergency-response skills and to ensure that all staff members understand their specific duties during a power outage.
  • Ensuring that nursing home insurance policies provide coverage for natural disasters that result in loss of electrical service.
  • Identifying shelters that are able to maintain healthcare services for residents if they are forced to evacuate.

By taking these steps in advance of a power outage, nursing homes will be better equipped to provide continuous and safe care to residents, all without subjecting residents and staff to the risks associated with electrical service interruption.

 
Hurricanes
Hurricanes are dangerous and can cause major damage from storm surge, wind damage, rip currents and flooding. They can happen along any U.S. coast or in any territory in the Atlantic or Pacific oceans. Storm surge historically is the leading cause of hurricane-related deaths in the United States.

Hurricane season is here, take time to understand and prepare for how a hurricane could affect you. You can start your hurricane preparedness efforts by downloading FEMA’s Hurricane Hazard Information Sheet.

Visit Ready.gov/hurricanes for more information and tips about hurricanes. You can also download the FEMA app (free of charge) to learn how to prepare for common hazards, receive real-time alerts from the National Weather Service and search for additional disaster preparedness guidance.
 
Tornadoes
Tornadoes are violently rotating columns of air that extend from a thunderstorm to the ground. Tornadoes can destroy buildings, flip cars and create deadly flying debris.

A tornado can:

  • Happen anytime and anywhere.
  • Bring intense winds, over 200 miles per hour.
  • Look like funnels.

The National Weather Service (NWS) provides numerous tornado safety resources. They can be accessed directly at Tornado Safety.

 
 

Shelter In Place: A Critical Component of Your Emergency Operations Plan: Updates from an Expert

by HQIN Consulting Subject Matter Expert Jordan Rennie, Owner and Principal of Rennie Consulting

Jordan assists the Health Quality Innovation Network (HQIN) as a subject matter expert working with nursing homes on emergency preparedness plan reviews and emergency preparedness education.

In the face of emergencies, healthcare facilities must be prepared to make quick and informed decisions to protect residents, staff and resources. A well-crafted Shelter in Place (SIP) section within your Emergency Preparedness Plan (EPP) is essential to ensuring operational continuity and safety. Here is a concise guide on key elements your SIP strategy should cover:
 

1. Preparation and Planning
 
Risk Assessment: Conduct a thorough risk assessment to identify potential scenarios that may necessitate SIP, such as severe weather, hazardous materials incidents or infrastructure failures. Tailor your SIP plan to these specific threats. This can be done while completing your annual Hazardous Vulnerability Assessment (HVA).

SIP Locations: Identify and designate safe areas within the facility where residents and staff can gather. These areas should be protected from external hazards and have access to necessary resources.

Supplies Inventory: Ensure a robust inventory of emergency supplies, including medications, food, water and medical equipment. Stock enough to sustain operations for at least 72 hours.

Upstaffing: Plan for increased staffing levels in anticipation of an SIP event. Arrange for additional clinical and support staff to be on site to handle increased demands and resident care needs.

Family: Ensure your family is prepared at home with their own shelter in place plan. You will not be able to adequately respond to an emergency at your facility if you are worried about folks at home.

2. Decision-Making: Shelter or Evacuate?
 
Criteria for SIP vs. Evacuation: Establish clear criteria to guide the decision on whether to shelter in place or evacuate. Consider factors such as the nature and scope of the threat, the condition of the facility and the safety of evacuation routes.

Decision Authority: Define who has the authority to make the SIP or evacuation decision. Ensure this individual or team is trained and has access to real-time information and communication channels.

Communication Plan: Develop a communication strategy to relay the decision to staff, residents and their families. Ensure everyone understands the protocol and their specific roles during an SIP event.

3. Proactive Measures
 
Resource Management: Maintain increased levels of critical supplies. Establish relationships with vendors to ensure quick resupply of essentials such as food, water, fuel and medical supplies. In addition, consider having a list of vendors both in your area and outside. This will increase resilience should vendors in your area be impacted as well.

Generator Capacity: Verify that your backup power systems, including generators, are functional and can support critical operations for extended periods. Regularly test these systems and ensure fuel supply arrangements are in place. Consider installation of generator “quick connects” that allow easy deployment of external generators.

Environmental Controls: Ensure that HVAC systems and other environmental controls can be managed during an SIP to maintain safe and comfortable conditions for residents and staff.

4. Communication with External Entities
 
Local Emergency Management: Establish and maintain open lines of communication with local emergency management agencies. Share your SIP plans and seek alignment with community emergency response strategies. Local emergency management leaders can assist you in making the decision to shelter in place or facilitate evacuation.

Vendor Coordination: Develop agreements with vendors for emergency delivery of essential supplies, including fuel, water, food and medical goods. Ensure contact information is current and establish protocols for rapid response.

Information Sharing: Implement mechanisms to share and receive information with external partners during an SIP event. This includes updating local authorities on your facility’s status and needs and receiving critical updates from emergency management agencies.

5. Training and Drills
 
Regular Training: Conduct regular training sessions for all staff on SIP procedures. Ensure everyone understands their roles and responsibilities during an SIP event.

Drills and Exercises: Perform regular SIP drills to test your facility’s preparedness. Use these exercises to identify gaps in your plan and refine your strategies.

6. Regulatory Requirements and Resources
 
Planning and preparation are great practices. They can assist in creating a more resilient and safer environment for staff and residents. However, it is also important to keep regulatory requirements in mind. The following E-Tags are covered by the CMS Emergency Preparedness Rule relating to SIP and Evacuation.

Regulatory E-Tags: E0018, E0020, E0022, E0015, E0041

For more information, refer to the CMS Emergency Preparedness Rule Webpage.
 

Conclusion
A comprehensive SIP plan is vital to the resilience of healthcare facilities during emergencies. By focusing on preparation, clear decision-making processes, proactive measures and robust communication with external entities, you can ensure that your facility is ready to protect and care for residents and staff when the unexpected occurs.

 
Training and Education Importance
Emergency Preparedness Plan training and education is crucial for both staff and residents in nursing homes.

You want your staff to be prepared and you want your residents to feel safe.
You can accomplish this by providing staff with:

  • Knowledge and Skills: Staff need to be well trained in emergency procedures, including evacuation, communication and response protocols. Training ensures they know what to do during various emergencies.
  • Drills and Exercises: Regular drills and exercises help staff practice their roles, understand evacuation routes and learn how to handle different scenarios.

Trained staff can respond efficiently, minimizing risks to residents and themselves.

For resident safety, providing residents with:

  • Awareness: Residents should be informed about emergency plans, evacuation routes and safety measures. Training helps them understand what to expect during emergencies.
  • Shelter In Place and Evacuation Readiness: Residents need to know how to safely shelter in place, evacuate safely and how to follow instructions from staff.
  • Reducing Panic: Proper training reduces panic and confusion during emergencies, ensuring residents can follow procedures calmly.

Remember, ongoing training, exercises and evaluation are essential to ensure staff and residents respond appropriately during emergencies.

 
Is Your Emergency Preparedness Plan Survey Ready?

See What People Are Saying About Our EPP Review Assessment Tool:

“I truly appreciate your insights. This was extremely helpful as I get my EPP updated.”
“Thanks for your insight and expertise.”
“I’m so grateful for your help.  This review was exactly what I needed.”
“Time well spent.”

Are You in Need of a Turnkey,
Ready to Implement, Tabletop Exercise?

The team of experts at the Health Quality Innovation Network (HQIN) is offering free support to ensure your facility’s emergency preparedness plan meets all the necessary criteria.
 
Take our online assessment, which guides you through a series of questions that will quickly identify what could be missing in your current emergency preparedness plan. After you submit your responses, an HQIN quality improvement advisor will review your responses and provide you with tools and resources to help support survey readiness. In addition, we will send you a complete, ready to implement, Tabletop Exercise and After-Action report.

Ready to get started? Scan the QR code or click the button below:

 
Click HERE to Take the Assessment
 
After Action Report Improvement Plan Template
Download our After Action Report Improvement Plan Template, which is a tracking form that allows teams to record real emergency events and exercises to document the scenario, capabilities tested, strengths, areas for improvement and more.

Nursing Home Excellence:
Prepare, Prevent, Protect (3P) Top Performer Program
The Health Quality Innovation Network’s (HQIN) Prepare, Prevent, Protect (3P) Top Performer Program recognizes participating nursing homes who are proactive in delivering high quality care to their residents and ensuring a safe environment for residents, staff and visitors.

The 3P Top Performer facilities achieve success in the following three designations:

  • PREPARE: Implement planning, policies and training on emergency preparedness and infection prevention.
  • PREVENT: Prevent avoidable resident emergency department visits, readmissions and hospitalizations.
  • PROTECT: Commit to ongoing, proactive immunization program.

Congratulations on achieving success in all three designations! Share with your staff and recognize them for their contributions.

Download the list of nursing home facilities being recognized.

 
Emergency Protocol for Long-Term Care Homes
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 resulting 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 provides the cellular telephone number 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 because survey staff carry the cell phone and may be conducting a survey or inspection during working hours and may not answer immediately.

Download the Emergency Protocol Handout for Facilities for the phone number to use in your area.

This protocol is NOT to be used to self-report incidents normally reported to the Elderly Abuse & Neglect Hotline (1-800-392-0210).

If you have any questions about the Emergency Protocol for Long-Term Care Homes, please contact the Section for Long-Term Care Regulation at 573-526-8524.

 
 

Learning Opportunities

Facility Assessment: More Than a Regulatory Requirement

Learn CMS Required Regulatory Components Due by August 8!

July 17 at 10 a.m. ET
Join us on July 17 where we will focus on the new facility assessment requirements from the Centers for Medicare & Medicaid Services (CMS). You will not want to miss this opportunity to learn what needs to be done by August 8 to ensure your facility assessment meets all required regulatory components
 
The facility assessment is referenced 172 times in the 329-page staffing rule and is also the first requirement in preparation for the staffing requirement. F838 has been in play since 2016 but is taking on a new shape and focus with less than a month to make the required updates by August 8.
 
At the end of the session, you will:

  • Understand the revised facility assessment requirements and regulatory updates.
  • Understand how to complete the facility assessment process with your team.
  • Understand how to identify resources that are necessary to care for residents competently during normal day-to-day operations and emergencies.
  • Understand how to link the facility assessment to your emergency preparedness plan (EPP) and QAPI program.

Learn how the Health Quality Innovation Network (HQIN), as your Quality Improvement Organization, can provide assistance.

Register Here
 
 

Learning Modules for Nursing Home Staff, Visitors and Residents Teach Infection Prevention

Infections can be deadly in nursing homes. Solid infection prevention practices, coupled with the COVID-19 vaccine, are key to protecting those who live and work there.

Download our flyer and post it in your nursing home to encourage staff, visitors and residents to learn how to prevent infections. The brief learning modules, which are accessible through a link on the flyer or by scanning the QR code, review the dangers of infections and how to prevent them.

 
 

Newly Updated CMS Training for Frontline Nursing Home Staff and Management – Modules 5 and 8

Learn about the impact of dementia in caring for nursing home residents with COVID-19 and how to protect the emotional health of nursing home staff through this no-cost, updated Quality, Safety & Education Portal (QSEP) online training developed by the Centers for Medicare & Medicaid Services (CMS).

View scenarios In Module 5: Caring for Residents with Dementia to gain more understanding of the special needs that residents with dementia have and how to best care for them. Master content at your own pace, learning anytime and anywhere, even on your mobile devices.

While many concerns rest on the physical health and well-being of nursing home staff and residents, emotional health is also important. Module 8: Emotional Health, is designed for nursing home managers to learn how to develop creative strategies to promote and support emotional health for staff and residents.

 
 

New Learning Modules on Diabetes Available Now!

We are pleased to announce the release of our comprehensive new learning modules on diabetes. These modules are designed to enhance your knowledge and skills in identifying, treating and managing diabetes, providing you with the latest best practices for optimal resident care. To access these modules, and others on a variety of topics, visit HQI Academy, our online learning management system.  
 
New to HQI Academy? After you follow the link, click “SIGNUP” in the upper right. Fill out the short form to create your account. Once logged in, you’ll have access to a variety of courses on the main dashboard. Simply click on the cover of any course to start learning.
Access HQI Academy
 
 
About the Health Quality Innovation Network
Led by Health Quality Innovators and its quality improvement partners, Constellation Quality Health, KFMC Health Improvement Partners and the Kansas Healthcare Collaborative, HQIN is the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Kansas, Missouri, South Carolina and Virginia. To learn more about HQIN visit https://www.hqin.org.
 

Celebrate & Support Nursing Assistants

National Nursing Assistants Week was celebrated June 13-19, 2024. Join CDC’s Project Firstline to recognize Certified Nursing Assistants (CNAs) across the nation who show an unwavering commitment to providing quality care to their patients and residents.

CNAs are skilled, vital members of the healthcare team, and we express our gratitude for their commitment to serving on the frontlines each day. CNAs dedicate themselves to infection prevention and control and help maintain safe and healthy environments for all patients and residents.

Show your Support

Support CNAs in your facility by saying “thank you” and acknowledging their contributions, which enhance infection control knowledge and make a significant impact in people’s lives.

Build their Knowledge

Utilize these important resources with CNAs in your facility to continue to build knowledge and strengthen infection control practices:

  • Interactive infection control activities: CNA’s can test their knowledge in real time and learn how to apply infection control solutions to stop the spread of germs.
  • Infection Control training toolkits: View ready-made materials and resources to host facilitated training sessions on a variety of infection control topics.
  • Micro-learn series: Use a series of guided discussions to help your staff recognize common infection risks and stop the spread of germs.
  • Enhanced Barrier Precautions resources: If you work in a nursing home, share these resources to help support your staff in understanding and effectively using Enhanced Barrier Precautions to protect residents and themselves.

Frequently asked questions
Pocket card
Overview video

Missouri’s Master Plan on Aging Needs to Hear From You!

Help us make the State of Missouri a great place to live and age with dignity!

On June 13, we will be launching the State of Missouri 2024 Needs Assessment Survey on Polco, our online civic engagement platform. Randomly selected households will receive mailed survey invitations around that time. If you receive an invite and meet the criteria listed, please follow the instructions to participate!

If you aren’t selected for this initial survey effort, stay tuned: in July, the survey will be open to all adults age 50+, adults (age 18+) with disabilities, and unpaid caregivers (adults 18+ who provide care for another adult).

To receive an email notification when this survey is available, click the link below, select “Follow” next to Missouri Association of Area Agencies on Aging, and set up a Polco account.

Thank you for helping to create a better community for all!

Set Up a Polco Account

Thanks to all of our champions who work tirelessly to create communities in Missouri where we can all age well.

Your Voice Matters!

2024 SLCR Annual Provider Meetings

Sponsored by the Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation

Thank you to all that attended one of the 2024 Provider Meetings.

There is no cost to attend any of these meetings.

New this Year – Online Registration!

Earn up to 5 CEUs (2.75 Admin/2.25 PC). 

September 4, 2024: Region 2 Agenda
Location: Drury Plaza Hotel & Convention Center, Cape Girardeau

September 5, 2024: Region 7 Agenda
Location: Crowne Plaza St. Louis Airport, Bridgeton

September 18, 2024: Region 1 Agenda
Location: Oasis Hotel & Convention Center, Springfield

September 24, 2024: Region 6 Agenda
Location: Special Olympics Missouri, Jefferson City

September 26, 2024: Region 5 Agenda
Location: Moberly Municipal Auditorium, Moberly

October 1, 2024: Region 4 Agenda
Location: Stoney Creek Hotel, St. Joseph

October 2, 2024: Region 3 Agenda
Location: Adams Pointe Conference Center, Blue Springs

 

Handouts
1. Activities for Special Populations
2. Supporting Well Being A Foundation for Person-Centered Care

3. Missouri Medicaid Case Mix
4. Survey Success Tips and Pearls for Excellence in LTC Compliance
4b. 7 Week Survey Prep

5. Region 2 Section Update
5. Region 7 Section Update
5. Region 1 Section Update
5. Region 6 Section Update
5. Region 5 Section Update
5. Region 4 Section Update
5. Region 3 Section Update
7. Enhanced Barrier Precautions

MO Health Ambassador Trainings

Attention Missouri Nursing Homes!

Register for a Free In-Person Health Ambassador Training

Sessions Will Be Held in Jackson/Cape Girardeau, Saint Louis and Springfield

Don’t miss this opportunity to register two individuals from your nursing home for a free regional in-person Health Ambassador Training in Missouri being presented by the Health Quality Innovation Network (HQIN) and Johns Hopkins University.

This training uses the Be REAL framework which focuses on building trust by forming relationships, targeting resources responsive to a facility’s population, and always keeping the door open for interactions to improve health outcomes such as immunizations and infection prevention.

Two people may register per facility and a maximum of 40 participants will be allowed for each session. Recommended participants include all staff, such as:

  • Nurses
  • Infection Prevention Nurses
  • Nursing assistants
  • Social services
  • Dietary
  • Environmental services
  • Also, please consider sending a resident, family member or volunteer.

These sessions will be interactive and include group discussion, small-group activities, games, and an opportunity to practice what has been learned. 

MO Health Ambassador Trainings

For questions, please contact us at ltc@hqi.solutions.

These trainings have been made available by the Health Quality Innovation Network (HQIN) and the Institute for Vaccine Safety – Johns Hopkins Bloomberg School of Public Health.

Cyber Security Preparedness Reminder

Managers from the Division of Regulation and Licensure within the Missouri Department of Health and Senior Services recently attended an update meeting with the CMS Regional Office in Kansas City. An informative presentation was provided by Captain Skip Payne, Director of the Emergency Preparedness & Response Operations (EPRO). Please see the attached key points and reminders.

HQIN Strategies to Use During Your Nursing Home Stand-Up Meetings

Entire Series Now Available for Download!

The Health Quality Innovation Network’s free 9-week education series is now available for download on our Resource Center. Download the topic(s) that you want to focus on in your facility or download the entire series and work through all nine weeks.

The five short, concentrated evidence-based talking points in each week can easily be included in daily stand-up meetings to increase staff knowledge on relevant topics. The program is designed to empower nursing home staff with practical knowledge to foster a safer environment and decrease preventable emergency room visits and hospital readmissions.

We’d appreciate your feedback on this education series. Please share your experience in using the content and materials offered in the Nursing Home Stand-Up Series.

VOYCE’s Upcoming Events

April 16, 2024: Community Education: Tips to Remain Fiscally Fit as You Age

Are you worried about being financially scammed, missing bill payments, or neglecting to review your bank account statements? Or have you struggled to update your beneficiaries? If so, a daily money manager can help. These financial professionals offer personal services to individuals, families, older adults, people with disabilities, busy professionals, high-net-worth individuals, and small businesses. Learn more about their services and how you can protect your assets as you grow older.

April 22, 2024: Caregivers’ Resilience and Family Resources

Becoming a sudden caregiver for your loved one can be overwhelming. Identify tips on how to sustain your lifestyle and invest in self-care.

May 2, 2024: Professional Development Webinar: Cultivating an LGBTQ+ Friendly Community

The National Gay and Lesbian Task Force has outlined that the population of LGBTQ+ older adults in the U.S. is expected to double in size, becoming six million strong by 2030. Questions about the availability of inclusive housing for older LGBTQ+ people are rising. The purpose of this presentation is to inform attendees about the barriers that LGBTQ+ elders face when seeking out housing and long-term care services. This presentation will also introduce attendees to the Long-Term Care Equality Index (LEI), a tool founded by SAGE and the Human Rights Campaign to assist Long Term Care Communities in becoming more inclusive to LGBTQ+ elders. Attendees will leave this presentation with actionable steps on how to get connected to the LEI and how to start making their communities more inclusive to LGBTQ+ older adults.

May 7, 2024: Legacy Planning 101: Don’t Leave Your Family Guessing

With proper assistance, planning for the next chapter of life need not be stressful. Learn from an elder law attorney about the five essential documents to honor friends’ and relatives’ wishes.

May 20, 2024: ABUSE – Verbal, Physical, Sexual, Financial – Help Protect Your Loved Ones

Learn how to identify the signs of abuse, how and where to report it, and how to support your loved one, friend, or family member if they are experiencing abuse.

MC5 Upcoming Meetings

April 19, 2024: We Honor Veterans Program and End-of-Life Care for Veterans
Location: Cape Girardeau Public Library, Cape Girardeau

The purpose of this program is to bring awareness to issues veterans face at end-of-life and to explain the We Honor Veterans Program. Veterans face different issues at end-of-life that are not often experienced by non-veterans. The We Honor Veterans Program helps navigate caregivers through these issues as well as provides education regarding resources within the community.

April 26, 2024: Person-Centered Program Planning
Location: Brentmoor Retirement Community, St. Louis

Programming is at the center of a community’s culture and can have a ripple effect throughout a community, by fostering inclusivity and an all-hands-on deck approach. We will be discussing various ways to incorporate person-centered values during the programming planning process; as well as giving examples of real-life programming that embodies the whole team and whole community approach. Attendees will be asked to bring a copy of the community activity calendar for an interactive approach to looking at those calendars through another set of lens’.

MANHA’s 2024 Annual Convention

June 2-5, 2024: Kick Off Your Summer with an Unforgettable MANHA Experience!
Location: The Resort at the Lake of the Ozarks

Missouri Association of Nursing Home Administrators is pleased to invite you to attend the 2024 Annual Convention. The goal of this conference is to provide meaningful, forward thinking, and real-time education to pave the path forward while acknowledging the past and working together.

HQIN Strategies to Use During Your Nursing Home Stand-Up Meetings (Purposeful Conversations)

HQIN is presenting an educational series tailored for nursing home stand-up meetings, aimed at decreasing preventable emergency room (ED) visits and hospital readmissions. HQIN is sending out talking points that can be included in daily stand-up meetings to increase staff knowledge on relevant topics like effective communication, adverse drug events and infection prevention. The program is designed to empower nursing home staff with practical knowledge to foster a safer environment.

This week is the final week of the series. This week’s strategies include Purposeful Conversations. Below is an overview of information and resources.

  • Purposeful conversation refers to intentional and meaningful communication that serves specific objectives or goals. It goes beyond casual chitchat and aims to achieve specific outcomes.
    Print and discuss with the team the following resource, Go to the Hospital or Stay Here. Social services staff or nurses can use this decision guide to facilitate clear and informative conversations of a resident’s choice to “Go to the Hospital or Stay Here.”
  • Do all of your residents have a documented advanced directive? Review which residents are a full code, and which are a Do Not Resuscitate (DNR). Discuss how staff know which residents are DNR and what the current process is to communicate this to all staff.

Print and discuss Education on CPR for Residents/Patients and their Representatives with the clinical team to guide conversations when providing education for residents and their family.

Advanced directives should be reviewed upon admission, quarterly, and if a change in condition would warrant it. Use this Advance Care Planning Tracking Form to assist with tracking these reviews.

  • It is often helpful to involve the physician or healthcare provider, in addition to the resident and their family, in purposeful conversations during care plan meetings. You may want to have an ad hoc care plan meeting if a decline in condition is noted.  Discuss with the team the importance of being proactive with change in condition. Consider inviting the physician or nurse practitioner to participate in a care plan meeting to participate in difficult conversations.

Print and discuss A Patient’s Guide to Serious Illness Conversations from the Institute for Healthcare Improvement to guide these conversations.

  • Advanced care planning for vaccinations is a best practice. The Planning for COVID-19 Care Conversation Tool can assist with having purposeful conversations centered around vaccinations upon admission and at quarterly care plan meetings. Print and share the same resource with the admissions and clinical care plan team and discuss how it can be incorporated into current practice.