2021 Annual SLCR Provider Meeting

The 2021 Annual Section for Long-Term Care Regulation Provider Meeting was held virtually on November 10, 2021.

The recorded videos are available at https://missouri.qualtrics.com/jfe/form/SV_ehWffJkM2r7WSHk.

 

Many questions asked during presentation were asked and have been compiled into a document with answers in the attached Provider Meeting Q&A.

In response to some specific questions, please see this medical marijuana presentation that was given by SLCR.

 

Please see the agenda here.

PowerPoint Handouts
1. Welcome & Section Updates
2. Division Introductions
3. Nursing Home Discharges
4. The New CNA Testing Process
5. Immediate Jeopardy and Past Noncompliance
6. Psychosocial Impact
7. Oral Health
8. ICAR Project
9. Life Safety Code Presentation

 

Level of Care Transformation (webinar posted)

Exciting transformation is coming for the Level of Care (LOC) process effective 10/31/2021! Our current LOC Process (many of us have referred to as the DA124 A/B forms) is undergoing major changes!

Here are some of the highlights:

The application process will all be ELECTRONIC. You will fill out and submit forms online on the COMRU website at https://health.mo.gov/seniors/nursinghomes/pasrr.php. For example, the forms will be able to be sent from the hospital to the nursing home to COMRU, all in one system. This electronic link will be available starting October 29, 2021. COMRU will not process these application until November 1, 2021.

The process of evaluating Level of Care will also change. New areas will be evaluated and previous areas will be changed in order to provide the best assessment for determining Level of Care. You can read about the new process in the proposed Regulation at 19 CSR 30-81.030, https://health.mo.gov/about/proposedrules/, which will go into effect on 10/31/2021.

To help facilities prepare for these changes, COMRU hosted a webinar on 10/28/2021. The recorded version of the New LOC Webex Training may be found on the COMRU webpage. A Q & A document from this webinar is also available.

Additionally, COMRU will be hosting a follow-up Webex training for the LOC Transformation. Details below:

November 19, 2021 at 10:00 a.m.

When it’s time, join your Webex meeting here – Join meeting

Join from the meeting link
https://stateofmo.webex.com/stateofmo/j.php?MTID=m0f8dc5933c03862f60654e49cfb9a1dd

Join by meeting number
Meeting number (access code): 2466 296 8040
Meeting password: A2CaeX3FZP9

Join by phone
1-650-479-3207 Call-in toll number (US/Canada)
+1-312-535-8110 United States Toll (Chicago)

Level of Care Transformation

Exciting transformation is coming for the Level of Care (LOC) process effective 10/31/2021! Our current LOC Process (many of us have referred to as the DA124 A/B forms) is undergoing major changes!

Here are some of the highlights:

The application process will all be ELECTRONIC. You will fill out and submit forms online on the COMRU website at https://health.mo.gov/seniors/nursinghomes/pasrr.php. For example, the forms will be able to be sent from the hospital to the nursing home to COMRU, all in one system. This electronic link will be available starting October 29, 2021. COMRU will not process these application until November 1, 2021.

The process of evaluating Level of Care will also change. New areas will be evaluated and previous areas will be changed in order to provide the best assessment for determining Level of Care. You can read about the new process in the proposed Regulation at 19 CSR 30-81.030, https://health.mo.gov/about/proposedrules/, which will go into effect on 10/31/2021.

To help facilities prepare for these changes, COMRU will be hosting a webinar. Additional trainings to follow.

Thursday, October 28, 2021 at 10:00 a.m.

Join from the meeting link
https://stateofmo.webex.com/stateofmo/j.php?MTID=m37d648b96f1c1d7176099f11c07b6185

Join by meeting number
Meeting number (access code): 2451 311 8637
Meeting password: 3YXgTsdkc37

Tap to join from a mobile device (attendees only)
+1-650-479-3207,,24513118637## Call-in toll number (US/Canada)
+1-312-535-8110,,24513118637## United States Toll (Chicago)

Join by phone
1-650-479-3207 Call-in toll number (US/Canada)
+1-312-535-8110 United States Toll (Chicago)

Pioneer Network Hot Topics – Culture Change in Action

November 16, 2021: Recharge with a Nature Fix
Speaker: Tammy Marshall, Biophiliac & Longevity Expert and Founder & CEO of Biophilia Pharma

Join Pioneer Network for the last of the 2021 Share the Vision webinars, where speaker, Tammy Marshall, Biophiliac & Longevity Expert and Founder & CEO of Biophilia Pharma, will share with attendees the power of nature in supporting health and well-being – not only the residents you support, but for you!

Tammy will explain the value of nature as a health equity and the science behind nature immersion (Yes, spending all those hours outdoors engaging with nature has value beyond just the fact that you like it and it is fun!) She will share tips on how you can find yourself a nature fix, how it is all about knowing thyself.

In Tammy’s work, she has seen how supporting residents so that they can enjoy the outdoors is often very challenging for care communities, and as we approach the winter months, that challenge can become greater, and so Tammy will also be sharing ways to bring the outdoors in.

Action Pact’s Conversations with Carmen

November 19, 2021: Creating Connectedness
Presenter and Host: Carmen Bowman

LTC communities face daunting challenges when it comes to the difficulties of staffing right now. Employees have increased expectations of their leaders and managers than in the past. For organizations to thrive during rapid change, they need a mindset shift from traditional problem solving to an increased emphasis on the needs of the employee and the vital roles they hold. Learn to identify the top reasons why employees leave, and ideas for a culture that honors and includes employees like never before.

2021 Annual SLCR Provider Meeting – SAVE the DATE

Sponsored by the Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation in partnership with MU Sinclair School of Nursing, this year’s SLCR Provider Meeting will be held virtually.

Wednesday, November 10, 2021

With the meeting being conducted virtually this year, registration will be required. The link to register along with session information will be coming soon. Please stay tuned to the LTC Information Update for more details.

CMS Memo QSO-20-38-NH: Interim Final Rule (IFC), CMS-3401-IFC, Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency related to Long-Term Care (LTC) Facility Testing Requirements

Long-Term Care (LTC) Facility COVID-19 Testing Requirements (QSO 20-38-NH, revised 9/10/2021)

Please read the memo carefully. CMS has revised testing requirements for nursing homes including testing of symptomatic residents and staff, and routine testing of staff. Two major changes are:

  • Facilities now have two options to conduct outbreak testing, through either a contact tracing or broad-based testing approach. See Table 1.
  • Routine staff testing is now based on the facility’s county level of community transmission instead of county test positivity rate. The link to determine county level of community transmission is in the memo. The frequency of testing has also been updated. See Table 2.

 

Table 1: Testing Summary

Testing Trigger

Staff

Residents

Symptomatic individual identified

Staff, vaccinated and unvaccinated, with signs or symptoms must be tested.

Residents, vaccinated and unvaccinated, with signs or symptoms must be tested.

Newly identified COVID- 19 positive staff or resident in a facility that can identify close contacts

Test all staff, vaccinated and   unvaccinated, that had a higher-risk exposure with a COVID-19 positive individual.

Test all residents, vaccinated and unvaccinated, that had close contact with a COVID-19 positive individual.

Newly identified COVID- 19 positive staff or resident in a facility that is unable to identify close contacts

Test all staff, vaccinated and unvaccinated, facility-wide or at a group level if staff are assigned to a specific location where the new case occurred (e.g., unit, floor, or other specific area(s) of the facility).

Test all residents, vaccinated and unvaccinated, facility-wide or at a group level (e.g., unit, floor, or other specific area(s) of the facility).

Routine testing

According to Table 2 below

Not generally recommended

 

Table 2: Routine Testing Intervals by County COVID-19 Level of Community Transmission

Level of COVID-19 Community

Transmission

Minimum Testing Frequency of

Unvaccinated Staff+

Low (blue)

Not recommended

Moderate (yellow)

Once a week*

Substantial (orange)

Twice a week*

High (red)

Twice a week*

+Vaccinated staff do not need to be routinely tested.

 

Please see the full memo for complete details at https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/interim-final-rule-ifc-cms-3401-ifc-additional-policy-and-regulatory-revisions-response-covid-19-0.

MHCA Virtual Convention 2021

October 1-31, 2021: MHCA Virtual Convention

For those who attended the convention in-person but missed an education session, you now have access to any missed sessions as well. Therefore, all of the facilities that registered for the in-person Convention are automatically enrolled in the Virtual Convention! Please note – each facility registered for the Virtual Convention can allow an unlimited number of attendees from your registered facility to participate in the education sessions offered virtually.

If you could not attend the in-person Convention, you can register now for the Virtual Convention. Once the Virtual Convention begins, the education sessions will be available 24/7 and run through October 31.

Pioneer Network Hot Topics – Culture Change in Action

October 21, 2021: Someone Just for Me: Recognizing a Critical Role for Volunteers
Speaker: Dr. Paul Falkowski, Ph.D., Gerontologist, Author, Speaker, Educator

Long before COVID-19, professionals working in long-term care knew about the devastating effects of social isolation. Now because of COVID-19, social isolation has become an all too familiar term to the general population. We heard reports of people passing due to being disconnected from their families and friends during the past year. But what about the people who did not have family or friends?

Creating and sustaining intimate relationships takes time and commitment. In this session, you will learn the critical components for creating “authentic” relationships. You will learn how to recruit, screen for, and train a cadre of volunteers, who go on to become “companions” or, as one older woman observed, “…someone that is here just for me.” We’ll look at the transformational power volunteers like these can have on the people you serve, the people serving them, the volunteers themselves, and your surrounding community.

Action Pact’s Conversations with Carmen

October 15, 2021: Why Employees Leave and Ideas for Honoring, Retaining and Recruiting Them
Guest: Linda Shell, RN, PhD; with Host Carmen Bowman

LTC communities face daunting challenges when it comes to the difficulties of staffing right now. Employees have increased expectations of their leaders and managers than in the past. For organizations to thrive during rapid change, they need a mindset shift from traditional problem solving to an increased emphasis on the needs of the employee and the vital roles they hold. Learn to identify the top reasons why employees leave, and ideas for a culture that honors and includes employees like never before.

Action Pact’s Conversations with Carmen

November 19, 2021: Creating Connectedness
Presenter and Host: Carmen Bowman

LTC communities face daunting challenges when it comes to the difficulties of staffing right now. Employees have increased expectations of their leaders and managers than in the past. For organizations to thrive during rapid change, they need a mindset shift from traditional problem solving to an increased emphasis on the needs of the employee and the vital roles they hold. Learn to identify the top reasons why employees leave, and ideas for a culture that honors and includes employees like never before.

VOYCE Professional & Community Education Series Webinar

October 12, 2021: Cannabis and CBD for Older Adults and LTC Residents

The use of cannabis and CBD products as alternative medical treatments has been widely contested in the United States. Yet, the use of these products can be highly beneficial to patients with a variety of health conditions – many of which are prevalent in aging and long-term care populations. Join us for a discussion with local experts about the function, benefits, and options for medical cannabis and CBD use. This course will also discuss the legal considerations for individuals and long-term care organizations interested in trying these alternative therapies. This webinar is available to both long-term care serving professionals and interested community members.

VOYCE Professional Education Series Webinar

September 28, 2021: Eliminating Elderspeak through Compassionate Communication

Understanding elderspeak as a type of biased communication is vital to prevent future ageist behavior towards older adult patients and, thus, improve health outcomes. Elderspeak, most commonly found in long-term care settings, has been identified as a growing communication barrier between younger and older generations, especially in healthcare. Effective communication between patients and providers improves trust and adherence to treatment plans. Health communication and cultural sensitivity training are crucial for incoming, young health providers. As Boomer clinicians age and retire, they will be replaced by millennials who will need to learn how to navigate intergenerational relationships with their new Boomer patients.

Monoclonal Antibody Infusion Medication Information

There has been a significant change in the ordering process for monoclonal antibody infusion medications. If you are currently utilizing these medications, please review the attached notice and plan on attending the webinar tomorrow. Also attached is information on reporting usage through the Teletracking system. Reporting through this system is highly encouraged as the usage reported will determine future amounts allocated to the state.

 Status Update re: Monoclonal Antibody (mAb) Infusion Medication Ordering:

Missouri Department of Health and Senior Services (DHSS) was notified by U. S. Department of Health and Human Services (HHS) yesterday, September 14, 2021, that effective immediately the states are responsible to review and approve all monoclonal antibody medication orders. This includes orders for REGEN-COV (casirivimab and imdevimab) and the Eli Lilly cocktail of bamlanivimab/etesevimab through AmeriSource Bergen. This was DHSS’ first notification of this change. We had no prior information to allow for planning, development of platforms for ordering/approvals or procedures, or messaging. Thus, all of this is occurring currently and as quickly as possible. Information on this change is still forthcoming from HHS, thus we may have process implementation delays at the state level as a result.

mAb Request Process Implementation and Timeline:

DHSS will host a webinar to introduce the state’s new mAb request process, details are below:

Friday, September 17, 2021

10:30-11:30 a.m.

Join from the meeting link

https://stateofmo.webex.com/stateofmo/j.php?MTID=mcb62b527fff05778bd574584e06c8b6d

 

Join by meeting number

Meeting number (access code): 2462 582 1044

Meeting password: pcGjudFE679

 

Tap to join from a mobile device (attendees only)
+1-650-479-3207,,24625821044## Call-in toll number (US/Canada)
+1-312-535-8110,,24625821044## United States Toll (Chicago)

Action Pact’s Conversations with Carmen

September 17, 2021: Living Life Outside of Groups – Dispelling the Pressure to Hold Them

Most residents end up spending most time in their room, with or without a pandemic. We have needed to hone helping people live life outside of groups all along. Groups can never be 24/7 or meet everyone’s needs anyway. Gift residents with lots of ideas of things to do beyond the norm and beyond television. Encourage people with time on their hands to try something new, do things they have not done in a while, refocus their capabilities, live out passions in adaptive ways and not lose their taste for life no matter their abilities. Work with people to tell their life story, share wisdom, leave a legacy, develop the invention, book or song in their heart, armchair travel, plan, sing, study, sort photos, serve others, and more. What a great moment in time to get creative and go deeper with people. Learn how to have every team member honor and validate every individual’s’ life role/contribution to your community.

MHCA’s Annual Convention

August 22-25, 2021: MHCA 73rd Annual Convention & Trade Show
Location: Branson Convention Center, Branson

The long-term care industry faced enormous challenges in 2020 due to the COVID-19 pandemic. Thanks to your hard work and perseverance, along with widespread access to vaccines, we feel comfortable about gathering in person in Branson.

Click HERE to view a message from MHCA Executive Director, Nikki Strong, regarding an update to safety protocols and masking requirements for the MHCA 73rd Annual Convention & Trade Show.

Empowering Elder Well-Being with Supportive Technology

August 26, 2021: Empowering Elder Well-Being with Supportive Technology

Today’s elders have more ways than ever to stay connected with their loved ones, but tech support at Life Plan Communities and other senior living campuses isn’t always geared toward them – and common resources online may not include solutions unique to their needs.

Even though the strict lockdowns at nursing homes and other communal settings have eased considerably, the pandemic revealed the very real need for elders to master technology in order to combat loneliness, provide entertainment, and even stay on top of their health through apps and wearables.

On August 26 at 3 p.m. ET, Join GroovyTek, The Green House Project, and the Pioneer Network for a can’t-miss discussion on empowering elders with technology.

Using the International Council on Active Aging’s Seven Dimensions of Wellness as a guide, we’ll:

  • Explore the current state of older adults’ relationship with technology,
  • Discuss strategies to overcome barriers to adopting common tech tools,
  • Discover how tech can promote elders’ independence, wellbeing, and health,
  • Hear directly from an elder about her personal experience with tech,
  • And much more.

Pioneer Network’s Virtual Symposium

September 22, 2021: Envisioning the Future: Finding Meaning & Purpose

Pioneer Network is proud to present the third in its series of four Symposia for 2021, each based on the theme, Envisioning the Future. In this symposium, the focus is on Finding Meaning & Purpose. Speakers include residents and innovators in the field who will draw on their experiences, including the collective experiences encountered as we all lived through the pandemic. They will explore how to find meaning and purpose for those who live and work in senior living communities as well as how we can move forward in a way that assures that isolation becomes a thing of the past, acknowledging that wherever we may reside, life is lived best in community.

MC5 – Special Virtual Meeting

September 22, 2021: Finding and Keeping Great Co-Workers
Presenter: Clint Maun, CSP

Healthcare Providers have taken the needed action to fight a global pandemic and have established the required systems to contain and prevent the spread of the Corona Virus. The never-before-seen challenges we have experienced in 2020 has made it more vital than effort to have superior staff in all roles in 2021. We know healthcare professionals and staff can work together to achieve amazing success at workforce stabilization which will also benefit our customers. Join Clint Maun for an overview of proven teaming strategies during this time of opportunity, including processes to build workforce resilience and reduce burnout.

Join us for this important Virtual meeting.

Conversations with Carmen

August 20, 2021: A Beautiful Day in the Neighborhood
Guest: LaVrene Norton, Action Pact Founder & Executive Leader and Megan Hannan, Action Pact Consultant; with Host Carmen Bowman

Need help getting everyone out of the doldrums of COVID? Let free the spirit of joy and love – work together to bring back the simple pleasures of home. Create team on the fly. Let music and laughter rock the halls. Wave!

Think Neighborhood. Have a block party.

We begin again with a short presentation on the Artifacts of Culture Change as they can offer us a measurable road map. We will then head down the path to Neighborhood where culture change begins. Where good neighbors work together to enjoy and share the simple pleasures of daily life.

CNA Update Training – Staffing Series 2: Take off on the Journey to Improve Staffing

September 14, 2021: Staffing
Location: Ameristar Hotel, St. Charles

September 15, 2021: Staffing
Location: Oasis Hotel, Springfield

September 28, 2021: Staffing
Location: Stoney Creek Hotel & Conference Center, Independence

September 29, 2021: Staffing
Location: Comfort Inn, Macon

CNA Training Update in Missouri

We have been waiting a long time and finally we see the results coming at us from our efforts to update and improve the training of Missouri CNA’s. The process has changed significantly effective August 31, 2021 “technically”. Administrators, DON’s, RN Instructors, HR Staff and CNA Training Organizations will want to understand how these changes affect them and their programs. The CNA Registry process for verification of employment in the last 24 months has also changed and will be handled through a third party site. You should already be registered as an employer and your CNA’s in the new system. This session will review all the new regulations, the new forms and the new testing/registry process through TMU Headmaster.

Staffing Series 2: Take off on the Journey to Improved Staffing

In Series 1, we explored Staffing Turnover and Retention and formulated a Roadmap to take us on a journey to improve staffing, increasing stability and quality of care, life and service for our residents. In this series we will take off on the journey and concentrate on the areas that Series 1 attendants identified as needing the most work; Recruitment and On-Boarding/Training. We will rethink where we are spending recruiting dollars, share ideas for improving landing quality applications and then build on reducing turnover and improving retention with improved and best practice ideas for Staff on-boarding/Orientation and training. Administrators and HR Staff will benefit from this interactive session. If you missed the first session, you can view it on-line on SDS Training site through MANHA.

Trauma-Informed Care: Nursing Home Responsibilities & Plan of Action

October 5, 2021: Trauma Informed Care
Location: Oasis Hotel, Springfield

October 6, 2021: Trauma Informed Care
Location: Comfort Inn, Macon

October 7, 2021: Trauma Informed Care
Location: Ameristar Hotel, St. Charles

October 12, 2021: Trauma Informed Care
Location: Stoney Creek Hotel & Conference Center, Independence

Sponsored by Missouri Health Care Association & Missouri Association of Nursing Home Administrators

We will review the regulatory requirements, available resources and necessary policy and procedure changes to keep your facility on the right side of Trauma Informed Care Compliance.