February 23-25. 2022: RAI Process from Start to Finish (Virtual Workshop)
March 9-10, 2022: Medicare from Start to Finish (Virtual Workshop)
Category: Training
MHCA’s Federal Review Course
March 21-22, 2022: Federal Review Course for Nursing Home Administrator Exam (Hybrid Workshop)
The Federal Review Course is to help attendees prepare for the nursing home administrator federal licensure exam. Review course materials have been revised and updated to reflect the structure of the current examination.
Missouri Required 4-Hour Update for CNA Instructors
April 5, 2022: Jefferson City, MO
April 6, 2022: Springfield, MO
April 7, 2022: Independence, MO
April 19, 2022: Cape Girardeau, MO
April 20, 2022: Maryland Heights, MO
April 21, 2022: Chillicothe, MO
MANHA and MHCA are proud to provide the required four-hour update training for Missouri CNA Instructors. This requirement is contained in the new CNA rules for the state. The training must be offered by a certified training agency to be accepted by the state.
Dementia Hacks 2.0
April 8, 2022: Dementia Hacks: Solutions for Every Stage
This all-day virtual education event will guide learners to develop refined observational and analytical skills to recognize hallmarks of early, moderate, and late-stage dementia. Learners will gain skills in matching their own care approaches to the person with dementia’s and care partner’s needs at each stage according to their abilities and strengths.
Certified Nurse Aide Regulation Update
The proposed amendments affecting the nursing assistant training program referenced in regulation sets 19 CSR 30-84.010 Nursing Assistant Training Program and 19 CSR 30-85.042 Administration and Resident Care Requirements for New and Existing Intermediate Care and Skilled Nursing Facilities, were published in the Code of State Regulations on November 30, 2021 and are effective December 30, 2021. This replaces the emergency amendment that was previously in effect.
The new regulations can be found on the Secretary of State’s website at: https://www.sos.mo.gov/cmsimages/adrules/csr/current/19csr/19c30-84.pdf.
What does this mean?
Reciprocity: Certified Nurse Aides who are certified and active in another state, may submit a request to be added to the Missouri registry. Note: A temporary CNA status is not recognized in Missouri. To learn more about reciprocity and the process to submit a request for reciprocity, use the following link: https://health.mo.gov/safety/cnaregistry/pdf/cna-reciprocity.pdf.
CNA Renewals/Work Updates: When a CNA passes the final examination, the individual’s name is placed on the CNA active registry. For nurse aide certification to remain active, CNAs are required to submit documentation (e.g., pay stubs, W-2, letter from employer, etc.) of their work in nursing or nursing related services for at least one (1) day (e.g. eight (8) hours) within each twenty-four- (24-) consecutive month time-period. Documentation shall be submitted to the department approved third party test administrator and a fee will be assessed for each renewal.
- If you are a CNA needing to renew your certification and work in a facility: Log into your profile in TMU and enter your employment under the employment tab, the software will then ask for payment. After the payment is processed, the software will send an email to your employer with a link to confirm your work in the last 24 months. After the employer clicks the link in the email to confirm employment your certification will be show active on the registry.
- If you are a CNA needing to renew your certification with out of state employment: Log into your profile and select “out of state employment” and send an email from your employer with name, date of birth, employment dates and hours worked to missouri@hdmaster.com.
- If you are CNA working private duty: Log into your profile in TMU and select private duty from a drop down menu. You will need to process the payment then email the proof of work documents to missouri@hdmaster.com. After work is confirmed, your certification will show active on the registry.
- If you are a facility wanting to pay for multiple CNA’s renewal: Headmaster is working on a process but until it is available you may email them at missouri@hdmaster.com or call at 800-393-8664 and ask for the Missouri team.
How to Renew Your CNAs via TMU
Inactive Status-CNA Challenge
A CNA who has been inactive on the registry for less than five (5) years and cannot provide documentation (e.g., pay stubs, W-2, letter from employer, etc.) of work in nursing or nursing related services for at least one (1) day (e.g. eight (8) hours) within each twenty-four- (24-) consecutive month period- shall challenge the final examination in accordance with section (8) of this rule before the CNA is reinstated to the active registry.
A CNA who has been inactive on the registry for more than five (5) years and cannot provide documentation (e.g., pay stubs, W-2, letter from employer, etc.) of work in nursing or nursing related services for at least one (1) day (e.g. eight (8) hours) within each twenty-four- (24-) consecutive month period is not eligible to challenge the final examination and shall successfully complete the entire basic course before the CNA is reinstated to the active registry.
Challenge Exams: As of December 30, 2021, all Challenge exams will be administered through Headmaster. Request for approval to challenge the exam should be sent to the Health Education Unit at CNARegistry@health.mo.gov.
Instructor 4-Hour Update every 5 years:
Instructors are required to attend a four (4) hour update training provided by a certifying agency every five (5) years. Any instructor who has not completed the required four (4) hour update training by August 31, 2022, and every five (5) years thereafter will be removed from the department-approved list of instructors. If removed from the department’s list, the instructor is required to attend and successfully complete the Nursing Assistant Instructor Workshop in order to be reinstated to act as an instructor.
Conversations of Culture Change with Carmen
This year Carmen Bowman will be hosting and presenting the Proactive Practices to Prevent Falls series.
Action Pact has exhausted the same old list of “interventions.” Replace old, institutional “interventions” with individualized approaches and proactive practices. Learn how to create a proactive fall reduction culture by all. Teach everyone they have the SUPERPOWER to help prevent falls.
January 28, 2022: Moving from the same old “interventions” to Proactive Practices to Prevent Falls
February 18, 2022: Proactive Practice to Prevent Falls: Anticipating Needs, particularly bathroom needs, by all
March 18, 2022: Proactive Practice to Prevent Falls: Proactively checking in with residents by all
MALA’s 2022 Train the Trainer
January 12, 2022: Train the Trainer
March 2, 2022: Train the Trainer
May 4, 2022: Train the Trainer
July 6, 2022: Train the Trainer
September 7, 2022: Train the Trainer
November 2, 2022: Train the Trainer
Participants must receive approval in order to attend this workshop. Those wishing to attend must submit the application and all other necessary paperwork to MALA at least two weeks prior to the workshop date.
2022 MANHA Winterfest
February 2-4, 2022: Reeling in Change – Get Hooked with MANHA
Location: Oasis Hotel and Convention Center, Springfield
Missouri Association of Nursing Home Administrators is pleased to invite you to attend our Winterfest Convention and Trade Show. The goal of this conference is to provide long-term care administrators and their staff practical and inspirational education hours along with the opportunity to network and socialize with colleagues. It is also the only MANHA sponsored conference that provides you a chance to view the latest technology, products, and services offered by suppliers.
MLN Nursing Home Administrator Conference
March 2-4, 2022: 31st Annual Nursing Home Administrator Conference
Location: Virtual
The 31st Annual Nursing Home Administrators Conference will be held virtually. During these challenging times when person to person interaction is limited, the goal is to not only provide education but to also maintain connections and facilitate the networking that is part of a live event.
After registration, attendees will be sent a personal link and details regarding how to access and participate through the online event.
MALA’s 2022 ALF Assessment Training
March 14-16, 2022: ALF Assessment Training
As required by 198.005 RSMo and 19 CSR 30-86.047, residents of Assisted Living Facilities are required to undergo a community based assessment performed by an appropriately trained and qualified individual. This individual must complete a DHSS approved 24-hour training program prior to performing resident assessments. The MALA ALF Assessment Training satisfies this regulatory requirement.
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)
QIPMO PPE Protocol
The NEW! who/where/what of wearing PPE in your facility.
Click HERE for the most updated document from QIPMO.
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.
DHSS Health Update
Please see the DHSS Health Update entitled “Update: Indications for Monoclonal Antibodies in Management of COVID-19.”
Should you have any questions, please contact the Missouri Department of Health and Senior Services’ Bureau of Communicable Disease Control and Prevention at 573-751-6113.