2013 Annual Long-Term Care Emergency Preparedness Survey

The Section for Long-Term Care Regulation (SLCR) is conducting the sixth annual Emergency Preparedness Survey of all licensed long-term care homes in Missouri.  All licensed homes will receive the survey via regular U.S. mail.  Homes may complete the survey online at http://health.mo.gov/LTCsurvey/

Homes are asked to provide information concerning the development and contents of their emergency plans.  The information will be compiled to assist homes and emergency planners in emergency situations.  The survey is anonymous; no identification is required.  Your confidential responses are for planning purposes only and will not be used for regulatory reasons. 

SLCR received 538 responses last year and hopes to increase that number this year.  The section thanks all homes in advance for their participation and welcomes questions at 573-522-1333. 

Emergency preparedness planning resources are also available at http://health.mo.gov/emergencies/readyin3/adultcare.php.

Cardiopulmonary Resuscitation (CPR) in Nursing Homes

CMS Memo S&C: 14-01-NH

The Section for Long-Term Care Regulation wants to make certified providers aware that this Memo requires “certification” of some nursing home staff as part of the nursing home’s compliance with regard to CPR.  CMS’ guidance had previously been that an on-duty staff member be able to perform CPR appropriately at all times.  If a question arose during a federal process regarding whether someone could perform CPR properly, a surveyor may have needed to ask for an explanation of appropriate technique from some available staff member to verify compliance with that requirement, but verifying the certification of a particular staff member typically wasn’t necessary.

One point that remains unaddressed in this new S&C Memo is that many different CPR training agencies offer “certification” of their own, and this Memo doesn’t specify which agency’s certifications are acceptable to CMS and which are not.  SLCR has requested a clarification of this point from the CMS Central Office, and so has the Kansas City Regional CMS office.  Neither of our offices have received a response.  When we receive further guidance, we will provide it to you via this Listserv.  Until then, we will not be altering our current survey practices, but we want to make providers aware that this new S&C Memo has been issued by CMS, and that depending on their answer to our questions, it’s likely that some of your staff may need to obtain CPR certification with very short notice.

Because this memo references the American Heart Association as a standard-setting organization with regard to CPR, it is our belief that provider certification through the AHA will almost certainly be deemed acceptable by CMS.  Whether other certifications will suffice is less clear at this time.  As soon as we have some clarification on this point, we will share it with you.  We apologize that we can’t offer more specific guidance at this time, and appreciate your patience.

View the CMS Memo S&C: 14-01-NH here:  Survey-and-Cert-Letter-14-01 or click here. 




Change Your Clock – Change Your Batteries!

When you change your clocks, do not forget to replace your smoke alarm and CO detector batteries.  Daylight Saving Time ends on Sunday, November 3, 2013.  For more safety tips, visit the U.S. Consumer Product Safety Commission (CPSC) at http://www.cpsc.gov/Newsroom/Multimedia/?vid=61711.

View the news release here:  www.cpsc.gov/en/Newsroom/News-Releases/2014/CPSC-Urges-Consumers-to-Replace-Batteries-in-Smoke-and-CO-Alarms-When-Turning-Clocks-Back-/.

Long-Term Care Emergency Preparedness Report 2012/2013

The Section for Long-Term Care Regulation (SLCR) conducted the fifth annual Emergency Preparedness Survey of all licensed long-term care homes in Missouri.  SLCR received 538 completed surveys and would like to thank the homes that responded.  For the first time, SLCR also conducted an Emergency Generator Survey that asked specific questions regarding a home’s electrical generator capacity.  819 long-term care homes completed this survey.  SLCR welcomes any questions concerning the surveys or emergency preparedness planning at 573-522-1333.  The new report is available on our website, please visit http://health.mo.gov/seniors/nursinghomes/providerinfo.php.

New Generations – Summer 2013 Quarterly Newsletter

The Section for Long-Term Care has published New Generations – Volume 11, Issue 3, Summer 2013.  This issue is now available on our website, along with an archive of previous newsletters.  Please visit http://health.mo.gov/seniors/nursinghomes/providerinfo.php.

Missouri’s New Time Critical Diagnosis (TCD) System


Missouri’s emergency medical response system saves thousands of lives every year, and now improvements will assist health care providers in providing quicker, more coordinated responses when victims of medical emergencies dial 911

The new TCD System was developed in partnership with the Missouri Department of Health and Senior Services, the Missouri Foundation for Health and other health-related organizations and health care professionals throughout the state.

To learn more about the improvements, please visit health.mo.gov/tcdsystem.  You may share this life-saving information by distributing the printable publications located here to members of your organization.

Emergency Generator Online Survey

Emergency Generator Survey data collection 80% complete

You may complete the online survey at https://webapp03.dhss.mo.gov/snapwebhost/surveylogin.asp?k=134426740643.

In a situation where electricity is disrupted it is helpful for emergency planners to know which nursing homes have back-up generators and perhaps more importantly, which do not have back-up generators.  This web-based survey asks whether you have an emergency generator (or not), its fuel type, your ability to connect a temporary generator and other data helpful in an emergency situation.  This data can be valuable to DHSS and your local emergency planners in their preparedness plans, but the data collection is not yet complete.  If you have not completed the generator survey, please help us by doing so now.  At the end of the survey, you will have an opportunity to “opt out” of sharing this data with other emergency preparedness agencies if you prefer.

Please remember that since different levels of care may be housed in different buildings or may have different electrical service, we need a separate survey for each licensed level of care.  Also, if you have had a significant change in your generator set-up since completing the survey, or if you do not remember if you completed the survey, please contact Melissa Hope, Planner II, at (573) 522-1333 or send an email to Melissa.hope@health.mo.gov.

Thank you for your participation in this effort.

Emergency Generator Survey

Does your home have an emergency generator?  Is your home’s electrical system pre-wired to accept a temporary emergency generator?  Knowing your status in advance of an emergency can be vital to responders and to recovery efforts.

Due date extended – if your home has not submitted the survey yet, please support this community emergency preparedness effort by completing the online survey.  This survey will provide quick access to vital information about your home in the event of an emergency.

Click here to complete the Emergency Generator Survey

The Missouri Department of Health & Senior Services (DHSS), Section for Long-Term Care Regulation, is gathering emergency generator information for all licensed long-term care homes in the state as part of our emergency preparedness and planning objectives.  Our intention is to gather information in advance, since communication during a disaster (like the Joplin tornado) may be impossible or could be disruptive to a facility focused on caring for residents.  This data will give DHSS the ability to quickly provide information during an actual emergency to governing bodies and to the DHSS Center for Emergency Response and Terrorism to coordinate with responding agencies so that they may identify the most vulnerable populations first.  Homes that do not complete the survey will be contacted.  If you have any questions regarding the Emergency Generator Survey, please contact Melissa Hope at 573-522-1333 or email:  Melissa.Hope@health.mo.gov.

CMS Life Safety Code Reminders

  • Fire extinguishers should not be mounted over five feet from the floor to the top of the extinguisher

 Fire extinguishers having a gross weight not exceeding 40 pounds shall be installed so that the top of the fire extinguisher is not more than 5 feet above the floor.  Fire extinguishers having a gross weight greater than 40 pounds shall be so installed that the top of the fire extinguisher is not more than 3 ½ feet above the floor.  In no case shall the clearance between the bottom of the fire extinguisher and the floor be less than 4 inches.  1998 NFPA 10, 1-6.10.

  • A facility which allows smoking needs to have a metal container with a self-closing cover provided in the area.  A smokers urn, only meets the requirement of an ashtray of safe design.  Providers are under the impression that if these urns are metal that they meet the requirement of the container with a self-closing cover

Metal self-closing containers for disposing of cigarette butts and ashes from ashtrays, and ashtrays of noncombustible material and safe design, shall be provided in all areas where smoking is permitted as required in NFPA 101, 18/19.7.4.

  • Facilities need to have a zone evacuation plan in their fire emergency procedures

The administration of every health care occupancy shall have, in effect and available to all supervisory personnel, written copies of a plan for the protection of all persons in the event of a fire, for their evacuation to areas of refuge, and for their evacuation from the building when necessary.  All employees shall be periodically instructed and kept informed with respect to their duties under the plan.  A copy of the plan shall be readily available at all times in the telephone operator’s position or at the security center.  The provisions of through shall apply.  2000 NFPA 101, 18/

A written health care occupancy fire safety plan shall provide for the following:  1) Use of alarms 2) Transmission of alarm to the fire department 3) Response to alarms 4) Isolation of fire 5) Evacuation of immediate area 6) Evacuation of smoke compartment 7) Preparation of floors and building for evacuation, 8 Extinguishment of fire.  2000 NFPA 101, 18/

CMS website:  https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/LSC.html

National Fire Protection Association (NFPA) website:  http://www.nfpa.org/

Extreme Heat Conditions

The Department of Health & Senior Services website contains helpful resources during extreme heat conditions.  Please visit:  http://health.mo.gov/living/healthcondiseases/hyperthermia/index.php

Centers for Disease Control and Prevention (CDC) guidance:  Your best defense against heat-related illness is prevention.  Staying cool and making simple changes in your fluid intake, activities, and clothing during hot weather can help you remain safe and healthy.  Please visit:  http://www.bt.cdc.gov/disasters/extremeheat/

National Institute on Aging Newsroom, NIH provides heat-related illness advice for older people: http://www.nia.nih.gov/newsroom/2012/06/hyperthermia-too-hot-your-health

Improving Disaster Planning in Nursing Homes and Home Health Agencies

Tuesday, May 8, 2012 Time: 2:00 – 3:00 pm (Eastern Time)  Conference Call Information:  http://emergency.cdc.gov/coca/calls/ 

Participate by Phone:  Dial: 888-790-6180 Passcode: 1281914

Participate by Webinar:  https://www.mymeetings.com/emeet/join/index.jsp?customHeader=mymeetings&netId=PW7035569&netPass=1281914&netType=conference&acceptTerms=on

The CDC Emergency Communication System’s Clinician Communication Team manages the Clinician Outreach Communication Activity (COCA) to ensure that clinicians have the up-to-date information they need.  COCA is designed to provide two-way communication between clinicians and the CDC about emerging health threats, such as pandemics, natural disasters, and terrorism.

National Scald Prevention Campaign

The Missouri Division of Fire Safety in conjunction with the National Scald Prevention Steering Committee

The Division of Fire Safety has made the Scald Prevention Brochure available for distribution.  Fire Safety Inspectors will also distribute the brochure when they conduct facility inspections.  The brochure is printed in both English and in Spanish.  Please visit the website for more information:  http://www.dfs.dps.mo.gov/