Missouri Long-Term Care Information Update

Enhanced Leadership Development Academy for LTC Leaders

Do you…..

❍ need a leadership course that addresses the unique challenges SNF leaders face?
❍ want to feel inspired and passionate about leading your SNF?
❍ want to connect with other SNF leaders and have access to free professional development, tools, and resources?
❍ want free CE credit without sacrificing quality and practical application?
❍ want to have the flexibility to learn at the pace and place the works best for you?

If you answer YES to any of these questions, this course may be for YOU!

Open to RNs, NHAs and LPNs!

For more information visit our web site, download the postcard or contact Todd Winterbower at winterbowert@missouri.edu.

Take the survey now to see if you qualify for FREE registration.

DMH Free Webinar – Tools for Everyone

April 4, 2023: Registration
April 12, 2023: Registration
April 17, 2023: Registration
April 25, 2023: Registration

Presenter: Kathleen Deppeler, Director of Positive Supports

Tools of Choice is an evidence-based program focused on the implementation of universal positive practices. This two-hour introductory training is open to community members, parents, and professionals. It covers key concepts of the Tools of Choice curriculum, including: What is behavior, building positive relationships, and how to increase desirable behavior. Join the Positive Support Consultants in learning strategies to make positive change by implementing universal positive practices.

MC5 Regional Events

April 5, 2023: Trauma Informed Care Across the Lifespan
Location: MC5 West Central Region, Methodist Church, The Celebration Center, Sedalia

This training will define what trauma is and understand its prevalence in our clients, define PTSD and provide an overview of the brain and body physiology of the impact of trauma. This training will also discuss the impact of trauma at various stages in life and the prolonged effects as well as generational and cultural trauma. Participants will be able to take tools/methods with them to cope with client crisis and trauma related triggers.

ma4 Show Me Summit on Aging & Health

September 11-13, 2023: Show Me Summit on Aging and Health 2023
Location: Holiday Inn Executive Center, Columbia

The 18th Show Me Summit on Aging & Health returns to Columbia, MO September 11th to 13th, 2023. Our theme this year is Expanding the Possibilities. With the Governor launching a statewide Master Plan on Aging, Missouri’s 1.1 million adults ages 60 and older take center stage in Missouri. Join us this fall to learn innovative ideas in aging services and to exchange best practices with fellow professionals in Missouri’s growing field of aging services.

Please share your expertise and experience with your AAA and aging network colleagues across the state! We week session proposals that highlight leading-edge tactics, innovative program ideas, and new and diverse thoughts. This is a great way to share your experience with your colleagues and leaders in aging from all across Missouri. We look forward to showcasing your subject-matter expertise, fresh thinking, and best practices as a presenter.

Submit your proposal by April 30, 2023. Notifications will be in May 2023.

Learning Modules Explain Sepsis in 3-Minute Doses

The Health Quality Innovation Network (HQIN), the Quality Innovation Network-Quality Improvement Organization (QIN-QIO), has released a brief Sepsis Learning Module Series to help frontline staff recognize and treat sepsis.

The series includes four modules:

  • Act Fast! Early Detection of Sepsis Requires Fast Action
  • It Takes Teamwork to Beat Sepsis
  • Effective Communication is Critical for Rapid Sepsis Intervention
  • The Transition Home: Stop, Look and Listen for Sepsis

The modules average three minutes in length and the series webpage includes free downloadable resources to accompany the information. The modules can be accessed via the link above or visit the HQIN Resource Center to access the series and supplementary resources, which include printable wallet cards and a poster.

MC5 Event – Re-Imagining Person-Directed Culture: It Starts with a Conversation

Join members of the team from MC5 and special guests the 4th Wednesday of each month as we share stories and best practices, explore challenges faced, and together re-envision what Person-Directed Care can look like for seniors in Missouri, especially for those living and working in Missouri’s Long-Term Care and Assisted Livings communities.

Using Zoom, the format will be casual – a conversation – with special guests inviting participants to share, ask questions, explore, and plan for how through MC5, we can re-imagine and “move the movement” forward as we come out of the pandemic.

March 22, 2023: Re-Imaging Person-Directed Culture: It Starts with a Conversation
Special Guest: Julie Wilson, RN, Regulatory Compliance Manager ICF/IID Unit & COMRU Unit, Section for Long-Term Care Regulation, Division of Regulation and Licensure, DHSS
Conversation Starter: One of MC5’s founders and past board President, Julie will give us a glimpse into the successes and challenges faced over the years as she shares the story of MC5 and the Culture Change Movement in Missouri. A look at the past to help guide us as we envision the future.

April 26, 2023: Save the Date
Special Guest: Sheila Winchester, Regulatory Compliance Manager, Quality Assurance and Education, Section for Long-Term Care Regulation at Missouri DHSS
Conversation: Providers and regulators share a common vision as evidenced by the Person-centered philosophy and practices that are incorporated into and supported by regulations, both Federal and State. Sheila will share ways that regulators and providers can work together as we move forward following the pandemic.

May 24, 2023: Save the Date
Special Guest: Penny Cook, Chief Culture Officer, Center for Innovation (CFI) / Pioneer Network
Conversation Starter: A goal of CFI/PN is to help support and grow state culture change coalitions. Penny will share what is happening at coalitions around the country as well as through initiatives such as the Moving Forward Coalition.

Missouri Open Door (MOD) Workshop

March 22, 2023: FREE Missouri Open Door (MOD) Workshop Series: Self-Advocacy and Assistive Technology

During this workshop, David Forbes will share his experiences in using Charting the LifeCourse tools and approaches to help him plan in his own life. The workshop will also provide information on how assistive technology can assist people with self-advocacy skills and increase self-determination.

The goals of this workshop are to provide a focus on:

  • Providing immediate-use ideas for how people can implement Charting the LifeCourse and Assistive Technology
  • Strengthening everyday knowledge around technology
  • Incorporating and understanding local service and support strategies

CNA Certification Status & Renewals

The DHSS Health Education Unit encourages you to check the certification status of your CNA staff. CNA’s are required to renew their certification every 24 months to remain “active” on the registry.

Please see the link to login: MO TMU (tmutest.com)

Please note: If a CNA has never logged into the TMU registry, they will need to call HEU at 573-526-5686 the first time for assistance.

HEU is very excited to announce a new option for CNA Renewals coming soon!!! This new feature will allow employers to verify employment and pay for multiple CNA staff electronically. Please stay tuned for the official announcement and details.

LTC Ombudsman Program

The Long-Term Care Ombudsman Program invites you to follow them on Facebook. The page includes information relevant to long-term care, national information and advocacy work, updates about the Ombudsman Program and so much more! Feel free to share the Facebook posts with others. Visit us on Facebook

Artifacts of Culture Change 2.0

Originally developed by Pioneer Network in collaboration with CMS, The Artifacts of Culture Change was revised in 2020. Artifacts of Culture Change 2.0 (ACC) is an internal implementation, inspiration, and self-assessment tool available for both SNF and AL and is a great tool to help re-ignite your person-centered journey.

Artifacts of Culture Change (Be sure to check out the drop-down menu on the left side of the page for more information, resources and On-Demand Videos)
Self-Assessment for Nursing Homes
Self-Assessment for Assisted Living Communities

Free Four-part Webinar Series: Brain Health and Trauma-Informed Care for People with Intellectual and Developmental Disabilities (I/DD)

March 8, 2023 (1:00 pm – 2:00 pm): Trauma and Ableism as Social Determinant of Health for People with Intellectual and Developmental Disabilities
April 26, 2023 (1:00 pm – 2:00 pm): People with an Intellectual and Developmental Disability Experiencing Abuse: Tips, Tools, and Strategies for Providers
May 10, 2023 (1:00 pm – 2:00 pm): Beyond Silos: Trauma Informed Care for People with Intellectual and Developmental Disabilities

This four-part webinar series presented by the HealthMatters Program will focus on brain health and trauma-informed care through conversations with national peer advocate survivors, allies, and healthcare providers. Brain health and trauma resources for people with I/DD will be shared to increase awareness of systems change efforts to eliminate disability bias through culturally relevant healthcare.

The Green House Project Events

March 29, 2023: Transform the Culture of Care

The alliance between The Green House Project and Pioneer Network brings together two leading drivers of cultural transformation in long-term care.

For organizations that don’t have the ability to build new or substantially renovate an existing building, we have an entire suite of solutions that bring the best of empowered, elder-directed care to even the most institutional settings.

Resident to Staff Aggression: Prevention & Response Training

March 30-July 20, 2023: Resident to Staff Aggression: Prevention & Response Training (Webinar)
April 20, 2023: Resident to Staff Aggression: Prevention & Response Training (In Person)

Resident to staff aggression occurs, but it shouldn’t be thought of as just part of a caregivers’ job. Tools for prevention and response to resident aggression are critical for promoting worker safety and satisfaction as well as the resident experience. This interactive, application-based training will explore some of the reasons for resident aggression, provide strategies for violence prevention, de-escalation and during incident response as well as post incident response strategies that promote the prevention of future incidents. The role of policy, consistent and effective communication and a workplace violence prevention culture will be explored. Interactive learning experiences and discussions will help trainees practice and apply learning.

MALA Spring Conference

April 16-18, 2023: Don’t Take a Chance – Bet On MALA
Location: Branson Hilton Landing Hotel and Convention Center

Information including the conference agenda and registration for attending the Missouri Assisted Living Association’s 2023 Spring Conference is now available.

MALA’s ALF Community Based Assessment Training

June 5-7, 2023: 2023 ALF Community Based Assessment Training
Location: Courtyard by Marriott, Columbia

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.

The Green House Project 2023 Conference

July 23-26, 2023: Ready to Impact
Location: Pittsburg, PA

It’s official: Green House and Pioneer are coming together for one incredible event.

Everything you’ve come to expect from our conferences — fellowship, education, new ideas, and fun — now with even more leaders, caregivers, visionaries, and supporters from around the country and the world!

The theme of the first annual Center for Innovation Conference, Ready to Impact, reflects the power our organizations have under one banner. Together, let’s make 2023 a year of real change for elders in the United States and around the world, uniting in one voice to broaden the reach and deepen the impact of our work to build something better.

Funding Opportunity for Missouri Nursing Facility Strike Team and Infrastructure Award

The Missouri Department of Health and Senior Services (DHSS) is excited to announce the Missouri Nursing Facility Strike Team and Infrastructure Award, a reimbursement opportunity available to Skilled Nursing Facilities (SNF) and Long Term Care and Other Nursing Facilities (LTC). Beginning March 1, 2023, facility owners and operators may apply for reimbursement for expenses incurred between July 1, 2022 and August 31, 2023, directly related to preparing, preventing, and responding to the COVID-19 pandemic.

If you operated a Skilled Nursing Facilities or Long Term Care and Other Nursing Facilities licensed with DHSS between July 1, 2022 and August 31, 2023, you are eligible for reimbursement for allowable expenses.

Owner/operator applicant must be registered as a vendor with the State of Missouri prior to submitting an application. If not already registered, visit https://missouribuys.mo.gov/registration. Vendor name and address used in registering as a vendor must be the same vendor name address used on the reimbursement application. Be sure to register only the operating entity and not all individual facilities owned by the same company.

Please see the attached Frequently Asked Questions and Application Checklist documents below.

Missouri Nursing Facility Strike Team and Infrastructure Award FAQ Checklist
Missouri Nursing Facility Strike Team and Infrastructure Award Application
Missouri Nursing Facility Strike Team and Infrastructure Award Eligible Facilities

All questions should be directed to the DHSS Strike Team via email at LTCStrikeTeam@health.mo.gov.

Public Health Emergency (PHE) 1135 Waivers: Updated Guidance for Providers

On February 9, the Department of Health and Human Services (HHS) announced the Public Health Emergency (PHE) for COVID-19 will end on May, 11, 2023. COVID-19 remains a significant priority for the Biden-Harris Administration and over the next several months, the Centers for Medicare & Medicaid Services (CMS) will work to ensure a smooth transition. During the PHE, CMS has used a combination of emergency authority waivers, regulations, enforcement discretion, and sub-regulatory guidance to ensure easier access to care during the PHE for health care providers and their beneficiaries.

Some of the flexibilities that were created during the pandemic were recently expanded by the Consolidated Appropriations Act, 2023. Others, while critical during our initial responses to COVID-19, are no longer needed. CMS has made further updates to our CMS Emergencies Page with useful information for providers – specifically around major telehealth and individual waivers – that were initiated during the Public Health Emergency (PHE).

Please reference the following guidance in response to the PHE ending May 11, 2023:

Provider-specific fact sheets about COVID-19 Public Health Emergency (PHE) waivers and flexibilities: https://www.cms.gov/coronavirus-waivers

CMS COVID-19 Waivers and Flexibilities for Providers include:

  • Physicians and Other Clinicians
  • Hospitals and CAHs (including Swing Beds, DPUs), ASCs and CMHCs
  • Teaching Hospitals, Teaching Physicians and Medical Residents
  • Long Term Care Facilities (Skilled Nursing Facilities and/or Nursing Facilities)
  • Home Health Agencies
  • Hospice
  • Inpatient Rehabilitation Facilities
  • Long Term Care Hospitals & Extended Neoplastic Disease Care Hospitals
  • Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
  • Laboratories
  • Medicare Shared Savings Program
  • Durable Medical Equipment, Prosthetics, Orthotics and Supplies
  • Medicare Advantage and Part D Plans
  • Ambulances
  • End Stage Renal Disease (ESRD) Facilities
  • Participants in the Medicare Diabetes Prevention Program
  • Intermediate Care Facility for Individuals with Intellectual Disabilities

 Department of Health & Human Services Fact Sheet: https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html

In the coming weeks, CMS will be hosting stakeholder calls and office hours to provide additional information. Please continue to visit the CMS Emergencies Page for continuous updates regarding PHE sunsetting guidance as information becomes available to the public.

Pre-Admission Screening and Resident Review (PASRR) Flexibility Ending May 11, 2023

With the recent announcement from the White House regarding the official end of the Public Health Emergency on May 11, 2023, the waiver that allowed nursing homes to admit new residents who have not received PASRR Level I screenings and Level II evaluations will terminate on May 11, 2023.

That date is beyond the 60 notice that CMS has previously said would be given to allow states to unwind any COVID related changes to their PASRR program. As such, CMS will expect states to resume the completion of PASRR activities prior to admission as of May 12, 2023.

The PASRR process requires that all applicants admitting to Medicaid-certified nursing facilities be screened for possible serious mental disorders or intellectual disabilities and related conditions. This initial pre-screening is referred to as PASRR Level I, and is completed prior to admission to a nursing facility. A negative Level I screen permits admission to proceed and ends the PASRR process unless a possible serious mental disorder or intellectual disability arises later. A positive Level 1 screen necessitates an in-depth evaluation of the individual by the state-designated authority, known as PASRR Level II, which must be conducted prior to admission to a nursing facility.

Long-term care facilities, hospitals, and other referral agencies should educate admission and discharge planners to this requirement- as it is a return to pre-COVID activities that they may be unfamiliar with.

iQIES for Minimum Data Set (MDS) Submission Release on April 17, 2023

CMS is excited to announce that the transition of the Minimum Data Set (MDS) assessment submission and reporting functionality to the Internet Quality Improvement and Evaluation System (iQIES) will occur on Monday, April 17, 2023.

To properly prepare for the transition, the QIES Assessment Submission and Processing (ASAP) system for MDS submissions will be turned off on Thursday, April 13 at 8:00 p.m. ET. Providers should submit completed MDS records prior to 8:00 p.m. ET on April 13 to QIES (ASAP) or wait until 8:00 a.m. ET on April 17 to submit data in iQIES. Providers are expected to take into account all requirements when determining the date they submit completed MDS records, including but not limited to, submission timeliness, claims processing, and care planning requirements.

CMS will provide additional information through various email notifications regarding training, technical guidance, details on what to expect, and more.

Register for an iQIES Account

Please note that failure to obtain access to iQIES prior to April 17, 2023 will impact your ability to submit MDS records. As mentioned in previous communications, nursing home and swing bed providers who are required to submit data to CMS must have at least one staff person assigned and approved as the facility Provider Security Official (PSO), who works for the provider and is responsible for approving all other users for their facility. For information and instructions to register for an iQIES account, please visit: https://qtso.cms.gov/news-and-updates/action-required-register-iqies-account.

iQIES Service Center

If you have questions or require assistance, please contact the iQIES Service Center at iqies@cms.hhs.gov or by phone at (800) 339-9313. Please note that call volume may be higher than normal during this time.

AADD Conference

May 15-16, 2023: 32nd Annual Aging with Developmental Disabilities Conference
Location: St. Charles Convention Center

The Annual Aging with Developmental Disabilities Conference has a goal of bringing the aging and developmental disability professionals together to learn about best support models and practices and the most current information on aging with a developmental disability. Through information, education, and networking, participants from across the United States will have a better understanding of both medical care, medical changes and best practices that will help them support people with developmental disabilities with living their best life as well as end-of-life care.