Missouri Long-Term Care Information Update

MHCA Webinar – Developing New Leaders in Your Facility

Full series recordings are available through September 1, 2022: Developing New Leaders in Your Facility

Ensuring that potential or new supervisors have the skills to lead is vital to the achievement of your clinical, financial, regulatory, and resident experience goals. Far too often staff are promoted simply because they were exceptional in their current roles. A great nurse, cook, or admission coordinator may not yet be ready to be a great unit manager, food service or marketing director. This series will help your people make that leap – and familiarize you with the strategies you need to help them succeed!

MU Care of the Older Adult

August 19-20, 2022: Care of the Older Adult
Location: Holiday Inn Executive Center, Columbia & Virtual

This conference will provide health professionals the opportunity to gain knowledge in interdisciplinary approaches to clinical management and ethical treatment of older adults, a forum to discuss complex care issues common to all who care for the older adult and an awareness of innovative models of geriatric care delivery. The focus is on promoting excellence in gerontology health care by keeping abreast of the latest evidence-based practice.

This conference will be a hybrid event, you may attend in-person or online/virtual. If you choose to attend virtually, information will be emailed to you prior to the conference, using the email address you provide during registration.

New Release: Heat and Humidity can be a Dangerous Combination

(JEFFERSON CITY, MO) – The Missouri Department of Health and Senior Services (DHSS) urges Missourians of all ages to take precautions as heat and humidity rise to dangerous levels.

Heat-related illnesses often affect the very young, the elderly and the chronically ill, but summer temperatures can also take a toll on healthy young and middle-aged adults.

In 2021, 18 people died from heat exposure in Missouri, ranging in age from 35-105 years. Half of the deaths occurred among those between the ages of 35-64.

During prolonged periods of high temperatures, using air conditioning – either at home or by seeking shelter in a local cooling center – is the best preventive measure.

“Heat and humidity can place a lot of stress on the body,” said DHSS Acting Director Paula Nickelson. “Heat exhaustion can come on suddenly, with little warning, and lead to heatstroke which becomes a very dangerous situation.”

During excessive heat, Nickelson urges Missourians to check on friends and neighbors, especially those who are elderly and chronically ill. To report a senior citizen or an adult with disabilities who is in need of assistance due to the heat, call the state’s toll-free abuse and neglect hotline at 1-800-392-0210, or make a report online.

Medications can impair a body’s response to heat, making them more vulnerable to the heat.

There are a number of steps individuals can take to stay cool including:

  • Wear appropriate clothing – wear lightweight, light-colored, loose-fitting clothing.
  • Stay cool indoors – stay in air-conditioned places as much as possible. Find a local cooling center.
  • Stay hydrated – drink plenty of fluids regardless of your activity level, and do not wait to until you are thirsty. Avoid sugary and alcoholic beverages; these actually cause you to lose body fluids.
  • Schedule outdoor activities carefully – try to plan outdoor activity for morning or evening hours when the temperature is coolest.
  • Pace yourself – reduce exercise or physical activity during the hottest part of the day, and take frequent breaks in the shade or in an air-conditioned place.
  • Wear sunscreen – sunburn affects your body’s ability to cool down and can make you dehydrated.
  • Prepare your home – change air conditioner filters, cover windows that receive morning or afternoon sun with drapes or shades, and make sure you have portable fans if necessary.

Knowing the signs and symptoms of heat related illness and how treat them is also important. Signs of heat exhaustion may include muscle cramps; heavy sweating; cold, pale and clammy skin; dizziness; headache; nausea or vomiting; and fainting or passing out. If you think you or a loved one are experiencing heat exhaustion, you should stop physical activity move to a cool place – preferably air-conditioned, loosen clothing, and sip cool water. Seek medical attention immediately if you are throwing up, your symptoms get worse or symptoms last longer than one hour.

Signs of heat stroke may include high body temperature (103°F or higher); hot, red, dry or damp skin; fast, strong pulse; headache; dizziness; nausea; confusion; or loss of consciousness. If you think you or a loved one are experiencing heat stroke you should call 911 immediately. Heat stroke is a medical emergency. Move the person to a cool place – preferably air-conditioned. Help lower the person’s body temperature with cool cloths or a cool bath until medical personnel arrive. Do not give the person anything to drink.

For more information regarding heat-related illness and prevention, visit the websites of DHSS or the CDC.

 

Emergency Protocol for Facilities
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 that results 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 (Emergency Protocol Handout for Facilities) provides the cellular telephone number corresponding to the region in which your home is located if you experience a loss in a necessary service – for instance Air Conditioning – 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 as survey staff carry the cell phone and may be conducting a survey or inspection during working hours and may not answer immediately.

Provider Feedback Survey

The Section for Long-Term Care Regulation is again seeking input from providers we serve. We are asking for your help in identifying areas in our Section where excellent customer service is provided and areas where we need to focus on improving our customer service experience. Please take a couple minutes to complete our 2022 Provider Feedback Survey by June 30, 2022 at https://www.surveymonkey.com/r/72PRNZY.

June 15 is World Elder Abuse Awareness Day

World Elder Abuse Awareness Day (WEAAD) was launched in 2006 by the International Network for the Prevention of Elder Abuse and the World Health Organization at the United Nations, in an effort to unite communities around the world to raise awareness about elder abuse.

Each year, an estimated 5 million older adults are abused, neglected, bullied or exploited. World Elder Abuse Awareness Day on June 15 serves as a call-to-action for individuals, organizations and communities to raise awareness about abuse, neglect and exploitation of elders. In Missouri, the Department of Health and Senior Services (DHSS) receives and investigates reports of abuse, neglect, bullying and exploitation of the elderly and disabled. Last year, DHSS received and investigated 42,422 reports, an average of about 116 each day. That number is on the rise, though the crimes are vastly underreported.

DHSS is excited to host a WEAAD Facebook Live event on Tuesday, June 14 at 11 a.m. to help build strong supports for elders in Missouri. Join the discussion and learn how to recognize the signs of adult abuse and how to report it. Everyone is encouraged to wear purple and communities across Missouri are encouraged to display purple ribbons, flags, pinwheels or light up landmarks on June 15 to bring awareness to this public health issue.

Anyone who suspects a senior or disabled Missourian is being abused, neglected, bullied or exploited, should call the toll-free Missouri Adult Abuse and Neglect Hotline at 1-800-392-0210 or report online at health.mo.gov/abuse. The hotline is operational from 7:00 am through 8:00 pm, 365 days a year. Online reporting is available 24/7.

WEAAD reminds us that elder abuse has implications for all of us. It is a call to action for individuals, organizations, and communities to learn how to identify, address, and prevent elder abuse so we can all do our part to support everyone as they age. To learn more about WEAAD, Adult Abuse in MO, and what you can do to help or to access the WEAAD promotional toolkit, visit: www.health.mo.gov/weaad.

Resident Advocate Newsletter Spring 2022

The Spring 2022 issue of The Resident Advocate is now available. This newsletter provides information on residents’ rights and care issues; news and updates on national policy; and self-advocacy tips for obtaining person-centered, quality care.

This issue includes:

  • An overview of recently released nursing home reforms and how to advocate for better care,
  • Tips for residents as they prepare to vote in elections later this year,
  • Voices of residents speaking about nursing home staffing, and
  • Information about this year’s Residents’ Rights Month.

The Resident Advocate is a great resource to share with long-term care residents. Nursing home staff, long-term care Ombudsman programs, family members, and other advocates are encouraged to forward this newsletter to residents or print and share copies. Download this issue or past issues from our website.

MHCA Annual Convention

August 28-31, 2022: MHCA 74th Annual Convention & Trade Show
Location: Branson Convention Center, Branson

The Missouri Health Care Association invites you to join us at the 74th Annual Convention & Trade Show! MHCA is excited to bring you another year of the most requested and up-to-date education sessions available. Each day is scheduled to offer a wide range of education to meet the needs of the entire staff. Convention will be held again this year at the Branson Convention Center, conveniently located adjacent to the Branson Landing which is enjoyed by many. Don’t miss the opportunity to tour the Trade Show, widely regarded as the leading long term care trade show in Missouri with over 150 booths.

Show-Me ECHO Invites Participants

The Show-Me ECHO (Extension for Community Healthcare Outcomes) invites you to join the Post-Acute and Long-Term Care ECHO (PAC/LTC). Sponsored by the Missouri Telehealth Network at the University of Missouri, the PAC/LTC ECHO supports providers and administrators who work at or with residential care communities. The ECHO meets virtually on the 2nd and 4th Thursday of each month from 9:30 – 10:30 am (central time). To learn more about the PAC/LTC ECHO, please see flyer or visit www.showmeecho.org.

Virtual CST Certification Training & Summer Geriatric Institute

June 15, 2022: Cognitive Stimulation Therapy Certification Training
June 16-17, 2022: Caring for Older Adults and Families

The Saint Louis University Summer Geriatric Institute is an annual continuing education event for practitioners, faculty, fellows, residents, and students who are or will provide care and services to older adults and their families. The Institute includes lectures and workshops by an interprofessional group of practitioners and researchers on new and emerging areas of geriatric medicine and services. As an extension of the Institute, a one-day training on Cognitive Stimulation Therapy (CST) will be offered. CST is a non-pharmacologic intervention for persons with mild to moderate dementia. The training fulfills the first requirement for CST Facilitator Certification.

The audience for this program includes students and professionals working with older adults, with a special emphasis on clinicians and administrators, including physicians, nurses, occupational therapists, social workers, physical therapists, speech therapists, dietitians, marriage and family therapists, nursing home administrators, and those who specialize in alternative medicine.

QIPMO Staffing Workshops

What You Do Matters: Applying Lessons Learned from the Pandemic to Staff Stability and Resident Safety
QIPMO Staffing Workshops | Three-Part Series

June 2, 2022: Register HERE
June 20, 2022: Register HERE
May 16, 2022: Review the recording HERE | Download the handouts HERE
Presenters: David Farrell, MSW, LNHA, Alameda County Public Health Department; Cathie Brady, MS, and Barbara Frank, MPA, B&F Consulting

COVID has highlighted the dedication and courage of long-term care staff, the fragility of residents, and the impact of good leadership. With so much happening outside of leaders’ control, we found that leaders’ practices and decisions about how to communicate with and support staff, residents, and families made the difference. Attendees will take home low-cost, practical strategies that support staff and create the conditions for stability and good outcomes. This three-part series includes action steps in between sessions, to apply person-centered leadership practices immediately. We ask that you please encourage any corporate leaders to attend as well!

COVID-19 Testing Reimbursement and Supplies

COVID-19 TESTING REIMBURSEMENT ENDING JUNE 15, 2022:
The last day to submit COVID-19 testing invoices for reimbursement via the DSS invoice portal is June 15, 2022. After June 15, 2022, the portal will be closed and no other testing invoices will be accepted.

Additional Testing Resources:
Free Antigen Testing Supplies
The Missouri Department of Health and Senior Services (DHSS) continues to have an adequate supply of free ACON Flow Flex rapid antigen tests all Long Term Care Facilities may apply to receive. Full details regarding the product, CLIA requirements, standing physician orders, and the Rapid Antigen Test Kit Application can be found here: https://ltc.health.mo.gov/archives/15339.

Missouri launches dashboard displaying opioid overdose related data

Record high number of fatal overdoses recorded, according to most recent data available

With 1,878 deaths, 2020 had the highest number of fatal drug overdoses to date in the state of Missouri – a 19% increase from 2019. 1,375 of these deaths involved opioids. Today, the Missouri Department of Health and Senior Services (DHSS) launched a new, interactive dashboard showing data regarding both fatal and nonfatal overdoses, where they occurred in the state and the demographic makeup of those who overdosed.

Following national trends, drug overdoses have become an epidemic in Missouri over the past decade. Missouri ranked 32nd in the nation for drug overdose death rates in 2020.

Among adults aged 18-44 in Missouri, drug overdose is the leading cause of death, and more than 70% of all drug overdose deaths in the state involve opioids. The opioid class of drugs includes heroin, fentanyl, methadone, morphine, oxycodone and many other prescription and non-prescription pain relievers.

“The opioid crisis is an issue only made worse by the COVID-19 pandemic,” said Paula Nickelson, DHSS Acting Director. “This is a health crisis that knows no bounds–it affects all genders, races and ages in both rural and urban communities. Our efforts at the state level to combat opioid misuse and overdose include monitoring and prevention strategies designed to improve data quality, inform decision making and implement targeted interventions.”

The new dashboard shows a sharp increase in recent years of deaths, from those involving heroin (with no synthetic opioids present) to deaths involving synthetic opioids. Synthetic opioids, including fentanyl and its analogs, were involved in 1,204 drug overdose deaths in 2020 in Missouri. The 2020 figure is nearly seven times higher than the 2015 count of 179 synthetic opioid-involved deaths.

In an effort to alter this trajectory, DHSS has several strategies and activities currently underway or in development. These efforts are supported through the Overdose Data to Action (OD2A) cooperative agreement with the Centers for Disease Control and Prevention (CDC) which began in 2019.

Data Monitoring

  • Collect and disseminate timely Emergency Department data on all suspected drug, opioid, heroin and stimulant overdoses: Perform monitoring in Missouri’s Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) using case definitions for all drugs, opioids, heroin and stimulant overdoses.
  • Collect and disseminate descriptions of drug overdose death circumstances using death certificates and medical examiner/coroner data: Collect data from death certificates and medical examiner/coroner reports and enter data into the State Unintentional Drug Overdose Reporting System (SUDORS).
  • Implement Innovative Surveillance: Link records between two nonfatal data sources, ESSENCE and Patient Abstract System, on various overdose types to evaluate the relationship between overdoses reported with more real time data versus more comprehensive but lagged data.

Prevention Methods

  • Prescription Monitoring Compliance: Conduct regulatory inspections on high-risk prescribers and outliers; seek regulatory actions and remedies; provide information and education to prescribers about CDC prescribing guidelines.
  • State/local Integration Efforts: DHSS has established 16 current contracts with select local public health agencies to focus on opioid and illicit drug use prevention and response efforts.
    • DHSS collaborated with the Missouri Department of Mental Health and provided funding to three local prevention centers to combat opioid misuse and overdose.
    • The DHSS Office of Minority Health responds to overdoses in the St. Louis area and provides resources to overdose patients regarding treatment services.
    • DHSS held its inaugural Harm Reduction Conference in June of 2021 and is in the planning stages for the 2022 conference.
    • DHSS is developing a second Missouri vulnerability assessment focusing on dual issues of opioid misuse and blood-borne infection.
    • The DHSS Bureau of HIV, STD and Hepatitis provides Harm Reduction 101 training and technical assistance to local public health agencies and community-based organizations.
  • Linkages to Care: DHSS has supported contracted HIV Peer Navigators and other designated staff to attend the Missouri Credentialing Board Medication Assisted Recovery training, integrated the HIV Reduction 101 training into the HIV/Hepatitis C training and continues to look for professional certification opportunities to build system staff capacity.
  • Public Safety Partnerships: The DHSS Bureau of Healthcare Analysis and Data Dissemination has established a linkage of opioid overdose mortality data with offenders released from the Missouri Department of Corrections. DHSS has a linkage with the Midwest High Intensity Drug Trafficking Area to review drug seizure data and compare with opioid overdose mortality data.
  • Public Awareness: DHSS will launch a new media campaign based on most recent data to raise awareness of opioid misuse and overdose. DHSS has previously implemented three separate campaigns to focus on opioid awareness, harm reduction strategies and CDC Rx Awareness facets. The campaign targeted zip codes with the highest opioid mortality rates; these campaigns have been marketed on radio, billboards, at gas stations, across social media platforms and through other venues and platforms.

View the drug overdose dashboard at health.mo.gov/data/opioids, or visit Time2ActMissouri.com for more information or resources.

Update for COVID-19 Module Surveillance Pathways and Weekly HCP and Resident COVID-19 Vaccination Module Training dates

The NHSN Vaccination team will host 2 training sessions in preparation for the upcoming NHSN release on May 30th. These sessions were previously scheduled to incorporate the LTC COVID-19 Module Surveillance Pathways, however the training has been scaled down to solely focus on the COVID-19 Vaccination Module.

Please register to attend one or more sessions to learn how reporting forms will change and how to report data accurately. After registering, you will receive a confirmation email containing information about joining the webinar. Please note these training sessions are repeated and you may not find it necessary to register more than once. After each training session, you will be allowed to ask questions as it pertains to the webinar.

Thanks for your participation!
The NHSN LTCF Team

**COVID-19 Vaccination Modules Webinar**

When: Tuesday, May 17, 2022, 1:00 – 2:00 PM Eastern Time (US and Canada)
Topic: Updates to the COVID-19 Vaccination Modules for Residents and Healthcare Personnel
Register in advance for this webinar:
https://cdc.zoomgov.com/webinar/register/WN_2vwCHWGkQj63Nvka5h5GUA

When: Thursday, May 19, 2022, 1:00 – 2:00 PM Eastern Time (US and Canada)
Topic: Updates to the COVID-19 Vaccination Modules for Residents and Healthcare Personnel
Register in advance for this webinar:
https://cdc.zoomgov.com/webinar/register/WN_dG7knYLOQJu9lwT__8cV2Q

New QIPMO Newsletter – May 2022

The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls (Volume 9, Issue 3).

In this issue:

  • Addressing Your Residents’ Psychosocial Needs
  • Building and Keeping Great Staff
  • ICAR Corner
  • Down and Dirty in the Dementia Unit
  • Discharge before Admission
  • Visitation and Visitation Guidance

Please visit QIPMO’s website here for this and other previous newsletters.

CNA Training Agency Renewals

Just a reminder from the Health Education Unit!

Regulatory Guidance: 19 CSR 30-84.010 (9) Training agencies shall be approved for a two- (2-) year period and shall submit a new application for approval thirty (30) calendar days prior to the expiration of approval.

Please check your training applications to ensure they are current for holding the CNA Training Program. Failure to keep your training applications up-to-date may delay the ability to train and/or test CNA’s from your facility. Please see the link below to our website which includes information on training applications:

https://health.mo.gov/safety/cnaregistry/pdf/580-2469.pdf

You may contact the Health Education Unit for questions at 573-526-5686 or the CNARegistry@health.mo.gov.

2022 SLCR Annual Provider Meetings

We are currently in the planning phase to host in-person provider meetings in all regions this year and are considering the best topics to provide the most beneficial information. We would like to hear from you about what LTC related topics and info you believe would be helpful and educational!

Please take a moment to answer complete a short questionnaire by May 31, 2022 at https://www.surveymonkey.com/r/9287QZQ.

New Changes coming in May for the COVID-19 Module Surveillance Pathways and Weekly HCP & Resident COVID-19 Vaccination Module

There will be various revisions to the LTCF COVID-19 Module surveillance pathways and COVID-19 Vaccination Modules for residents and healthcare personnel in the upcoming NHSN May release. CDC will be conducting training webinars next month. Please attend a training session to learn how data entry forms will change and receive instructions for accurate reporting. Below are a few changes you will see starting next month in the COVID-19 Module surveillance pathways.

NHSN COVID-19 Module Surveillance Pathway Forms will be Revised
New Changes Coming in May!!

What are the main changes?

Simplifications

  1. REMOVAL of Supplies and PPE Pathway
    1. Users will no longer need to report data to this pathway
  2. The Resident Impact and Facility Capacity Pathway (RIFC) and the Staff and Personnel Impact Pathway will have several data elements removed:
    1. COVID-19 test type
    2. Vaccine manufacturer (RIFC only)
    3. COVID-19 re-infections
    4. Other respiratory illness
    5. Testing performed and time for receiving results

Possible Additions

  1. Expand vaccination status options for boosters.
  2. Include simplified PPE shortage question.

How should I prepare for the upcoming changes?

  • Review ALL E-mail communication from NHSN
  • Attend COVID-19 Module trainings
  • Review the TOIs to assist with reporting elements
  • Update your CSV files as applicable
  • Templates will be updated on the COVID-19 webpage in May

How can I learn more?
CDC will be conducting training webinars in May. More information on these webinars will be shared in the coming weeks, so stayed tuned!

If you have questions, please send an e-mail to NHSN@cdc.gov with ‘COVID-19 Surveillance Pathway Forms’ in the subject line. Below are the changes that will also take place in the COVID-19 Vaccination Module starting next month.

 

NHSN Weekly COVID-19 Vaccination Cumulative Summary Forms will be Revised
New Changes Coming in May!!

What are the main changes?

Simplifications

  1. COVID-19 vaccination data will no longer be reported by vaccine manufacturer for questions on primary vaccine series and additional/booster doses.
  2. Questions on vaccine supply will be removed.
  3. Completing monthly reporting plans for COVID-19 vaccination modules in the Long-Term Care Facility Component will no longer be required. Instead, upon saving or uploading data, users will agree to the following:
    1. The data reported are consistent with definitions outlined in NHSN surveillance protocols (including tables of instructions and frequently asked questions).
    2. The data will be sent to the Centers for Medicare and Medicaid Services (CMS) to fulfill CMS quality reporting requirements (when applicable).

Additions

  1. Adding a note at the top of form specifying that data can be submitted by completing the questions on the data collection form or by using the new event-level COVID-19 vaccination forms.
  2. Adding a question for facilities to report the cumulative number of individuals who are up to date with COVID-19 vaccination.
  3. Adding two fields to question #4 to report the cumulative number of individuals who received only one booster dose and two or more booster doses of COVID-19 vaccine (Note: For residents only)

How should I prepare?
Facilities should develop or update data tracking mechanisms to collect weekly COVID-19 vaccination data on residents and healthcare personnel for the additional questions.

Tip: Using the new event-level COVID-19 vaccination forms in NHSN’s Long-Term Care Facility Component can simplify the tracking and reporting of data on multiple booster doses and up to date status.

How can I learn more?
CDC will be conducting training webinars in May. More information on these webinars will be shared in the coming weeks, so stayed tuned so you can register for the sessions.

If you have questions, please send an e-mail to NHSN@cdc.gov with ‘COVID-19 Vaccination Data Reporting’ in the subject line.

SNF Quality Reporting Program (QRP) Submission Deadline Reminder

SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. MDS and NHSN data for 10/1/21 through 12/31/21 must be submitted no later than 11:59 p.m. on May 16, 2022.

The Minimum Data Set (MDS) 3.0 must be transmitted to the Centers for Medicare & Medicaid Services (CMS) through the Assessment Submission and Processing (ASAP) system to the Quality Improvement Evaluation System (QIES). Data for the National Healthcare Safety Network (NHSN) measures must be submitted to the Centers for Disease Control and Prevention (CDC). No additional data submission is required for the claims-based measures.

As a reminder, it is recommended that providers run applicable CASPER reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.

Swingtech sends informational messages to SNFs that are not meeting APU thresholds on a quarterly basis ahead of each submission deadlines. If you need to add or change the email addresses to which these messages are sent, please email QRPHelp@swingtech.com and be sure to include your facility name and CMS Certification Number (CCN) along with any requested email updates.

More information about SNF QRP can be found on the following webpages:

Payroll-Based Journal (PBJ) Submission Deadline Reminder

Nursing homes are required to electronically submit direct care staffing information to the Payroll-Based Journal (PBJ) system. Submissions must be received by the end of the 45th calendar day (11:59 PM Eastern Standard Time) after the last day in each fiscal quarter to be considered timely. PBJ data for 1/1/22 through 3/31/22 is due May 15, 2022. Please submit PBJ data as soon as possible to avoid delays. CMS recommends running staffing reports in CASPER prior to the submission deadline to ensure the accuracy and completeness of submissions. Please remember, the Final File Validation Report verifies that the submission was successful.

Please note: If you need assistance with the PBJ quarterly submission and the deadline falls on a weekend, you must contact the QIES/iQIES Service Center no later than the Friday before the submission deadline, as the Service Center will be unavailable to assist on the weekend.

More information about PBJ can be found on the following webpages:

CDC Health Advisory 463: Updated Info of Treatments COVID-19

Please see the CDC Health Advisory, number 463, dated 2/25/2022, entitled “Updated Information on Availability and Use of Treatments for Outpatients with Mild to Moderate COVID-19 Who are at Increased Risk for Severe Outcomes of COVID-19.”

Missouri healthcare providers and public health practitioners: Please contact your Local Public Health Agency or the Missouri Department of Health and Senior Services’ Bureau of Communicable Disease Control and Prevention at 573-751-6113 or 800-392-0272 (24/7) with questions regarding this Health Advisory.

Summary of Key Points: New Optional Event-Level COVID-19 Vaccination Forms in NHSN (replacing the Excel Data Tracking Worksheets)

The NHSN Vaccination Team hosted two office hours webinars for the Event-Level COVID-19 Vaccination Forms on Tuesday, April 12th and Tuesday, April 19th. During these webinars, CDC provided long-term care facilities with an overview of how to use this feature to manage person-level vaccination data directly in the application for the COVID-19 Vaccination Modules and discussed frequently asked questions in detail.

The slides used during the webinars are linked under the “Educational Resources” section of this message, and webinar recordings will be posted on the NHSN website at a later date.

Summary of Key Points:

  • The Event-Level COVID-19 Vaccination Forms are available in the NHSN application for long-term care facilities (other modules coming soon) to manage person-level vaccination data and simplify summarizing data for weekly COVID-19 Vaccination Modules.
  • There are three ways to report data: directly into the COVID-19 Vaccination Modules, via .CSV upload, or by selecting the ‘View reporting summary and submit’ button of the Event-Level COVID-19 Vaccination Forms.
  • SAMS Level 3 access is required to complete reporting using the Event-Level COVID-19 vaccination forms. If your facility does not have a Level 3 user, please contact the SAMS Help Desk between the hours of 8:00 AM and 8:00 PM EST Monday through Friday (excepting U.S. Federal holidays) at the following: Toll Free: 877-681-2901; E-mail: samshelp@cdc.gov. You can also find additional information in the SAMS User FAQs published on the SAMS Homepage at https://sams.cdc.gov.
  • Data are entered line by line in the optional Event-Level COVID-19 Vaccination Forms, similar to the Excel Data Tracking Worksheet.
  • You can complete a one-time upload of any current data in the Excel Data Tracking Worksheet to the NHSN Event-Level COVID-19 Vaccination Forms. Once your data are transferred to the NHSN application, do not continue to use/re-upload the Excel Data Tracking Worksheet because the two tools do not function the same way.
  • You can export a .CSV file and upload data via .CSV .CSV files templates and examples for healthcare personnel and residents of long-term care facilities are available on the NHSN website: https://www.cdc.gov/nhsn/pdfs/ltc/covidvax/c19-event-layout-508.pdf.
  • There is no need to enter a new line for an individual each week or when their status changes; instead, Event-Level COVID-19 Vaccination Forms capture changes in individuals’ vaccination status over time.

The one exception is for extended leave. If a healthcare worker goes on leave for longer than 2 weeks (14 days) and returns to work after more than 2 weeks, or if a resident is discharged or leaves the facility for any reason for longer than 1 week (7 days) and returns or is re-admitted after more than 1 week:

– You should enter a discharge/end date on the day they were discharged or left.

– When they return or are re-admitted, you should duplicate their row (using the + button next to their row) and enter a new admission date on their new row.

  • These forms allow users to record religious exemption as a reason for declining COVID-19 vaccination.
  • 2nd booster dose fields will be added to the forms.

Coming Soon – May 2022 Release:

  • The Event-Level COVID-19 Vaccination Forms will include new columns to record second and third booster doses.
  • The weekly summary form will include a question on “number of individuals who are up to date on COVID-19 vaccines.” This field will be auto-calculated for those using and submitting data with the Event-Level COVID-19 Vaccination Forms.
  • The weekly resident summary form will include questions on number of residents who received only one booster dose, and number of residents who received two or more booster doses. These fields will be auto-calculated for those using and submitting data with the Event-Level COVID-19 Vaccination Forms.
  • Rows will no longer appear green after submission for individuals with a discharge date earlier than 3/28/2022.

Note: NHSN encourages facilities to enter the same IDs for residents and healthcare personnel as those used for reporting the POC Tool and the RIFC Event-Level Form when applicable.

Educational Resources:

For specific information about CMS reporting requirements for long-term care facilities, please contact CMS at: DNH_TriageTeam@cms.hhs.gov.

Reporting of Positive COVID-19 Cases – Changes Effective Monday, April 18th

Effective April 18, 2022, the existing Electronic COVID-19 Case Reporting System (ECD-1) will be disabled. This system will be replaced by the Missouri Disease Reporting Online Portal (MODROP). MODROP can be accessed directly from https://modrop.health.mo.gov/ or by using the existing ECD-1 link at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/case-reporting.php and selecting the MODROP button.

NOTE: The recommended browser for use of MODROP is Google Chrome. Other browsers may cause issues with MODROP.

Facilities will need to register for a MODROP account the first time they use the new portal. MODROP allows reporting of only COVID-19 cases. Reports of other reportable conditions may be faxed to 573-751-6417.

Facilities performing their own COVID-19 testing (antigen testing) must report positive results through one of the following portals:

  • MODROP
  • In bulk via HL7 or CSV file using the DHSS- Electronic Lab Reporting process
  • National Healthcare Safety Network (NHSN) or the Association of Public Health Laboratories (APHL) Informatics Messaging Services (AIMS) Platform.

Facilities using an external laboratory (PCR testing) must enter positive case information into MODROP.

We are excited for this change and elimination of duplicate reporting of positive cases! If you have any questions or encounter any issues utilizing MODROP or for questions about HL7 or CSV reporting, please reach out to the EpiTrax Help Desk via e-mail at epitrax@health.mo.gov. The EpiTrax Help Desk e-mail account is monitored from 8AM-5PM CST Monday-Friday.

Please see the FAQ and thank you for your efforts to provide complete and accurate COVID-19 data to public health.

Office Hours and Frequently Asked Questions Webinar for the Optional Event-Level

The NHSN Vaccination Team is providing two webinars on Tuesday, April 12th and Tuesday, April 19th at 2:00 PM Eastern Time to provide additional training on the Event-Level COVID-19 Vaccination Forms in the COVID-19 Vaccination Modules and to answer frequently asked questions. These worksheets are available in the NHSN application for long-term care facilities (other modules coming soon!) to manage person-level vaccination data and simplify data for weekly COVID-19 Vaccination Modules.

During this session, the team will review key points about the forms and provide answers to frequently asked questions raised during the training webinars held in March 2022. Users attending the training can also ask questions in in the Q&A box.

Registration information for both webinars is listed below. The content for both webinars will be the same, but individuals are welcome to register for and join both for additional reinforcement if they choose.

When: Tuesday, April 12, 2022 at 02:00 PM Eastern Time (US and Canada)
Topic: Event-Level COVID-19 Vaccination Forms: Office Hours and FAQs

Register in advance for this webinar: https://cdc.zoomgov.com/webinar/register/WN_CQN5faRJTRictvPA512RmA
After registering, you will receive a confirmation email containing information about joining the webinar.

When: Tuesday, April 19, 2022 at 02:00 PM Eastern Time (US and Canada)
Topic: Event-Level COVID-19 Vaccination Forms: Office Hours and FAQs

Register in advance for this webinar: https://cdc.zoomgov.com/webinar/register/WN_asYca_YuTj2gzJbMiFM7ow
After registering, you will receive a confirmation email containing information about joining the webinar.

For specific questions about registration for this webinar, please e-mail NHSN@cdc.gov and place in the subject line: Event-Level COVID-19 Vaccination Form Office Hours.

DHSS Warehouse Shipment Update

Beginning April 11, 2022, DHSS will ship PPE, test kits, and other warehoused items on Monday and Thursday each week.

If you have an urgent need outside of these shipment dates, please email Tracy.Niekamp@health.mo.gov after your order has been submitted through the ordering portal.

CNA Renewals/Work Updates

Note: The requirement to renew the CNA certification every 24 months is not a new regulation; however, the process to renew has been updated and a fee has been added.

**Please see this link for information on how to renew.

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, upload your documents for proof of 8 hours of work and then pay the required fee. After the fee is processed, you will 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: You will need to fill out the form Employer Renewal Payment. If you have additional questions please email them at missouri@hdmaster.com or call at 800-393-8664 and ask for the Missouri team.