CMS Memo: S&C 18-04-NH: Temporary Enforcement Delays for Certain Phase 2 F-Tags and Changes to Nursing Home Compare

  • Temporary moratorium on imposing certain enforcement remedies for specific Phase 2 requirements: CMS will provide an 18 month moratorium on the imposition of certain enforcement remedies for specific Phase 2 requirements. This 18 month period will be used to educate facilities about specific new Phase 2 standards.
  • Freeze Health Inspection Star Ratings: Following the implementation of the new LTC survey process on November 28, 2017, CMS will hold constant the current health inspection star ratings on the Nursing Home Compare (NHC) website for any surveys occurring between November 28, 2017 and November 27, 2018.
  • Availability of Survey Findings: The survey findings of facilities surveyed under the new LTC survey process will be published on NHC, but will not be incorporated into calculations for the Five-Star Quality Rating System for 12 months. CMS will add indicators to NHC that summarize survey findings.
  • Methodological Changes and Changes in Nursing Home Compare: In early 2018, NHC health inspection star ratings will be based on the two most recent cycles of findings for standard health inspection surveys and the two most recent years of complaint inspections.

Please see the full memo and details at www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-18-04.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending.

New SLCR Assistant Administrator

The Section for Long-Term Care Regulation is pleased to announce Tracy Niekamp will be joining the Section as the Assistant Administrator. As many of you know, Tracy worked in a management capacity for SLCR until a couple of years ago when she became the Licensure and Certification Manager for the Department of Mental Health. Tracy’s experience both here and at the Department of Mental Health will be invaluable to the Section. Tracy’s first day with SLCR will be December 18, 2017.

AHRQ Releases TeamSTEPPS 2.0 to Improve Patient Safety in Long-Term Care

AHRQ has updated its TeamSTEPPS® training for long-term care facilities. Now called TeamSTEPPS 2.0 for Long-Term Care, the curriculum updates have improved the usability and flow of materials, added training scenarios to reflect health care issues in long-term care settings, and added a new measurement module to help teams track progress. The revisions also bring this version of the TeamSTEPPS “train-the-trainer” curriculum in line with changes made to TeamSTEPPS 2.0 for hospital-based teams. Users may download and/or print all the free TeamSTEPPS 2.0 for Long-Term Care materials for training in any post-acute or long-term care facility.

Nursing Home Training Sessions: Clostridium difficile Part Two – Strategies to Prevent, Track and Monitor C. difficile

This nursing home training session provides strategies to prevent and track incidence and prevalence of Clostridium difficile (C. difficile) infections in nursing homes. Click on the links below to take the training and receive nursing contact hours.

The session is one of a six-part series supporting nursing homes in implementing antibiotic stewardship as well as in preventing and managing C. difficile infections. (2.0 Nursing Contact Hours Available)

Clostridium difficile Part Two – Strategies to Prevent, Track and Monitor
Continuing Education Information: Nursing Home Online Training Series (PDF)

MC5 Restorative Sleep Vitality Program (RSVP)

MC5 is seeking 30 SNF communities to participate in an 18-month program to restore restful sleep to residents and elders. The Restorative Sleep Program seeks to promote active engagement during the day and restful restorative sleep at night.

MC5 will utilize Empira’s Restorative Sleep program, which was developed from evidence-based sleep hygiene research studies and consultation with subject matter experts. Using cutting-edge practices to enhance residents’ sleeping and waking patterns, Restorative Sleep has created new best practices outlining how all 24 hours of the day impact residents’ sleep quality.

Enrolling in this program will include commitment to implementing a multi-pronged approach including clinical, operational, and environmental interventions and solutions to create a culture of restorative sleep.

Please visit www.momc5.com  for more details including the application to participate in the MC5 Restorative Sleep Vitality Program.

Nursing Home Training Session: Clostridium difficile Part One – Clinical Overview

This nursing home training session provides information on the etiology, transmission, risk, signs, symptoms and treatment of Clostridium difficile infection. Click on the links below to take the training and receive nursing contact hours.

The session is one in a six-part series to support nursing homes in implementing antibiotic stewardship as well as in preventing and managing Clostridium difficile infections. (2.4 Nursing Contact Hours Available)

Nursing Home Training Session: Clostridium difficile Part One – Clinical Overview
Continuing Education Information: Nursing Home Online Training Series (PDF)

Nursing Home Training Session: Antibiotic Stewardship

This nursing home training session provides information on the concept and practical aspects of antibiotic stewardship, the core elements of a long-term care antibiotic stewardship program and the need for a community-based approach. Click on the links below to take the training and receive nursing contact hours.

The session is one in a six-part series to support nursing homes in implementing antibiotic stewardship as well as preventing and managing Clostridium difficile infections. (2.1 Nursing Contact Hours Available)

Nursing Home Training Session: Antibiotic Stewardship
Continuing Education Information: Nursing Home Online Training Series (PDF)

ELDA – November 2017-May 2018

A professional development certificate program for RNs, NHAs and Social Workers using a proven curriculum to improve leadership behaviors with a combination of face-to-face meetings and two webinars. Offered over 7 months, it features an innovative and evidence-based curriculum with a strong focus on application to practice and peer consultation.

This will be the last time the ELDA will be taught in a face-to-face format. If you prefer to learn in a live classroom, be sure to enroll now. Beginning in Spring/Summer 2018, we are pleased and excited to offer the ELDA in a mostly online format. You will receive a separate mailing on this option.

For more information, including the brochure and registration, please visit nursingoutreach.missouri.edu/lda.aspx.

Licensure and Certification Fees

Over the past several months the Licensure and Certification Unit has received an influx of checks from providers that come in with applications, bed/status/name changes, and/or changes of operator/owner. All checks and money orders must be mailed to the Fee Receipts Unit with the facility name indicated on them. Please send all fees to the Fee Receipts Unit at:

Department of Health & Senior Services
Section for Long Term Care Regulation
Fee Receipts
920 Wildwood Drive
P.O. Box 570
Jefferson City, MO  65102

Additionally, please indicate the check number on the application or other documents sent to the Licensure and Certification Unit. Please contact the Licensure and Certification Unit with any questions at 573-526-8508 or ltcapplication@health.mo.gov. Thank you!

Antibiotic Resistance: How It Happens and Strategies to Decrease the Spread of Resistance

This nursing home training session provides a foundation of information about antibiotic resistance and opportunities for improving appropriate antibiotic use. It also includes strategies toward reducing resistance.

The session is one in a six-part series to support nursing homes in implementing antibiotic stewardship as well as preventing and managing Clostridium difficile infections. (1.3 Nursing Contact Hours Available)

Antibiotic Resistance: How it Happens and Strategies to Decrease the Spread of Resistance
Continuing Education Information: Nursing Home Online Training Series (PDF)

Nursing Home Training Session: Exploring Antibiotics and Their Role in Fighting Bacterial Infections

This nursing home training session provides information on the basics of antibiotics, their functionality, potential risks and side effects, general considerations for usage and prescribing and an introduction to why using antibiotics appropriately is important.

This session is the first in a six-part series to support nursing homes in implementing antibiotic stewardship as well as preventing and managing Clostridium difficile infections. (1.5 Nursing Contact Hours Available)

Nursing Home Training Session: Exploring Antibiotics and their Role in Fighting Bacterial Infections
Continuing Education Information: Nursing Home Online Training Series (PDF)

MDS Items O0600 (Physician Examinations) and O0700 (Physician Orders)

As of 10-1-17, Version 1.15 of the RAI Manual went into effect. The RAI Manual now states CMS does not require completion of items O0600 or O0700, however, some States continue to require the completion of these items. The RAI Manual states if the State does not require the completion of these items, use the standard “no information” code (a dash, “”).

Missouri does not require completion of items O0600 and O0700; staff in Missouri facilities may dash these items as the RAI Manual directs.

If you have any questions concerning this information, please contact Stacey Bryan, the State RAI Coordinator, at 573-751-6308 or Stacey.Bryan@health.mo.gov.

SNF QRP Confidential Feedback Reports for Claims-Based Measures

The SNF QRP Confidential Feedback Reports containing the claims-based IMPACT Act measures are now available via the CASPER Reporting System.

For more information on these reports, please refer to the September 28, 2017 presentation and audio and transcript on the SNF QRP Training website.

Please note that these reports only contain information for the following claims-based quality measures:

  • Total Estimated Medicare Spending Per Beneficiary Measure
  • Discharge to Community-Post Acute Care– SNF QRP
  • Potentially Preventable 30-Day Post Discharge Readmission Measure

The full Confidential Feedback Reports or Quality Measure reports containing all SNF QRP quality measures (claims-based and assessment-based) will be released later this year and further training will be forthcoming.

If you have questions about the information contained in your report, please contact the SNF QRP Help Desk at SNFQualityQuestions@cms.hhs.gov.