The Missouri Nurse Aide Candidate Handbook for CNA testing has been updated effective February 2025.
Please see the changes and let us know if you have any questions. You may contact us at the CNARegistry@health.mo.gov or call us at 573-526-5686.
The Missouri Nurse Aide Candidate Handbook for CNA testing has been updated effective February 2025.
Please see the changes and let us know if you have any questions. You may contact us at the CNARegistry@health.mo.gov or call us at 573-526-5686.
Click here to learn about The Einstein Option then join them for a Virtual Event on Wednesday, February 26 from 12:00 – 1:00 to learn about the key discussions, outcomes, and the next steps identified during their summit.
The Division of Senior and Disability Services (DSDS) is seeking additional Direct Service Workers to join the existing panel. Last year we received valuable information from our panelist and are excited to continue the work through this year. We are seeking Direct Service Workers currently working in the role with experience and knowledge to share. If you know of someone who would be a great contribution to this panel, please send this application information for consideration. Click the image below to learn more and apply.
Any questions should be directed to the Bureau of Policy and Quality Enhancements at LTSS@health.mo.gov.
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 10/1/24 through 12/31/24 is due February 14, 2025. Please submit PBJ data as soon as possible to avoid delays.
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. The following data must be submitted no later than 11:59 p.m. on February 18, 2025:
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.
FREE THREE-PART VIRTUAL SERIES
All staff in CMS-certified nursing facilities across the U.S. are invited to join this three-part learning series to enhance skills in person-centered care, engaging with residents, and de-escalation with expert guidance and peer support.
More information including topics and specific dates for each can be found here.
The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls (Volume 12, Issue 2).
In this issue:
Please see the most frequently cited deficiencies report from the fourth quarter of 2024.
The Medicare and Medicaid Poster is now updated for homes to print and display for residents. Note the asset limits for MO HealthNet are no longer provided on the poster, as they change every year. Please obtain the latest update on the Missouri Long-Term Care Ombudsman website. The Medicare and Medicaid Poster can be located under the Online Only section at: https://health.mo.gov/seniors/ombudsman/resources.php.
Myers and Stauffer conducted a MDS Documentation Requirements Refresher training on December 17, 2024, which can be found at https://myersandstauffer.com/client-portal/missouri/. Under “Helpful Downloads for Nursing Facilities MDS and Rate Setting” and “MDS Refresher Training – December 2024” you can find the training recording, slide deck, and FAQ document.
The Section for Long-Term Care Regulation’s Health Education Unit is excited to present this summer event.
Please stay tuned for more details including agenda!
Snow and ice are a mainstay of Missouri winter weather. Because of the variety of weather conditions as well as other events, facilities must have an emergency preparedness plan and be ready to act in an emergency to ensure they are to adequately prepared to meet the needs of patients, clients, residents, and participants during disasters and emergency situations.
If your facility experiences a loss of a necessary service (electricity, water, gas, phone, etc.), contact SLCR via the Regional Office emergency phone line and keep them informed of their status. If, for some reason, the facility cannot contact SLCR staff through the regional office phone number, you should contact the hotline. The emergency protocol is located here.
When you call, be prepared to answer to the following:
Facility name
Here are a few things to consider in examining your emergency preparedness plan, specifically as it relates to snow, ice, and power outages.
During a disaster is the least ideal time to learn an emergency plan will not work or to search for a contracted service. All contracted services including, but not limited to, transportation, fuel needs, evacuation location, food, and water needs to be in the emergency plan. The emergency preparedness team needs to consider and plan all services and contract prior to an actual emergency. During an emergency, it may be very difficult or impossible to get a contracted service due to volume of request, road conditions, and/or other factors.
Thank you for preparing in advance and keeping us informed!
Memorandum Summary
Please see the full memo for details located at https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos/policy-memos-states-and-cms-locations/long-term-care-ltc-facility-acute-respiratory-illness-reporting-requirements.
The NHSN Long-Term Care Team and Vaccination Team provided a refresher training about the newly combined reporting form for Respiratory Pathogens and Vaccination. The team also reviewed upcoming required reporting fields beginning January 1, 2025.
NHSN LTCF Component: Respiratory Pathogens & Vaccination Reporting Requirement Updates – December 2024
Register in advance for the webinar replay on January 7: https://cdc.zoomgov.com/webinar/register/WN_Sd8zLQXEQCWl9vKCrfJcpw#/registration.
More resources can be found at https://www.cdc.gov/nhsn/ltc/covid19/rpv-resources.html.
Center of Excellence for Behavioral Health in Nursing Facilities – Webinar Opportunity
Holiday Seasonal Depression: Ways to Support Nursing Facility Residents
The holidays can be tough for both residents and those who support them. The Center of Excellence of Behavioral Health in Nursing Facilities is hosting a live virtual event on 12/17/24 @ 1:00 PM CST to talk about the fundamentals of Seasonal Affective Disorder (SAD) and its effects on holiday depression. This training FREE, available to residential care, assisted living, skilled nursing, Ombudsman, and state survey agency team members. It is designed to provide participants with a basic understanding of depression, seasonal onset, symptoms, and treatments to support residents experiencing challenges from SAD. Register today- as space may be limited.
Please see the attached as a similar letter is being sent out by DHSS and the Healthcare-Associated Infections & Antimicrobial Resistance team of epidemiologists regarding some education for C auris (emerging fungal infection).
The Association for Professionals in Infection Control and Epidemiology along with American Association of Post-Acute Care Nursing, has released a practice guidance tool and resource guide to help implement EBP in skilled long-term care facilities. The practice guidance tool outlines when EBP should be implemented for residents, provides infection control recommendations for routine care activities, and includes case study examples with a self-quiz to help reinforce learning. The resource guide also provides a comprehensive list of infection control websites and references. More information including the guide can be found here.
Myers and Stauffer to conduct MDS Documentation Requirements Refresher
Please see the attached flier for the MDS Documentation Requirements Refresher scheduled for December 17, 2024 from 9:00 AM – 10:30 AM CST. Please click the link within the flier (or below) to register for the webinar. Registration is required.
Link to Register: https://mslc.webex.com/weblink/register/rc0eb002a1e79b4ee18d8f94400fe85b4
The training materials and recorded webinar will be available for download after the training should you be unable to attend the live session. Please direct any questions to MO_MDSINFO@mslc.com.
Special Information Related to COVID-19 Reporting:
The original MODROP portal was developed in conjunction with the EpiTrax application. DHSS transitioned from EpiTrax to the ShowMe WorldCare application on August 26, 2024. A new version of MODROP is now available through ShowMe WorldCare: The Missouri Disease Reporting Online Portal (MODROP).
Active users of the earlier version of MODROP were notified of the system transition via the email address linked to their MODROP account. These users were provided with new account credentials prior to the launch of ShowMe WorldCare in August 2024. If an individual needs to utilize MODROP and has not already received this information via email, a new request for an account must be submitted.
Use this link for more information on electronic laboratory reporting and electronic case reporting for reportable conditions: Electronic Laboratory Reporting and Electronic Case Reporting for Reportable Conditions in ShowMe WorldCare.
For the state regulations regarding reporting infectious, contagious, communicable, or dangerous diseases go to Missouri Secretary of State: Code of State Regulations.
SLCR recently had an opportunity to meet with Livanta, the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) that receives the appeals of non-coverage (SNF ABN and NOMNC) required in F582. A couple items to note- the required forms are updated periodically- so please make sure the most recent forms are being used. The most recent forms and instructions for their use can be found here: Beneficiary Notices Initiative (BNI) | CMS. Changes were made in November 2024 and additional changes will be effective beginning January 1, 2025.
SLCR has heard recent concerns from facilities and residents regarding Medicare Advantage beneficiaries being denied services or delays in services. If you hear these concerns, please share with Medicare Advantage residents and/or families that the NOMNC has been modified to reflect regulations providing enrollees additional fast-track appeal rights when they untimely request an appeal to the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO), or still wish to appeal after they end services on or before the planned termination date (See: CMS-4205-F, p. 30827).
These notices should be provided timely to beneficiaries whose Medicare covered services will end to inform them of their rights and protections related to financial liability and appeals under the Fee-for-Service Medicare and Medicare Advantage (MA) programs.
Additionally, facilities and beneficiaries can find contact information for Missouri’s BFCC-QIO, Livanta, here: https://www.livantaqio.cms.gov/en/states/missouri.
The 2024 Long Term Care Annual Facility Survey will become available in the NHSN application, January 2025. Facilities that currently, or plan to, participate in the Healthcare Associated Infection (HAI) modules, such as urinary tract infections, laboratory-identified events for C. difficile and/or multidrug resistant organisms, and/or prevention process measures are required to complete the survey by March 1, 2025.
Facilities that complete the annual survey help drive significant improvements within the NHSN surveillance system, enabling the development of targeted resources, surveillance guidance, and meaningful performance comparisons among Long-Term Care Facilities.
Here are a few reasons why completing the 2024 Annual Facility Survey is important:
Please note that for facilities primarily reporting in the Respiratory Pathogens Vaccination module, the annual survey is not mandatory. However, we strongly encourage all Long-Term Care Facilities (LTCFs) to complete the survey, as it provides valuable benefits, as outlined above, for your facility.
If you have questions, please contact NHSN-ServiceNow and include “2024 LTCF Annual Facility Survey” in the subject line. The portal can be accessed here or through your SAMS account. After logging into SAMS, the NHSN-ServiceNow link is located at the bottom of the page.
If you are unable to access ServiceNow, you can email the NHSN Help Desk at nhsn@cdc.gov.
Thank you for your continued commitment to improving care in long-term care settings.
The NHSN LTCF Team
DHSS Section for Long Term Care would like to say thank you to all that were able to take time out of their busy schedules to attend the webinar, “An Engaged Medical Director: A Real Asset to a LTCF,” on 11/20/2024, presented by Dr. Michael Nash. We would like to extend this thank you to Dr. Nash for sharing his wealth of knowledge and passion with us at DHSS, LTCF staff, educators, and providers. We believe the insights shared will be greatly beneficial for long-term term care facilities and Medical Directors.
This recorded presentation is now available on demand, along with the slides from the presentation.
Recording Link: “An Engaged Medical Director: A Real Asset to a LTCF”
Presentation Slides: Engaged Medical Director Presentation for MO DHSS 11-20-24 v2 MN edits
CDC recommended lowering the age for routine adult pneumococcal vaccination from 65 to 50 years old. Adults who are 19 through 49 years old with certain risk conditions should continue to get vaccinated against pneumococcal disease. There are now three pneumococcal conjugate vaccines (PCV15, PCV20, PCV21) available for adult vaccination. Healthcare providers can use any of these products to vaccinate adults against pneumococcal disease. Typically, only one dose of pneumococcal vaccine is needed as an adult. However, if PCV15 is used, a second type of vaccine (pneumococcal polysaccharide vaccine, PPSV23) is needed.
Job aids for adult pneumococcal vaccination
Shared clinical decision-making: This job aid should assist vaccine providers in discussions with older adults considering PCV20 or PCV21 vaccination.
Vaccine timing for adults: This job aid should help vaccine providers interpret adult pneumococcal vaccine recommendations.
During the Summer of 2024, COMRU implemented several enhancements to the online application system. To test the effectiveness of those enhancements, on September 1, 2024, COMRU began reviewing newly submitted applications as well as reviewing applications submitted prior to September 1.
COMRU is current with reviewing newly submitted applications and has made significant progress in reviewing applications submitted prior to September 1. Only applications submitted July 22 to August 31, 2024, are pending review. COMRU expects to have all applications submitted prior to September 1 reviewed by the end of the calendar year.
Please note: Applications returned to the submitter for correction will be deleted from the online application system if corrections are not made and resubmitted to COMRU within 60 days. he submitter may access the online application at any time to check the status of a pending application. Training on how to check the status of an application can be located on COMRU’s webpage (Under Trainings/WebEx Training – Level One Online Form Feb 2024).
Tips and Reminders
Many applications have one of these diagnoses listed and this question is answered “no” when the answer should be “yes”. When the question is marked “yes” follow-up questions populate; marking “no” results in an incomplete application which will be returned for correction.
For additional information and answers to frequently asked questions, please review the online training posted on the COMRU webpage.
CDC has designated November C. diff awareness month. They’ve complied several educational resources that can be used for families, staff, and partner providers. Please see the ICAR team’s flyer for more information.
Please see the ICAR team’s flyer for facilities related to current COVID guidance.