Missouri Long-Term Care Information Update

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.

CNA Upcoming Testing

Headmaster D & S: 1-800-393-8664 – Please ask for the Missouri Team!

  • April 9, 2022 – St. John
  • April 12, 2022 – St. Louis(Knowledge) & Jefferson City
  • April 13, 2022 – Trenton & Kansas City
  • April 14, 2022 – Gladstone & St. John
  • April 15, 2022 – Kansas City
  • April 21, 2022 – Gladstone, Kansas City & St. John
  • April 23, 2022 – St. Louis
  • April 24, 2022 – Kansas City
  • April 25, 2022 – Kansas City
  • April 28, 2022 – Gladstone, Kansas City, Jefferson City, St. John & Hillsboro
  • April 29, 2022 – Kansas City
  • April 30, 2022 – Kansas City

All Regional dates are viewable on the online calendar at https://mo.tmutest.com/calendar.

To help with scheduling your testing event, contact Headmaster a few days after the CNA course starts.

Health Update: Reporting COVID-19 Cases and SARS-CoV-2 Test Results

April 6, 2022: Update: Reporting COVID-19 Cases and SARS-CoV-2 Test Results

The Missouri Department of Health and Senior Services (DHSS) is issuing this Health Update to provide reporting laboratories and healthcare providers information regarding the changes in the reporting requirements for COVID-19 and SARS-CoV-2 test results in Missouri.

During the early stages of the pandemic response there were several changes to the reporting rules that were established through waivers during the State of Emergency issued by Governor Parson. The changes included the requirement that both negative and positive test results for COVID-19 were to be reported to DHSS within twenty-four hours. Additionally, reporters were required to only report directly to DHSS rather than having the option to report to either the Local Public Health Agency (LPHA) or DHSS. After the State of Emergency was lifted by Governor Parson, DHSS filed an emergency amendment to allow these requirements to continue. However, on April 1, 2022, DHSS terminated this emergency amendment and as a result, these requirements no longer exist. Please consider the following guidance regarding the reporting of COVID-19 and laboratory tests results for SARS-CoV-2.

Coronavirus Disease 2019 (COVID-19) remains an immediately reportable condition in Missouri. All positive laboratory results are required to continue to be reported to DHSS or the LPHA in accordance with rules established in 19 CSR 20.20.020. Healthcare providers, laboratories, and other mandated reporters should continue to report all COVID-19 positive test results including results from all Nucleic Acid Amplification Tests such as RT-PCR tests, and all rapid and antigen tests results for SARS-CoV-2. The reporting of positive home use tests is optional. However, DHSS will no longer require, or accept, negative laboratory results for SARS-CoV-2. In addition, DHSS is no longer requesting the routine reporting of positive or negative antibody tests results for SARS-CoV-2.

DHSS greatly appreciates the continued collaboration of our partners in healthcare and clinical laboratories. For questions regarding this Health Update and the reporting of COVID-19 in Missouri, please contact the DHSS Bureau of Communicable Disease Control and Prevention at 573-751-6113 or 800-392-0272 (24/7), or contact your local public health agency.

CMS Memo: QSO-22-15-NH & NLTC & LSC

Update to COVID-19 Emergency Declaration Blanket Waivers for Specific Providers

  • CMS continues to review the need for existing emergency blanket waivers issued in response to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE).
  • Over the course of the COVID-19 PHE, skilled nursing facilities/nursing facilities (SNFs/NFs), inpatient hospices, intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs), and end-stage renal disease (ESRD) facilities have developed policies or other practices that we believe mitigates the need for certain waivers.
  • Applicable waivers will remain in effect for hospitals and critical access hospitals (CAH).
  • CMS will end the specified waivers in two groups:
    • 60 days from issuance of this memorandum
    • 30 days from issuance of this memorandum

Please see the full memo at https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/update-covid-19-emergency-declaration-blanket-waivers-specific-providers.

Report Release Webinar: The National Imperative to Improve Nursing Home Quality

April 6, 2022: The National Imperative to Improve Nursing Home Quality: Report Release Webinar

Join the National Academies of Sciences, Engineering, and Medicine’s Committee on The Quality of Care in Nursing Homes as it discusses the soon to be released report, The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families and Staff.

This new report examines how our nation delivers, finances, regulates, and measures the quality of nursing home care with particular emphasis on challenges that have arisen in light of the COVID-19 pandemic.

A public report release webinar will be held on Wednesday, April 6, 2022 from 10:00 AM to 11:00 AM (Central Time) during which members of the committee will provide an overview of key findings, conclusions, and recommendations, followed by a moderated question and answer period.

MHCA Developing New Leaders in Your Facility-The Skills That Make All the Difference

May 17-June 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 webinar series will help your people make that leap – and familiarize you with the strategies you need to help them succeed!

MHCA’s Federal Review Course for NHA’s

June 27-28, 2022: Federal Review Course for Nursing Home Administrators Examinees

The purpose of the Review Course is to help attendees prepare for the nursing home administrators federal licensure exam. Theoretical, philosophical and practical aspects of long-term care administration are discussed. The instructor will review sample test questions from the study workbook, which is provided free to all attendees. Study tips will be suggested throughout the workshop, therefore, it is recommended that attendees allow sufficient time to study on their own after attending the review course and before sitting for the exam. Review course materials have been revised and updated to reflect the structure of the current examination. This workshop is being offered both in-seat and virtually.

Upcoming NHSN Long-term Care Release March 2022

Attached below is important information for the Long-term Care Facility COVID-19 Module regarding modifications for the NHSN release that will occur March 2022. Resources on the NHSN LTCF COVID-19 Module website will be updated, where indicated, with revised forms, instructions, FAQs and CSV templates. Information regarding training opportunities is also available on the NHSN LTCF COVID-19 Module Website.

NHSN LTC COVID-19 Facility Module Modifications-March 2022

HQIN COVID-19 Vaccine Office Hours

Have You Had Your Weekly Dose?

The Health Quality Innovation Network’s Weekly Dose Office Hours webinar series provides current updates on COVID-19 guidance and vaccine information. As a Medicare Quality Innovation Network – Quality Improvement Organization (QIN-QIO), HQIN is dedicated to helping you increase your vaccination rates.

This forum for vaccine and booster questions features interactive, peer-to-peer collaboration following a brief presentation. Each session includes best practices and innovative idea sharing as well as tips for improving resident and staff safety. Weekly Dose Office Hours are held Wednesdays at 1:00 p.m. CT/2:00 pm. ET. Register for the next Office Hours, as well as upcoming sessions, at this link: https://tinyurl.com/575d66tn.

For a 30-second overview of the Office Hours, watch this brief video: https://tinyurl.com/2p83yhjy.

MHCA Developing New Leaders in Your Facility-The Skills That Make All the Difference

May 17-June 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 webinar series will help your people make that leap – and familiarize you with the strategies you need to help them succeed!

MHCA LTC Administrator Training

May 25, 2022: Long-Term Care Administrator 101

If you are like most administrators, your endless daily to-do’s get longer and longer. This course is a new administrator’s one-stop-shop! It is also a great review for an experienced administrator. This course will review operational and administrative topics such as requirements of participation (ROPs), the survey process, CASPER reports (including how to access them), Five-Star Quality Rating System (all three domains!), Care Compare, QAPI and SO MUCH MORE! You will also be guided through all the resources available at your fingertips. Join us for this full day of education that will promote your administrator knowledge to the next level. This workshop is being offered both in-seat and virtually.

 

MHCA’s Federal Review Course for NHA’s

June 27-28, 2022: Federal Review Course for Nursing Home Administrators Examinees

The purpose of the Review Course is to help attendees prepare for the nursing home administrators federal licensure exam. Theoretical, philosophical and practical aspects of long-term care administration are discussed. The instructor will review sample test questions from the study workbook, which is provided free to all attendees. Study tips will be suggested throughout the workshop, therefore, it is recommended that attendees allow sufficient time to study on their own after attending the review course and before sitting for the exam. Review course materials have been revised and updated to reflect the structure of the current examination. This workshop is being offered both in-seat and virtually.

CNA Upcoming Testing

The following are updated CNA Testing sites.

Note: These are not the only test sites available. Please contact Headmaster D&S if you are need a different testing location.

Headmaster D & S: 1-800-393-8664 – Please ask for the Missouri Team!

All Regional dates are viewable on the online calendar at https://mo.tmutest.com/calendar.

To help with scheduling your testing event, contact Headmaster a few days after the CNA course starts.

Gladstone

      • March 24
      • April 7
      • April 17
      • April 21
      • April 28

St John/ St. Louis Area

      • April 9
      • April 12
      • April 23

Bolivar

      • March 23

Kirkwood

      • March 24

Kansas City

      • March 21
      • March 24
      • March 25
      • March 29
      • March 31
      • April 1

Trenton

      • April 13
      • May 14

MANHA’s 2022 Annual Convention

June 5-8, 2022: Mandatory PPE – People Pride Endurance
Location: Camden on the Lake, Lake Ozark

Missouri Association of Nursing Home Administrators is pleased to invite you to attend our 2022 Annual Convention. This conference is a focus on the Administrators and staff after an unprecedented 2 years. The goal of this conference is to provide meaningful, forward thinking, and real-time education to pave the path forward while acknowledging the past and working through hard topics, together.

VOYCE 2022 Long-Term Care Conference

June 15, 2022: Care – Who We Are. What We Do. Where We Go From Here.
Location: Maryland Heights Community Center, St. Louis

The program will explore and highlight insights and learned experiences from internationally renowned geriatricians, educators, and leaders in the long-term care community. Join us as we reflect on the journey we have made together as a community and gain inspiration for the steps that we are yet to take.

Other presentation topics include residents’ rights, addressing loneliness and isolation for long-term care residents, and the interplay between ageism as a social determinant of health and end-of-life care.

Pioneer Network ‘s Annual Conference – Save the Date

July 24-27, 2022: Pioneering a New Culture of Aging: Honoring the Past, Treasuring the Present, Shaping the Future
Location: Sheraton Downtown Denver in Denver, Colorado

Pioneer Network’s goal is to bring together individuals from across the United States and other countries who care deeply about changing the culture of aging and to make this event meaningful to people who support culture change in all settings within the elder care continuum.

National Long-Term Care Administrator’s Week

March 14-18, 2022, is National Long-Term Care Administrator’s Week. During this week, please take the opportunity to say “thank you” and honor our Missouri administrators who lead our state’s long-term care communities.  Administrators are the key players in the care of our residents. They are entrusted with the responsibility of managing the long-term care communities to ensure that their staff provide the highest level of quality care to our residents.

CMS Memo: QSO-20-38-NH: Interim Final Rule (IFC), CMS-3401-IFC, Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency related to Long-Term Care (LTC) Facility Testing Requirements REVISED 03/10/2022

  • CMS is committed to taking critical steps to ensure America’s healthcare facilities continue to respond effectively to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE).
  • On August 25, 2020, CMS published an interim final rule with comment period (IFC). This rule establishes Long-Term Care (LTC) Facility Testing Requirements for Staff and Residents. Specifically, facilities are required to test residents and staff, including individuals providing services under arrangement and volunteers, for COVID-19 based on parameters set forth by the HHS Secretary. This memorandum provides guidance for facilities to meet the new requirements.
  • Replaced the term “vaccinated” with “Up-to-date with all recommended COVID-19 vaccine doses” and deleted the term “unvaccinated.”
  • Updated the recommendations for testing individuals within 90 days after recovering from COVID-19.

Please see the full memo at https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/interim-final-rule-ifc-cms-3401-ifc-additional-policy-and-regulatory-revisions-response-covid-19-0.

CMS Memo: QSO-20-39-NH: Nursing Home Visitation – COVID-19 REVISED 03/10/2022

  • CMS is committed to continuing to take critical steps to ensure America’s healthcare facilities are prepared to respond to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE).
  • Visitation Guidance: CMS is issuing new guidance for visitation in nursing homes during the COVID-19 PHE, including the impact of COVID-19 vaccination.
  • Visitation is allowed for all residents at all times.
  • Replaced the term “vaccinated” with “up-to-date with all recommended COVID-19 vaccine doses” and deleted “unvaccinated.”
  • Updated visitor screening and quarantine criteria.

Please see the full memo at https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/nursing-home-visitation-covid-19-revised.

Medicaid Resource (Spend-Down) Limit

The Medicaid Resource (Spend-Down) Limit has been increased to $5,035 as of 07/01/21. Please see the link https://dssmanuals.mo.gov/wp-content/uploads/2018/10/appendix_j.pdf.

F569 states the facility must notify each resident/legal guardian that receives Medicaid benefits when the amount in the resident’s account reaches $200 less than the SSI resource limit.

The current $200 amount would be at $4,835 or higher.

Feel free to contact Lynn Gilmore, Lead Auditor, at 573-508-4150 if you have any questions.

New Updates to the Headmaster Student Handbook and Mock Skills for CNA Testing

Please see the updated Headmaster Student Handbook and Mock Skills including key step changes for those students testing March 15, 2022 and after.

Please visit Headmaster’s website for those changes at https://hdmaster.com/testing/cnatesting/missouri/MO_CNA_Home.htm.

For questions regarding the changes, please call the Health Education Unit at 573-526-5686 or email us at CNARegistry@health.mo.gov. You may also call Headmaster and ask for the Missouri Team at 1-800-201-0462.