The Missouri Nursing Home Advisory Council and the Health Quality Innovation Network (HQIN) are pleased to share this white paper, which provides background on the use of antipsychotics in long-term care and recent trends in antipsychotic use.

Download this white paper for strategies and valuable resources to improve dementia care for your residents and reduce the use of antipsychotics.

Please contact HQI if you have questions

April 6-8, 2022: 68th Annual Long-Term Care Convention
Location: Margaritaville, Osage Beach

MLN’s primary goal during the Annual Long-Term Care Convention is to provide educational and networking opportunities that help our valued members, long-term care administrators and professionals, health care providers and guests. This program has been approved for 18.5 licensed administrator continuing education hours (8.5 A and 10 PC) by the Missouri Board of Nursing Home Administrators.

April 7, 2022: Independence
April 27, 2022: Lake Ozark
April 28, 2022: St. Louis

Dementia Programming: A Hands-on Approach

Understanding and managing dementia is difficult, even on the good days. This seminar will focus on a presentation of practical knowledge for the care of individuals with dementia in long-term care, including a brief overview of dementia as an illness including the various types and symptoms and the stages of the illness. By identifying the progression of the disease, you can tailor the care and communication to fit the needs of the resident in a compassionate and person-directed way. You will also learn the practical steps of running an effective dementia unit in a long-term care facility, including the regulations that apply specifically to this type of care. This hands-on workshop will give you real-time practice and knowledge for not only interpreting the difference between actions and “behaviors”, but it will expand your understanding of clinical symptoms versus human reactions and building that knowledge into a safe, compassionate, living environment that is supportive to your residents and your staff.

CMS has authorized the use of federal Civil Money Penalty (CMP) Reinvestment funds to purchase portable fans and portable room air cleaners with high-efficiency particulate air (HEPA, H-13 or – 14) filters to increase or improve air quality. A maximum use of $3,000 per facility including shipping costs may be requested. This opportunity is for facilities certified to participate in the Medicare and/or Medicaid programs. Since these are federal CMP funds, Residential Care and Assisted Living Facilities may not apply.

COVID-19_In-Person Visitation Application FAQ
COVID-19_In-Person Visitation Application Template

Please send completed applications to slcrcmp@health.mo.gov.

DHSS is collaborating with Resolve to Save Lives, an initiative of the global health organization Vital Strategies, to launch their “Voices of Long COVID” campaign throughout Missouri to increase public awareness of the impact of and unknowns associated with Long COVID. Our end goal is to encourage vaccine uptake, particularly among people ages 18-29, so fewer Missourians struggle with the devastating effects of Long COVID.

The “Voices of Long COVID” campaign features testimonials from a diverse group of people ages 18-29 who are suffering from long-term complications of COVID-19 infection. The initiative follows Resolve to Save Lives’ recent national survey, which found that nearly a third of American adults are unaware of Long COVID, and that long-hauler stories can motivate 40% of unvaccinated people to consider getting a COVID-19 vaccine.

“The brave young adults featured in the campaign are sharing their reality in order to help others avoid the harms of COVID infection,” said Dr. Tom Frieden, President and CEO of Resolve to Save Lives (and former CDC director). “Thousands of Americans struggle with Long COVID every day. Their stories are important reminders that vaccination is our best tool to prevent this potentially life-altering condition.”

The campaign shows the real-life stories of three COVID long-haulers who have been battling debilitating health problems over the past year believed to be caused by their original COVID-19 infection:

  • Katelyn Van Dyke, a 20-year-old Mizzou student who got COVID-19 in November 2020 and now has trouble breathing when walking and severe memory loss.
  • Rob Smith, a 22-year-old who used to run five miles a day and now struggles to climb stairs, maintain a healthy social life and manage the uncertainty of his COVID-19 recovery due to ongoing fatigue and brain fog. He shares his story in Spanish and English.
  • Isaiah Smith, a 26-year-old U.S. Air Force veteran, part-time student and essential worker who became infected with COVID-19 in October 2020 and now experiences extreme nausea, chest pain, shortness of breath, dizziness upon standing, heart palpitations and challenges with comprehension.

The patients spotlighted in the campaign want to warn others about the risks of being unvaccinated.

“Long COVID is real, and the struggle goes beyond what you can see,” Van Dyke said. “We don’t know enough about this condition yet, and there’s a good chance all of us know at least one person who is suffering from this. The best way to prevent COVID-19 and long COVID is to get vaccinated.”

“I’ve learned over the course of the past year that you should always value your personal health-this is especially needed among people who are refusing to get vaccinated,” said Rob Smith. “I’ve been trying to educate people about the long-term effects of COVID and the safety of the vaccine. The trade-off between COVID and the vaccine is not even close.”

Isaiah Smith is sharing his long COVID story “because I don’t want anyone else to experience what I’m going through.” He noted that some of his friends are vaccine-hesitant. “I tell them to talk to their doctor about getting the vaccine. They should avoid getting COVID at all costs because at the end of the day, they’re rolling the dice on what happens afterwards-they have no idea what’s going to happen.”

Missouri’s Long COVID webpage is at MOStopsCovid.com/LongHaul. If you would like to share educational materials, they can be found in both English and Spanish at this link.

Included are:

  • Web banners in various sizes
  • Radio ads in both 15- and 30-second spots
  • Videos
    • 15-second videos formatted for YouTube and Tremor
    • 15- and 30-second stories formatted for Facebook, Instagram and Snapchat

Please join COMRU (Central Office Medical Review unit) for a Q & A session via WebEx.

February 18, 2022
Time: 10:00 a.m.

Meeting number (access code): 2460 218 4769
Meeting password: MfVVW7asP23

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Needing to schedule a CNA test? The following are dates and locations are already set. Please call Headmaster to register.

February 12, 2022: Cape Girardeau
February 14, 2022: Farmington (opens to public 48 hours prior)
February 17, 2022: Macon
February 19, 2022: St. Charles Community College (opens to public 48 hours prior)
February 22, 2022: Friendship Village, St. Louis
March 7, 2022: Nichols Career Center, Jefferson City
March 9, 2022: North Central College, Trenton
April 4, 2022: Nichols Career Center, Jefferson City
May 9, 2022: Nichols Career Center, Jefferson City

Other dates and locations may be available. Please call Headmaster at 1-800-393-8664 and ask for the Missouri Team.

Please Read Information Below Carefully!

The Missouri Department of Health and Senior Services (DHSS) is pleased to announce that effective Thursday, February 10, 2022 at 8:00 a.m., we are reopening our antigen testing program! As you are aware, due to a nation-wide shortage of antigen tests and issues with receipt of tests from our distributor, it was necessary for us to suspend that program indefinitely in early January. For awareness, although Friday, February 11, 2022 is a state holiday, we will be accepting requests for tests, but no tests will be shipped on that day.

We have subsequently identified two distributors with adequate supply of ACON Flow Flex rapid antigen tests to allow us to reopen our antigen testing program. Information about ACON Flow Flex can be found here.

The transition to this different rapid antigen test requires the establishment of a new state-wide CLIA (although organizations with their own CLIA can continue to use their own) and thus verification of locations of testing and validation of training of all test administrators. Thus, it is not possible to simply transition existing BinaxNOW users to ordering for ACON Flow Flex – all existing users will need to re-apply to receive ACON Flow Flex, take the required training and provide verification of that training, resubmit a test plan inclusive of the infectious waste disposal plan, and provide the locations of testing in order to be approved to receive tests. Note: For organizations using their own CLIA, please be sure to add ACON Flow Flex to your CLIA waiver by contacting the state CLIA program (see additional information below).

New standing physician’s orders specific to ACON Flow Flex have been established for all tests users previously under a DHSS standing physician’s order. These new orders are available at: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/testing-resources.php.

The DHSS Rapid Antigen Test Kit Application and Resource web page includes the initial application and a subject index to answer questions we received during the previous distribution of antigen tests. The page also provides information about where to direct specific questions that test users may encounter. If a test user is unsure of where to direct a question, please contact antigentesting@health.mo.gov.

The DHSS Rapid Antigen Test Kit Application and Resource Page for ACON Flow Flex will be open effective 8:00 a.m. on Thursday, February 10, 2022 at: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/testing-resources.php.

Thank you for your continued work to fight COVID!

 

Adding ACON Flow Flex to Your CLIA Test Menu

The CLIA program has developed an email template that you can copy and paste, fill in the blanks, and email to CLIA@health.mo.gov to update your test menu to include ACON Flow Flex.

Email Subject line: Add COVID-19 Testing to existing CLIA Certificate for [FACILITY NAME]

Lab/Facility Name:  
Existing CLIA Waived Lab #:  
Lab Director Name:  
Which COVID-19/ SARS-CoV-2 Waived Test system added?
Check [X] all that may apply.

[    ] Abbott BinaxNOW COVID-19 Ag Card
[    ] Acon FlowFlex
[    ] Quidel Sofia 2 SARS-CoV-2 Antigen assay
[    ] Becton Dickinson Veritor™ Plus Antigen test kit
[    ] Abbott ID Now
[    ] OTHER Waived test(s) approved by FDA EUA (specify below):

As the Laboratory Director or administrator/owner’s agent of record for the CLIA facility holding a Waived Certificate identified above, I wish to append my facility’s existing CLIA# to include additional testing for COVID-19. I attest that my facility will provide reasonable assurances that:

  • All testing personnel for COVID-19 will be provided adequate and documented training
  • All Manufacturer’s Instructions for Use (IFU) will be strictly adhered to

All tests results (both positive and negative) will be reported to the proper public health entities under federal and state requirements. See MO DHSS link regarding reporting: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/how-to-report-lab-results.php

On February 2, 2022, CDC updated the following healthcare infection prevention and control (IPC) guidance documents: Infection Control: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) | CDC and Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes | CDC.

Updates were made in these guidance documents to align with prior updates made for healthcare personnel with higher-risk exposures in the Interim Guidance for Managing Healthcare Personnel with SARS-COV-2 Infection or Exposure to SARS-CoV-2, which was released on December 23, 2021.

A review of the updates was given on a recent Clinician Outreach and Communication Activity (COCA) Call, which was recorded and is accessible here: Webinar January 13, 2022 – Updates to CDC’s COVID-19 Quarantine and Isolation Guidelines in Healthcare and Non-healthcare Settings. Additionally, a brief summary of the updates can be found below. Please consult the guidance documents for the full recommendations.

Vaccination status

Use of N-95 respirators

*Please see complete guidance for full personal protective equipment recommendations

  • CDC continues to recommend gown, gloves, eye protection and a NIOSH-approved N95 or equivalent or higher-level respirator when caring for patients known or suspected to be infected with SARS-CoV-2.
  • In counties with substantial to high community transmission, a NIOSH-approved N95 or equivalent or higher-level respirator is also recommended instead of a facemask when caring for patients not known or suspected to have SARS-CoV-2 infection in the following higher-risk situations:
    • All aerosol-generating procedures;
    • Higher-risk surgical procedures;
    • These respirators can also be used by HCP in situations where additional risks for infection are present, such as caring for a patient who is not up to date with all recommended COVID-19 vaccine doses, the patient is not able to wear source control, and the area is poorly ventilated. They may also be used if healthcare-associated SARS-CoV-2 transmission is identified.

 Viral testing

  • CDC continues to emphasize that anyone with even mild symptoms of COVID-19, regardless of vaccination status, should receive a viral test as soon as possible.
  • Asymptomatic patients with close contact with someone with SARS-CoV-2 infection, regardless of vaccination status, should have a series of two viral tests for SARS-CoV-2 infection.
    • Generally, test immediately (but not earlier than 24 hours after the exposure) and, if negative, again 5-7 days after the exposure.
  • Testing is not generally necessary for asymptomatic people who have recovered from SARS-CoV-2 infection in the prior 90 days; however, if tested, an antigen test instead of a nucleic acid amplification test (NAAT) is recommended as some people may remain NAAT positive after they are no longer infectious.

Criteria to end isolation for patients with SARS-CoV-2 infection cared for in a healthcare facility

  • Asymptomatic patients or those with mild to moderate illness and who are not moderately to severely immunocompromised: manage with recommended precautions for 10 days after their symptoms first appeared.
  • Patients with severe to critical illness and who are not moderately to severely immunocompromised: manage with recommended precautions until at least 10 days and up to 20 days have passed since symptoms first appeared.
  • Symptomatic and asymptomatic patients who are moderately to severely immunocompromised: a test-based strategy and (if available) consultation with an infectious disease specialist or other expert is recommended to determine when these patients can be released from isolation.

Quarantine for patients:

  • Empiric use of Transmission-Based Precautions (quarantine) is recommended for patients who have had close contact with someone with SARS-CoV-2 infection if they are not up to date with all recommended COVID-19 vaccine doses. Duration of quarantine is described in the guidance.
  • Quarantine is not generally needed following close contact with someone with SARS-CoV-2 infection for asymptomatic patients who are up to date on all recommended COVID-19 vaccine doses or who have recovered from infection in the prior 90 days. Potential exceptions are described in the guidance.

Visitation

  • Even if they have met community criteria to discontinue isolation or quarantine, visitors should not visit if they have any of the following and have not met the same criteria used to discontinue isolation and quarantine for patients (typically until 10 days after last exposure or onset of symptoms has passed):

1) A positive viral test for SARS-CoV-2,
2) Symptoms of COVID-19, or
3) Close contact with someone with SARS-CoV-2 infection

  • If visitation cannot be postponed the visitor might be subject to additional precautions.

This guidance on infection prevention and control will continue to be refined as additional information becomes available.

There has been some confusion about the definition of “life support”, specifically related to the type of generator required. Life support refers to any function performed by equipment, which if stopped, could result in loss of human life or serious injuries. NFPA 99, 2012 edition: 3.3.42 defines Electrical Life Support Equipment as an electrically powered equipment whose continuous operation is necessary to maintain a patient’s life.

Life support is not limited to a ventilator. For example, it can be a BiPAP or suctioning machine. Facility staff should receive clarification from the physician prior to admission as to whether or not the equipment is necessary to maintain the resident’s life.

If a facility accepts a resident who requires life support, it is important to ensure all the following requirements are met per NFPA 99 and 110:

  • The facility must have a definition of life support;
  • The admission agreement must state the facility will accept a resident on life support;
  • The generator must comply with the standards of a Type 1 Essential Electrical System (ESS) (a Type 1 EES has the most stringent requirements for providing continuity of electrical service – the Acceptance Testing paperwork will show the type), complying with the National Fire Protection Association (NFPA);
  • Testing and maintenance must be maintained as outlined in the NFPA;
  • Depending on the generator, the power must be split into two or three branches, that would include critical care, life safety and mechanical;
  • There must be plans to show which rooms/areas are supported by the life support electrical system;
  • All outlets must be marked (such as a red outlet cover) to show which plugs will support life support functions.

NFPA 110, 2010 edition:

4.4-Level. This standard recognizes two levels of equipment installation, performance, and maintenance.

4.4.1-Level 1 systems shall be installed where failure of the equipment to perform could result in loss of human life or serious injuries.

4.4.2-Level 2 systems shall be installed where failure of the EPSS to perform is less critical to human life and safety.

4.4.3-All equipment shall be permanently installed.

K915

 Electrical Systems – Essential Electric System Categories

Critical care rooms (Category 1) in which electrical system failure is likely to cause major injury or death of patients, including all rooms where electric life support equipment is required, are served by a Type 1 EES.

Please join the Health Education Unit and Headmaster D&S for a Q & A session via WebEx.

February 24, 2022
Time: 3:00 p.m.

Meeting number (access code): 2469 473 6547
Meeting password: XmZzZpGU333

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March 2, 2022
Time: 10:00 a.m.

Meeting number (access code): 2461 178 6617
Meeting password: 8PrkA9XGZD6

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SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. MDS data for 7/1/21 through 6/30/21 must be submitted no later than 11:59 p.m. on February 15, 2022.

The Minimum Data Set (MDS) 3.0 must be transmitted to CMS through the Assessment Submission and Processing (ASAP) system to the Quality Improvement Evaluation System (QIES). No additional reporting is required.

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:

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 10/1/21 through 12/31/21 is due February 14, 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:

Needing to schedule a CNA test?

Open Regional Test Dates and Locations

February 5, 2022 & February 7, 2022: Farmington, MO
February 9, 2022: Trenton, MO
February 10, 2022: Gladstone, MO
February 12, 2022: Cape Girardeau, MO

Call Headmaster (888-401-0462) to get your students scheduled!

February 28-March 1, 2022: Mid-Year Conference & Lobby Day 2022
Location: Capitol Plaza Hotel, Jefferson City

The MHCA Staff and Education Committee have created a schedule of important and hot-topic education sessions to meet your needs in the current long-term care climate.

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

    • Census, including staff assessment of current needs of the residents and monitoring of the ill.
    • Contact person and emergency contact number that is not the facility main line.
    • Has the facility called the fire department and central monitoring company if phones, alarm systems are down?
    • Generator: Y/N
      • If yes, what equipment does the generator serve (fire alarm, HVAC systems)?
      • If yes, amount of fuel onsite and/or system for delivery? How long will fuel last?
      • If no, what is fire watch plan?
      • If no, how will the facility ensure resident needs are met, including maintenance of room temperatures in a safe manner?
        • Obtain generator- is the home set up to receive generator power once delivered? Estimated time for delivery? Estimated time when generator power will be established.
        • Evacuation- Where is facility relocating to, distance from facility, transportation to get there, staffing, sufficient supplies/medications, how will the facility ensure resident needs are met, including maintenance of room temperatures in a safe manner (does the location have a functional emergency generator?) If relocating to a SNF – will the home be over capacity? Is there sufficient beds/space in the receiving facility to house the extra residents?
      • Documentation may be requested, including:
        • If evacuated, a list of residents and were they went
        • Room temperature logs
        • Fire watch documentation

 

Here are a few things to consider in examining your emergency preparedness plan, specifically as it relates to snow, ice, and power outages.

  • If there is a loss of the primary power, how will the facility ensure adequate temperatures of the facility will be maintained during the emergency situation?
  • Is the plan feasible?
    • Plan for the worst. Most events do not occur on a sunny Tuesday afternoon and the plan should account for things such as poor weather, road conditions, weekends/holidays, evenings, staff ability to travel to work, and other obstacles that may cause issue during the actual emergency.
  • Are staff knowledgeable of the plan and have access to what is needed in order to implement the plan?
    • Phone numbers, contact persons, contracts.
  • Do staff know what to do during an emergency and know who is in charge? If the administrator is not onsite, who is in charge and does that person know all their duties?
    • This may be the DON, but it may also be a charge nurse (or another designated onsite staff)if the event happens in the “middle of the night”. Depending on when the administrator or someone higher up on the order of succession can arrive at the facility, that person (i.e. night charge nurse) may be in charge for an extended amount of time.
  • Is the plan detailed enough?
    • Is there a detailed plan that describes when the residents will evacuate during an emergency? If loss of power, does the plan instruct the staff to start the evacuation prior to the point when the facility is below appropriate air temperatures and to maximize their safety during travel? What is the distance to the emergency evacuation site? What types of roads do they have to traverse, such as “side roads”, bridges, or interstates; all of these roads can have their challenges. Does the facility have more than one contracted emergency site?
      • Is it likely that emergency events will also impact the surrounding areas? It is also possible that the evacuation site may be so far away, residents may not be able to get there when road conditions are less than optimal. Does the contracted site meet all the criteria to allow the residents to shelter in place at that location?
    • Is there a contract for transportation and will that transportation be able to get the residents to and from their current location to the contracted emergency location in a snow/ice storm? If the services have other contracted uses, such as school buses, will they be available at 3:00 P.M. on a school day or can they get drivers at 3:00 A.M. on a Wednesday?
  • Does the facility have a generator?
    • Is there enough fuel, a contract to get more fuel, and a list of what it does and does not operate?
      • Facilities (and the staff in charge) need to know in advance, what their generator will operate. At a minimum, this listing must include whether it runs: Life safety equipment (such as E-lights and fire alarm system(s)), magnetic door locks/door alarms (where applicable for safety), HVAC systems, cooking systems, what outlets residents and staff will be able to be use, and computer equipment/Wi-Fi (if electronic medical records (EMR) are utilized).
      • This list needs to be detailed so staff will know specifically what items will and will not work during a power outage. Many generators will run every second or third ceiling light for emergency lighting, but not all lights in the facility will work during a power outage. This needs to be listed so all staff will know that information.
    • If a facility does not have a generator, what are the plans when it may not be easily able to evacuate due to poor road conditions or other factors that may prohibit a smooth transition from a facility to another location?
      • If the facility plans to have a generator delivered during a loss of power, does the facility have a contract with the generator company to deliver one to them? This contract should include the size of the generator that the facility will need in order to ensure the safety and care needs of the residents are met during the emergency.
        • The building will need to be wired and ready to accept the generator in advance. The facility will not be able to install a generator during the emergency event unless the wiring for the generator has already been completed.
      • Facilities must maintain at least their fire safety equipment (E-lights, fire alarm, sprinkler system, range hood (if any cooking occurs), food, water, heating and cooling, and sewage disposal to shelter in place.
        • There must be a plan of how this will be achieved, emergency supplies, the detailed list of what the generator will run, and any contracts that will be needed during the emergency to ensure these services can continue during the emergency event.
          • Sometimes trucks will not be able to run regular schedules and it may take several days before the facility can get their first delivery after an emergency starts; depending on the extent and severity of the disaster.
        • A power outage may be as simple as a blip, may last for hours, or may last for days – depending on the extent of the power grid damage and when the crews can access the problem(s).
          • The facility needs a plan of when, how, and where they will evacuate if they cannot provide at least the components of the previous bullet point.

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!

The link below is a very brief survey that QIPMO would like you to complete about “staff stability.” QIPMO would like to learn more about staffing stability in our state, while also locating a few homes with exceptionally stable staff. The QIPMO and Infection Control Assessment and Response (ICAR) teams have secured Barbara Frank and David Farrell to speak on long-term care staffing (details will be coming soon). Barbara and David have requested your input so that they can make their workshop most beneficial to you, the leaders in our Missouri nursing homes.

Click HERE for the survey!

If you have questions, feel free to contact QIPMO.

  • CMS will begin posting the following information for each nursing home on the Medicare.gov Care Compare website:
    • Weekend Staffing: The level of total nurse and registered nurse (RN) staffing on weekends provided by each nursing home over a quarter.
    • Staff Turnover: The percent of nursing staff and number of administrators that stopped working at the nursing home over a 12-month period.

This information will be added to the Care Compare website in January 2022 and used in the Nursing Home Five Star Quality Rating System in July 2022.

  • Posting Detailed Staffing Data: CMS will begin posting the submitted employee-level staffing data for all nursing homes.
  • Reminder for Nursing Homes to Link Employee Identifiers when they are changed due to the changes in the facility’s staffing data systems.

Please see the full memo for details at https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/nursing-home-staff-turnover-and-weekend-staffing-levels.

National Healthcare Safety Network Users:

This is a reminder that for weekly COVID-19 vaccination data reporting, you should be reporting cumulative data for Question 5, the number of individuals who have received an additional or booster dose. This means that for each reporting week, you should be reporting the total number of individuals in Question 1 who have ever received an additional or booster dose of COVID-19 vaccine as of that week, since additional/booster doses became available in August 2021. You should not limit reporting to the number of individuals who received new additional/booster doses of COVID-19 vaccine during that reporting week.

To accurately report cumulative COVID-19 vaccination data for a reporting week, you should first report the total number of individuals at the facility for that week (Question 1).

  • For Question 2 (primary vaccination series): Of the individuals reported in question #1, report the number of individuals who have ever received COVID-19 vaccination (at that facility or elsewhere) since it became available in December 2020.
  • For Question 5 (additional/booster doses): Of the individuals reported in question #1, report the number of individuals who have ever received an additional or booster dose (at that facility or elsewhere) since August 2021.

For additional guidance on how to report cumulative data, please see the following Quick Learn demonstration, posted on the NHSN Vaccination website at: Reporting Weekly Cumulative COVID-19 Vaccination Data (cdc.gov).

We appreciate your time and effort reporting COVID-19 vaccination data in NHSN. Please contact NHSN@cdc.gov with “COVID-19 Vaccination” in the subject line with any additional questions or concerns.

February 8, 2022: What You Need to Know About Leaving a Nursing Home BEFORE You Move In
Presenter: Chien Hung, Program Director, VOYCE

What is a legitimate and legal nursing home discharge? How does a long-term care community avoid an unfortunate discharge scenario, or how do we get it done the right way? What are the resident’s rights? What are the important questions to ask and proper answers to anticipate? Where to find helpful information and resources? What can be done to contest or appeal a discharge?

March 8, 2022: The Role of a Care Manager
Presenter: Kristy Bull, BSBA, CMC, Care Choice Management

Navigating the systems of care can feel like a complex and confusing experience. With so many choices and options to consider a personal care manager can help residents and their families make effective decisions on care choices and finding the right services.

April 12, 2022: End of Life Care With Death Doulas
Presenter: Dr. Maurya Cockrell

Dying is a process we will all face at some point in our life’s journey. End-of-life doulas are non-medical professionals who can help the dying make peace with the dying process. End-of-life doulas, also known as Elder Doulas, can serve the elderly for years before their expected time of death and can provide holistic physical, emotional, and spiritual care for the elderly.