Staff Stability

Creating a quality-driven environment within a nursing home requires staff stability. Establishing processes, setting expectations and supporting staff are important aspects of this concept. Click on the following links to learn more about enhancing staff stability.


SAVE THE DATE :  MC5 2017 Annual Conference

  • May 2-4, 2017:  Branching Out with Culture Change

Save the Date for the upcoming MC5 conference. Learn how to implement person-centered care while following the new regulations with Carmen Bowman, assess your risks and learn management strategies from Ray Miller, and understand the personal part of person-centered care with Karen Stobbe…along with a variety of other intensive speakers from around the adult-care continuum. This is one conference you don’t want to miss!! We will send out more information as it becomes available.

Nursing Home Quality Improvement Webinar

  • February 2, 2017:  It Takes a Team: Reducing Antipsychotic Use
  • Presenter:  Elizabeth McManamy, RPh, CADDCT, CDP

Please join this webinar to learn strategies, including documentation and communication, for a team-based approach toward reducing antipsychotic medications.


Please see the event page here for registration.

The National Consumer Voice for Quality Long-Term Care Webinar

  • February 15, 2017:  A Deeper Dive into the Revised Federal Nursing Home Regulations – Part 1
  • Presenters:  Eric Carlson, Directing Attorney, Justice in Aging
    Toby Edelman, Senior Policy Attorney, Center for Medicare Advocacy
    Robyn Grant, Director of Public Policy and Advocacy, Consumer Voice
    Lori Smetanka, Executive Director, Consumer Voice

The Centers for Medicare & Medicaid Services (CMS) released its revised nursing home regulations. In this webinar, we will take a closer look at the following sections of the revised regulations:

  • Assessment, Care Planning & Discharge Planning
  • Transfer-Discharge
  • Nursing Services
  • Unnecessary and Antipsychotic Drugs

Join this webinar to hear Justice in Aging, Center for Medicare Advocacy and Consumer Voice discuss changes in the regulations and their impact on the care delivered to consumers.


Space is limited. Register now.

CMS Direction Regarding IDR’s

The Section for Long Term Care had a conversation with CMS in 2016 regarding the IDR/IIDR Review Release Process. CMS Regions V and VII recently provided guidance on this topic. The Missouri IDR process for certified homes has been to send the Primaris decision letter along with our own letter upon review and completion of the IDR process. We have been instructed by CMS that the third party (Primaris) decision and rationale can no longer be shared with the providers. Following is an excerpt of this guidance. The S&C referenced below is attached for your review.


S&C Memo 12-08-NH provided Interim Advance Guidance for IIDRs and provided some information that is one of the bases for our decision to take this approach: “[T]he documents and written report created by the Independent IDR entity, the State and CMS, other than the final decision of the Independent IDR process, are pre-decisional and deliberative, and therefore are protected from disclosure under the deliberative process privilege. See EPA v. Mink, 410 U.S. 73, 88 (1973); see also 5 U.S.C. § 522(b)(5) (inter-agency and intra-agency memoranda and letters generated before adoption of final agency policy or decision are protected from disclosure under Exemption 5 of the Freedom of Information Act).” (Please note the correct U.S. Code citation is actually 5 U.S.C § 552(b)(5).) Therefore, CMS asserts this privilege to not disclose documents used in our deliberative processes. Although the quoted language from the S&C Memo is not in SOM Chapter 7, the rationale remains sound.


We have communicated with the IDR Contractor about this change. Primaris will no longer prepare a letter to the provider and will simply provide their decision and rationale through memo format. Our office will continue to review the Primaris information and prepare a letter to the providers with the final decision.  The Section will then forward the SLCR Decision letter to the provider. At no time can we disclose the Primaris decision and rationale. This change applies only to certified facilities. The process will not change for those facilities that are state-licensed only.

S&C: 17-17-ALL: Recommendations to Providers Regarding Cyber Security

Recommendations for Providers and Suppliers for Cyber Security: The Centers for Medicare & Medicaid Services (CMS) is reminding providers and suppliers to keep current with best practices regarding mitigation of cyber security attacks. We have outlined resources to assist facilities in their reviews of their cyber security and IT programs.


Please see the attached for more information.  The S&C can also be found at

Music Therapy in Mental Health Treatment

  • January 27, 2017:  “Let’s Express Ourselves”: An Overview of Music Therapy in Mental Health Treatment
  • Location: CenterPointe Hospital Gym, St. Charles
  • Presenters:  Teresa Stamey, MT-BC and Catherine Decker, MA, MT-BC

Music is a powerful, non-threatening tool that can be used to help individuals of all ages who struggle with mental health issues. It can be used to explore personal feelings and therapeutic issues such as self-esteem or personal insight. It can help make positive changes in mood and emotional states. It can also give individuals a sense of control over life through successful experiences. During our time together we will explore music and the therapeutic benefits it has on the human spirit.


For more information, please see the event site here. Online registration is also available here.