S&C 17-21-ALL: Information to Assist Providers and Suppliers in Meeting the New Training and Testing Requirements of the Emergency Preparedness Requirements for Medicare & Medicaid Participating Providers and Suppliers Final Rule

  • Information for Implementation: The Centers for Medicare & Medicaid Services (CMS) is providing information to assist providers and suppliers in meeting the Training and Testing requirements of the new Emergency Preparedness Final Rule that was published on September 16, 2016 (81 FR 63860) and became effective on  November 15, 2016.


Please see the S&C attached or you may visit https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-17-21.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending.


RN Licenses Expire April 30, 2017

Nurses may go to www.nursys.com and enroll in e-Notify in order to receive notification when their license is actually renewed. It takes 3-4 business days after the renewal is received before the license is renewed. The MO Board of Nursing no longer provides a license card.

NFPA Notes

All areas of the building shall be accessible:  All areas of the facility must be accessible during all shifts by the charge nurse (or another designated staff, i.e. security) so that in the case of a fire, staff (including emergency response staff) can find and fight the fire (when possible). Reports show that recently facilities in varying areas of the country have had fires in areas that were locked (such as laundry rooms or the kitchen) during the evening/night shifts. When the fire alarm system sounded, staff did not have a key accessible to gain entry into the locked areas causing a delay in the response time.


  • NFPA 2012 101,

For health care occupancies, the proper protection of patients shall require the prompt and effective response of health care personnel.


  • NFPA Standard: 2012 NFPA 101,

All health care facilities shall be designed, constructed, maintained, and operated to minimize the possibility of a fire emergency requiring the evacuation of occupants.


  • NFPA 101 2012,

Emergency plans shall include the following:

(1) Procedures for reporting of emergencies

(2) Occupant and staff response to emergencies

(3) Evacuation procedures appropriate to the building, its occupancy, emergencies, and hazards (see Section 4.3)

(4) Appropriateness of the use of elevators

(5) Design and conduct of fire drills

(6) Type and coverage of building fire protection systems

(7) Other items required by the authority having jurisdiction


  • NFPA 2012 101,

Where means of egress doors are locked in a building that is not considered occupied, occupants shall not be locked beyond their control in buildings or building spaces, except for lockups in accordance with 22.4.5 and 23.4.5, detention and correctional occupancies, and health care occupancies.

Fire Reporting

19 CSR 30-85.022 (2) (F) for Skilled Nursing Facilities/Intermediate Care Facilities (SNFs/ICFs) and 19 CSR 30-86.022 (2)(C) for Residential Care Facilities (RCFs) and Assisted Living Facilities (ALFs) require that all facilities shall notify the department immediately after the emergency is addressed if there is a fire in the facility or premises and shall submit a complete written fire report (attached) to the department within seven (7) days of the fire, regardless of the size of the fire or the loss involved.


The Section for Long-Term Regulation defines fire as used in relation to fire/safety requirements as follows:  Fire is the active principle of burning, characterized by combustion.  This energy is evident when heat and/or smoke and/or light are present as the result of combustion.  Smoke is a product of combustion, and any time smoke is given off, combustion has occurred whether or not there has been a visible flame. Besides the obvious, some often-overlooked examples of fire include but are not limited to the following:

  • Smoking air conditioner unit or heater (whether or not the fire department responded);
  • Smoking pads or mop heads in the dryer (whether or not the fire department responded); and
  • Smoking trash in a waste receptacle (whether or not the fire department responded).


The facility submitted fire report must include the following:

  • A brief narrative of the event in the comments section of the report or in an attachment;
  • Documentation regarding whether or not the fire alarm and/or sprinkler system activated (if applicable) and if/when the system was back in service (if applicable);
  • In addition, the narrative must show whether or not fire extinguishers were used, and if so, when they were recharged or replaced;
  • A copy of the fire department report if the fire department responded; and
  • If a fire can be attributed to a particular person, the report must include identifying information for that person.

Expiring Administrator Licenses

Administrator licenses expiring June 30, 2017 are up for license renewal. License renewal notifications were sent via email to the email address on file. Please note that once the renewal is complete, an electronic license will be issued via email. The Board office will no longer mail paper licenses.


Please visit the Missouri Board of Nursing Home Administrator’s web page for the renewal instructions and renewal application at http://health.mo.gov/bnha. Remember to notify the Board office at BNHA@health.mo.gov with changes in your contact information, especially the email address.

Regulation Unit: Exceptions & Second Businesses – Email Correspondence

The  Regulation Unit is issuing all approval letters, approval certificates, reminder letters, and any other correspondence related to exceptions and second businesses via email. This email process will be the primary mode of communication, when possible. The Regulation Unit staff will contact facility administrators/operators to obtain a viable email address in order to issue correspondence by email. Original approval letters/certificates will no longer be mailed.


For approvals received via email, the facility administrator/operator must complete the following for:

  • Exception approval letters/certificates: Facility administrators/operators must print the approval certificate and post it alongside the facility license as required by regulation.  The approval letter must be made available to SLCR staff, upon request. 


  • Second business approval letters: Facility administrators/operators must make the approval letter available to SLCR staff, upon request.


Should you have any questions about this process, please contact the Regulation Unit at (573) 526-8523 or email RegulationUnit@health.mo.gov.

HHS OIG Hotline Scam

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently confirmed that the HHS OIG Hotline telephone number is being used as part of a telephone spoofing scam targeting individuals throughout the country. These scammers represent themselves as HHS OIG Hotline employees and can alter the appearance of the caller ID to make it seem as if the call is coming from the HHS OIG Hotline 1-800-HHS-TIPS (1-800-447-8477). The perpetrator may use various tactics to obtain or verify the victim’s personal information, which can then be used to steal money from an individual’s bank account or for other fraudulent activity. HHS OIG takes this matter seriously. We are actively investigating this matter and intend to have the perpetrators prosecuted.


It is important to know that HHS OIG will not use the HHS OIG Hotline telephone number to make outgoing calls and individuals should not answer calls from 1-800-HHS-TIPS (1-800-447-8477). We encourage the public to remain vigilant, protect their personal information, and guard against providing personal information during calls that purport to be from the HHS OIG Hotline telephone number. We also remind the public that it is still safe to call into the HHS OIG Hotline to report fraud.  We particularly encourage those who believe they may have been a victim of the telephone spoofing scam to report that information to us through the HHS OIG Hotline 1-800-HHS-TIPS (1-800-447-8477) or spoof@oig.hhs.gov. Individuals may also file a complaint with the Federal Trade Commission 1-877-FTC-HELP (1-877-382-4357).


More information is available on the OIG Consumer Alerts webpage.

VOYCE Conference

  • June 8-9, 2017: 2017 Changing the Landscape of Long Term Care Conference
  • Location:  Renaissance St. Louis Airport Hotel and Friendship Village Sunset Hills

Hear national and local experts discuss dynamic strategies, innovative tools and available long-term care options.

The format has been set with two educational tracks throughout the day; one for professionals working in long-term care and one for the general public who are looking for answers to the complexity of long-term care.

See the registration packet for the full description of the topics and the national and local expert speakers.

Throughout the day there are multiple opportunities to interact with exhibitors who showcase long-term care services across Greater St. Louis.

In addition to hearing thought-provoking speakers, facility administrators and social workers earn 7.25 CEUs.

Registration for all includes breakfast and lunch.


Please see the VOYCE event page for more information.

MU Leadership Development Academy for Long-Term Care

  • April 2016 – October 2016:  Kansas City and Springfield

Enrollment is now open for the next professional development certificate program offered by the University of Missouri.  Long-term care can be challenging, but the academy will help you better manage daily crises and get the most out of your employees. The academy has been proven to increase leadership skills and improve confidence, which will help to create a working environment that encourages teamwork and quality improvement.


Please see the brochure and registration details on the MU Leadership Development Academy’s web page here.