Conversations with Carmen

  • April 14, 2017:  From Annoyances to Conflict: How Much is Miscommunication Costing Your Organization?
  • Guest Presenter:  Ray Rusin, Quality Training Associates; Certified Workplace Conflict Mediator, retired RI Survey Agency Director

Day-to-day petty annoyances are experienced by each of us and are a fact of life. Without a strategic focus on recognizing and dealing with natural annoyances early, many grow into costly conflict events negatively impacting residents’ quality of care and quality of life.  We will discuss how ordinary annoyances interrupt the smooth operation of any organization, how to best prepare team members for coping with annoyances and ways to wisely handle any resulting conflicts. Find out what conflict may be costing your organization.


For more information and registration, please see the event details here.

S&C Memo 17-20-NH: Fiscal Year (FY) 2017 Special Focus Facility (SFF) Program Update

  • Total SFF slots and candidates for each State: The number of designated slots and candidates for FY 2017 (see Appendix A) will not change from those effective since May 1, 2014.
  • Initial selection notice: The State Survey Agency (SA) must notify the provider in writing of their SFF selection and conduct a meeting (either onsite or via telephone) with the nursing home’s accountable parties, and the Centers for Medicare & Medicaid Services (CMS) Regional Office (RO), if the RO wants to be included.
  • Graduation from the SFF program: Once an SFF has completed two consecutive standard surveys with no deficiencies cited at a scope and severity of “F” or greater (or “G” or greater for Life Safety Code (LSC) deficiencies), and has had no complaint surveys with deficiencies at “F” or greater (or “G” or greater for Life Safety Code (LSC) deficiencies) in between those two standard surveys, the facility will graduate from the SFF program. However, if the only deficiency preventing graduation is an “F” level deficiency for food safety requirements (42 CFR §483.60(i) Tag F371), the RO has discretion to allow the facility to graduate from the SFF program. F371 deficiencies at a “G” level or greater will prevent the facility from graduating from the SFF program.
  • Authority for termination: Consistent with longstanding authority, the CMS ROs may use discretionary termination for SFFs (or any facility) if necessary to protect resident health and safety.


Please see the S&C memo and appendices attached for more details or visit

Consumer Voice Webinar

  • March 15, 2017:  A Deeper Dive into the Revised Federal Nursing Home Regulations-Part II
  • 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 Consumer Voice, Justice in Aging, and Center for Medicare Advocacy are continuing to examine the revised federal nursing home regulations the Centers for Medicare & Medicaid Services released on October 4, 2016. In this webinar, we will take a closer look at the following sections of the revised regulations:

  • Admission, Return, and Bedhold
  • Visitation Rights
  • Rehabilitation Services

Join this webinar to hear experts from all three organizations discuss changes in the regulations and their impact on the care delivered to consumers.


Space is limited.  Register here.

Licensure and Certification Unit Update

Effective immediately the Licensure and Certification Unit will be conducting business primarily by email. Licensure and Certification Unit staff will be contacting facilities and/or operators to obtain email addresses. Items that will be emailed to providers include the facility license, relicensure application reminder letters, and any other correspondence when possible. Facility administrators/operators shall print the facility license and post as required in Chapter 198.015.5, RSMo., “Licenses shall be posted in a conspicuous place on the licensed premises”, as copies will not be mailed. If you have any questions about this process, please email

Reducing Inappropriate Use of Antipsychotic Medications – Full Assessment

To address the ongoing challenge of reducing inappropriate antipsychotic medications, staff on all shifts should fully assess and learn as much as possible about a resident, including interviewing the resident, family and friends. These steps assist staff in understanding the different behaviors a resident may exhibit. To learn more about assessing a resident’s goals and needs, click on the following links.

Flu Season

The middle of Flu season is a perfect time to think about the benefits of handwashing and recognizing signs and symptoms. Staying informed about reported cases in Missouri and which areas have the highest confirmed cases, is just a click away! 2017 Influenza Reports


New Fact Sheets on Revised Federal Nursing Home Regulations

Consumer Voice, along with Justice in Aging and Center for Medicare Advocacy, have released new issue briefs in our series on the revised federal nursing facility regulations. The fact sheets can help residents, family members and advocates better understand the regulations. New fact sheets cover: