November 13-14, 2023: Federal Review Course for Nursing Home Administrators Examinees – Hybrid Workshop

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. Prior to the workshop, it is essential the attendee understands concepts and principles involved in the long-term care industry.

November 15, 2023: Building Occupancy in your Assisted Living Center
Presenter: Lou Ann Brubaker – Lou Ann is the President of Brubaker Seminars

Traditional marketing and outreach strategies that once drove ALF move-ins are not as effective in today’s senior care marketplace. Across the country, the remarkable growth of assisted living centers and resident acuity have altered the competitive landscape. Any decline in occupancy is lost revenue that is nearly impossible to make up for. Assisted Living Centers need to be proactive to create a steady stream of inquiries by monitoring 3 data sets that enable more nimble strategies.

November 15, 2023: Registration
November 21, 2023: Registration

Presenters: Terri Werner, Central Area Positive Supports Consultant Lead
Brandy Allen, Northern Area Positive Supports Consultant Lead
Katherine Earll, Eastern Area Positive Supports Consultant Lead
Cana Poteet, Western Area Positive Supports Consultant Lead

Tools of Choice is an evidence-based program focused on the implementation of universal positive practices. This two-hour introductory training is open to community members, parents, and professionals. It covers key concepts of the Tools of Choice curriculum, including: What is behavior, building positive relationships, and how to increase desirable behavior. Join the Positive Support Consultants in learning strategies to make positive change by implementing universal positive practices.

Registration is also available on the Upcoming Webinar Webpage.

November 21, 2023: CNA Instructor Workshop – Hybrid
Presenter: Shellie Goodin, RN, MSN, MBA

This state-required and Missouri Department of Health & Senior Services approved CNA Instructor workshop is designed to prepare RNs to instruct nursing assistant students for long term care facilities in Missouri.

November 21, 2023: Clinical Supervisor Workshop – Hybrid
Presenter: Shellie Goodin, RN, MSN, MBA

This state-required and MO Department of Health & Senior Services-approved workshop is designed to prepare registered and licensed nurses to supervise nurse assistant students during their required on-the-job experience.

January 9-March 12, 2024: CMT/Insulin Certification Course

MHCA offers CMT Certification classes both in-person and hybrid. The next course is January 9, 2024 through March 12, 2024. Please contact Shellie Goodin, MHCA Director of Clinical and Quality Services, if you have questions. Pre-registration is required one week prior to the start date to assure materials are ordered.

The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls (Volume 11, Issue 1).

In this issue:

  • Recruit, Recruit, Recruit
  • The Importance of Discussing One’s Health Care Wishes
  • ICAR Corner
  • Are You Meeting the Baseline Care Plan Requirements?
  • What’s in the Water? Water-borne Illness

Please visit QIPMO’s website here for this and other previous newsletters.

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 7/1/23 through 9/30/23 is due November 14, 2023.

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:

CMS PBJ webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ

PBJ Reference Manuals – https://qtso.cms.gov/vendors/payroll-based-journal-pbj-vendors/reference-manuals

PBJ Training – https://qtso.cms.gov/training-materials/payroll-based-journal-pbj

SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. The following data must be submitted no later than 11:59 p.m. on November 15, 2023:

  • MDS data for 4/1/23 through 6/30/23;
  • NHSN data for COVID-19 Vaccination Coverage Among Healthcare Personnel for 4/1/23 through 6/30/23;

The Minimum Data Set (MDS) 3.0 must be transmitted to the Centers for Medicare & Medicaid Services (CMS) through the Internet Quality Improvement and Evaluation System (iQIES). Data for the National Healthcare Safety Network (NHSN) measures must be submitted to the Centers for Disease Control and Prevention (CDC). No additional data submission is required for the claims-based measures.

As a reminder, it is recommended that providers run applicable MDS 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:

CMS SNF QRP Data Submission Deadlines webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-Data-Submission-Deadlines

CMS SNF QRP Help webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-QRP-Help

CMS SNF QRP Measures and Technical Information webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-Measures-and-Technical-Information

CMS SNF QRP Training Webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-Training

November 7, 2023: What Living as a Resident Can Teach Long-Term Care Staff
Location: Online Webinar
Presenter: Leslie Pedtke, MHA, LNHA

MC5 is pleased to be able to repeat this program after having experienced technical issues on the initial showing on October 10.

 

November 8, 2023: Self-Care for Helpers
Location: Methodist Church, the Celebration Center, Sedalia and Virtual
Presenter: Jessica Janis, LPC

This presentation provides information on vicarious trauma, burnout, and self-care strategies for helpers. We will also discuss ways to reduce stress, increase happiness, and promote whole person well-being. Most importantly, we will discuss common barriers for helpers to implement self-care. This fun but in-depth look at how we choose to treat ourselves is sure to help put your need for self-care into perspective.

 

November 9, 2023: Exploring Person-Centered Care: Where We’ve Been, Where We Are, and Where We Want To Go
Location: The Sarah Community, Bridgeton
Presenters: Joan Devine, Advocate, and Sennora Williams, MC5 Board President

Over the past years, providers have been faced with many challenges as they have worked to continue on the path to growing a culture in their communities that is person-centered.  In order to find the way back to that path, we need to start by understanding the past – the ideals and the work that are the foundation of a person centered culture. Next step is to explore where we are. Current challenges, successes, and opportunities. With the past and present in mind, we are ready to define where we need to go, and what it will take, tools that can help up, and how, by working together, we can advance the work of growing person-centered cultures.

 

November 9, 2023: You’re Not Special: Navigating Staffing in the Me Culture
Location: Nevada Public Library, Nevada
Presenters: Wendy Boren, BSN, RN, QIPMO, University of Missouri, Sinclair School of Nursing and Nicky Martin, MPA, BS, LNHA, CDPQIPMO, Sinclair School of Nursing

Staffing is a constant battle, but the current culture makes staffing healthcare a different kind of challenge than we’ve ever faced before. Recruiting and retaining staff in the “me” culture requires ingenuity, patience, compromise, and a new spin on professionalism. This program will highlight those challenges through interactive discussion and give participants real tools to creative winning strategies that may just take them from “me” to “we.”

 

November 17, 2023: “Let’s Talk” on Regulation and Person-Centered Care
Location: Farmington Public Library, Farmington
Presenters: Kate Parsons, Regulatory Auditor Supervisor, and Cindy Rexroad, Regulatory Compliance Manager, DHSS Region 2

In this program we will talk about current hot topics related to long term care, frequently asked questions, recent changes, and frequent citations seen in the region. We will be focusing on moving forward with person centered care after the end of the COVID PHE.

 

November 17, 2023: You’re Not Special: Navigating Staffing in the Me Culture
Location: Cape Girardeau Public Library, Cape Girardeau
Presenters: Wendy Boren, BSN, RN, QIPMO, University of Missouri, Sinclair School of Nursing and Nicky Martin, MPA, BS, LNHA, CDPQIPMO, Sinclair School of Nursing

Staffing is a constant battle, but the current culture makes staffing healthcare a different kind of challenge than we’ve ever faced before. Recruiting and retaining staff in the “me” culture requires ingenuity, patience, compromise, and a new spin on professionalism. This program will highlight those challenges through interactive discussion and give participants real tools to creative winning strategies that may just take them from “me” to “we.”

The PDF file labeled “MDS3.0RAIManualv1.18.11R.Errata.v2.October.20.2023” is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The errata document contains revisions to the MDS 3.0 RAI Manual version (v)1.18.11R to provide clarity and additional guidance in Section D and Chapter 6 to support item D0100, Should Resident Mood Interview be Conducted? serving as a gateway item for the Resident Mood Interview (PHQ-2 to 9©) and D0500, Staff Assessment of Resident Mood (PHQ-9-OV©). Minor revisions also included are corrections to language in Section Q to provide proper guidance on Care Area Assessment (CAA) requirements, corrections to language in Chapter 2 to provide proper guidance on combining Omnibus Budget Reconciliation Act (OBRA) discharge assessments, an updated Internet Quality Improvement & Evaluation System (iQIES) warning error message in Chapter 5, updated screenshots in Section A and Section O, and an updated MDS Item Matrix. The errata document also includes all issues from previous MDS 3.0 RAI Manual v1.18.11R errata releases.

Changed manual pages are marked with the footer “October 2023 (R).”

The errata document begins with a table that lists all identified revisions and the pages to which they have been applied. Following the table are the actual corrected replacement pages for insertion into the printed manual.

The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.18.11 have been updated and are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. Changes in this version (listed below) align the item sets with the Errata V3.01.3 for MDS Data Specifications V3.01.1 (FINAL) posted September 21, 2023, on the Minimum Data Set (MDS) 3.0 Technical Information page. For a full list of changes to the final posted item sets since v1, see the Item Set Change Table Supplement that accompanies the posting. The MDS Item Sets v1.18.11 were effective beginning October 01, 2023.

M0300G1 on NPE

Replaced erroneous skip pattern <Skip to N2005, Medication Intervention> with the correct one: <Skip to N0415, High-Risk Drug Classes: Use and Indication>.

O0300A on NP and NQ

Corrected transposition of verbs in skip patterns (changed <Skip> to <Continue> in choice 0 and <Continue> to <Skip> in choice 1).

O0400 on NC and NQ

Removed completion language <Complete only when A0310B = 1 (complete O0400D2 when required by state)>.

O0400 on NP and SP

Removed completion language <Complete only when A0310B = 1>.

O0420 on NC, NP, and NQ

Removed completion language <Complete only when A0310B = 1>.

December 5, 2023: Transportation Resources for Older Adults
Location: St. Louis County Library Lewis & Clark Branch

What can I do when my ride cancels, and I cannot attend doctor appointments, shopping, church, and other social events? Learn about community resources and organizations specializing in transportation for older adults that help to address loneliness and isolation in our community.

November 16, 2023: Reaching Maximum Capacity: Improving Sales & Customer Experience

The selling landscape has changed: more competition, more individuals involved in the decision-making process, and more ways for buyers to research their options before ever talking with someone on your team. To reach and maintain maximum capacity, there are two key areas where you need to excel: (1) delivering a customer experience that creates champions for your community’s brand and (2) providing a prospect experience that sets you apart immediately and moves them forward efficiently. With the right strategies, you’ll not only convert more prospects but also foster strong customer–and employee–satisfaction.

On September 29, 2023, you received information from the LTC List Serve regarding the Infection Prevention Toolkit that would be delivered to your facility later this month as part of the COVID Prevention and Response Project of the Missouri Department of Health and Senior Services (DHSS). DHSS has entered into an agreement with Concordance Healthcare Solutions to deliver this Infection Prevention Toolkit to your facility with costs being paid by the Nursing Home & Long-Term Care Facility Strike Team and Infrastructure Project.

Contents of this Infection Prevention Toolkit include:

Pulse Oximeter: Fingertip
Digital Non-Contact Thermometer
3M Fit Testing Kit: BITREX
3M Fit Testing Solution: Saccharin 55 mL Fluid Volume
3M Respirator Wipes: Non-Alcohol
Glo Germ Glo Box Kit with 8oz gel

For those facilities who are in need of Respiratory Fit Testing assistance please contact the Healthcare Associated Infections/Antimicrobial Resistance Program at LTCStrikeTeam@health.mo.gov.

We will be using the administrator’s name and facility address as listed on the DHSS Website https://health.mo.gov/seniors/nursinghomes/licensecert.php as well as the information for the eight hospital based skilled nursing facilities for delivery and contact purposes. Shipment of the Toolkits will begin the week of October 23, 2023.

Phase II of the COVID Prevention and Response Project will focus on working with the facilities in hopes of acquiring needed communication equipment to assist in outbreak control, training and real-time communication with healthcare providers and the Strike Team. In the coming weeks you will receive information on how to order these devices.

Please contact Mary Menges, Project Specialist, at mary.menges@health.mo.gov should you have any questions or concerns regarding with project.

CMS is requesting information regarding wireless internet access in nursing homes. If your facility does not have facility-wide wireless internet access for residents, please fill out and submit the Wi-Fi questionnaire by 12/22/23. CMS will use this information to explore the reasons and possible solutions. The questionnaire can be found at here.

Below is some key information to help long-term care facilities (LTCFs) prepare for collecting annual healthcare personnel (HCP) influenza vaccination summary data for the 2023-2024 influenza season.

Which facilities are required to report these data?

  • CMS-certified skilled nursing facilities (SNFs) are required to report HCP influenza vaccination summary data through NHSN.

What data are submitted?

  • The reporting period for the 2023-2024 influenza season is from October 1, 2023, through March 31, 2024. Facilities are only required to submit one report that covers the entire reporting period by May 15, 2024.

How should facilities submit these data?

  • Facilities must report annual HCP influenza vaccination summary data through the NHSN Healthcare Personnel Safety (HPS) Component.

Who can activate the HPS Component?

  • Only the NHSN Facility Administrator (FA) can activate a new component. The NHSN FA can then add users, including the HPS Component Primary Contact, once the component is activated.
  • If the NHSN FA leaves the facility but does not transfer the role of FA to another individual prior to leaving, please complete the NHSN Facility Administrator Change Request Form: https://www.cdc.gov/nhsn/facadmin/index.html.
  • Please do not de-activate any other NHSN Components, such as the LTC Facility Component.

How can LTCFs add the HPS Component?

Where can facilities access training materials?

What are key training materials for LTCFs?

Are there any upcoming trainings for LTCFs?

  • Yes, there will be two refresher trainings on reporting annual HCP influenza vaccination summary data on November 21 and November 28. The content for each webinar is the same. After registering, you will receive a confirmation e-mail containing information about joining the webinar.

When: Tuesday, November 21, 2023, at 1:00 PM ET
Register in advance for this webinar: https://cdc.zoomgov.com/webinar/register/WN_PcTHDlv6SC6xyA1VYUEurQ

When: Tuesday, November 28, 2023, at 1:00 PM ET
Register in advance for this webinar: https://cdc.zoomgov.com/webinar/register/WN_lx1CWu4OSTmUDyuPgoo7AA

Who do facilities contact with questions?

  • Please direct all questions regarding CMS SNF QRP requirements and deadlines to: SNFQualityQuestions@cms.hhs.gov.
  • If you have any additional questions or concerns, please use NHSN-ServiceNow to submit questions to the NHSN Help Desk. The new portal can be accessed here and should be used in place of nhsn@cdc.gov. ServiceNow will help the NHSN team respond to your questions faster. Users will be authenticated using CDC’s Secure Access Management Services (SAMS), the same way you access NHSN. If you do not have a SAMS login, or are unable to access ServiceNow, you can still e-mail the NHSN Help Desk at: nhsn@cdc.gov, with “HPS Flu Summary – LTCF” in the e-mail subject line.

Thank you for your efforts reporting annual HCP influenza vaccination summary data through NHSN.

Artifacts of Culture Change 2.0

MC5 would like to thank the Section for Long-Term Care Regulation for allowing us to share the Artifacts of Culture Change at the recent provider meetings and for their continued support of our work to grow person-centered cultures in Missouri’s Senior Living Communities. It is our hope that providers will utilize the Artifacts tool to further advance resident-directed practices in their communities.

The Artifacts of Culture Change 2.0 (ACC) tool and associated supporting materials can be found at https://www.pioneernetwork.net/artifacts-culture-change/.

Watch for additional training opportunities related to implementing the Artifacts of Culture Change in future MC5 newsletters and here in the listserv.

 

Revitalizing MC5

MC5 is a non-profit organization whose mission is “to promote and support ongoing collaboration within the adult care continuum to create environments where the dignity and value of each individual who lives or works there is respected and celebrated”. Our mission, led by a team of passionate volunteers, is accomplished through education and networking, and provided through forums such webinars, symposiums, and at meetings held in the 13 regions located throughout Missouri.

As we plan for 2024, we would like to hear from you. What do you need from MC5, and perhaps, what talents might you be able to share with our team.

Please click here to complete a short survey.

Join members of the team from MC5 and special guests the 4th Wednesday of each month as we share stories and best practices, explore challenges faced, and together re-envision what Person-Directed Care can look like for seniors in Missouri, especially for those living and working in Missouri’s Long-Term Care and Assisted Livings communities.

October 25, 2023: Filling the Holidays with Meaning and Purpose
Special Guest: Carrie Chiusano, Executive Director for Presbyterian SeniorCare Network’s Dementia Care Center of Excellence
Conversation Starter: Come prepared to discuss best practices as well as challenges faced as you work to make the holiday season one that has meaning and purpose for the residents in your community.

Special guest, Carrie Chiusano has thirty plus years of long-term care experience with Presbyterian SeniorCare Network. Most of those years were spent helping to shape and implement the internationally renowned Woodside Place philosophy of specialty care for persons living with Alzheimer’s disease and other related dementias. Carrie is a Certified Dementia Practitioner (CDP) and a Certified Alzheimer’s Disease and Dementia Care Trainer (CADDCT) through the National Council of Certified Dementia Practitioners.

The Fall 2023 issue of The Resident Advocate is now available. This newsletter provides information on residents’ rights and care issues; news and updates on national policy; and self-advocacy tips for obtaining person-centered, quality care.

This issue includes information on:

  • Tips for living with a roommate in a long-term care facility,
  • Staffing issues in long-term care and how you can advocate for change,
  • Steps to take when there is a problem in your nursing home,
  • Reminders for visiting long-term care facilities during the holidays, and
  • Participating in this year’s Residents’ Rights Month.

The Resident Advocate is a great resource to share with long-term care residents. Nursing home staff, long-term care Ombudsman programs, family members, and other advocates are encouraged to forward this newsletter to residents or print and share copies. Download this issue or past issues from the website

Legal Series Webinars

Long-Term Care has been among the most litigated field in the USA. This series, delivered by expert attorneys, will share experiences and best practices to incorporate into your community. The entire series or individual sessions can be purchased.

October 11, 2023: Survey Process
October 12, 2023: Staffing Agency Potholes/Temporary Staffing
November 15, 2023: Hot Survey Issues (More information soon)
November 28, 2023: Best Practices for Policies (More information soon)