Missouri Long-Term Care Information Update

Changes to the Adult Abuse & Neglect Online Reporting App. – Goes Live on Monday!

Attention Mandated Reporters: Missouri’s Adult Abuse and Neglect Hotline online reporting application is being upgraded and the link will change on Monday, February 26 If you have saved the old link, it will no longer work after February 26; however, the online reporting application can still be accessed at Health.Mo.Gov/abuse. As a mandated reporter we encourage you to access the link on the webpage to report adult abuse, neglect, self-neglect, and financial exploitation.

Missouri Department of Health and Senior Services, Division of Senior and Disability Services is dedicated to providing you with the support you need, when you need it. If you have any questions or concerns, you may send them to DSDSOfficeofConstituentServices@health.mo.gov.

HQIN Strategies to Use During Your Nursing Home Stand-Up Meetings (Anticoagulants)

HQIN is presenting an educational series tailored for nursing home stand-up meetings, aimed at decreasing preventable emergency room (ED) visits and hospital readmissions. HQIN is sending out talking points that can be included in daily stand-up meetings to increase staff knowledge on relevant topics like effective communication, adverse drug events and infection prevention. The program is designed to empower nursing home staff with practical knowledge to foster a safer environment.

This week’s strategies include Adverse Drug Events – Anticoagulants. Below is an overview of information and resources.

  • An adverse drug event (ADE) is harm that results from medication use. These events can be due to allergic reactions, side effects, overmedication and medication errors. Anticoagulant medications are necessary for the treatment of some conditions but are also a leading cause of ADEs resulting in ER visits or hospitalization. Review ADE risk factors and sign/symptoms on this Anticoagulant Antithrombotic Tip Sheet.
  • Also, review the Centers for Disease Control and Prevention’s (CDC) Adverse Drug Events in Adults for more safety information.
  • Review your policy for medication education. Blood Thinner Pills: Your Guide to Using Them Safely provides resources for educating residents and families.
  • Evaluating your facility’s anticoagulant program can assist you with identifying and addressing opportunities for improvement.
  • This Anticoagulant Adverse Drug Events Self-Assessment provides a checklist for anticoagulant programs.

DHSS Antibiotic Stewardship Survey

The Missouri Antimicrobial Stewardship Educational Collaborative is working with Washington University on an antibiotic stewardship project and are seeking input from Skilled Nursing Facility and other Long Term Care Facilities (Intermediate, Assisted, and Residential Care Facilities), in addition to MO hospitals. Please take a few minutes to complete their survey.

Washington University School of Medicine is performing a survey on behalf of the Missouri Department of Health and Senior Services, Hospital Associated Infections and Antimicrobial Resistance Program.

The survey can be found at the attached link here: Survey Link. It should take approximately 15 minutes to complete.

This survey is intended to evaluate the current state of antimicrobial stewardship activities at Missouri long-term care facilities. Please forwards it to whomever at your facility is most involved with the antimicrobial stewardship and the management of antimicrobial use, or if no such person exists your medical director or pharmacy leadership. We request this survey be completed by March 1, 2024.

For any questions regarding this facility antimicrobial stewardship survey, please submit a new email to mo.stewardship@wustl.edu; use “MO DHSS Antimicrobial Stewardship Survey” in the subject line.

We appreciate the time you take to complete these surveys!

REMINDER! The Long-Term Care Ombudsman Program Bed and Service Availability Portal is now available!

Long-Term Care Facilities (all levels of care) are strongly encouraged to complete an electronic survey weekly to report how many beds they have available, and which residents they can serve, i.e., memory care, behavioral health, bariatric, etc. This information is used to generate a dashboard that is beneficial to facilities, families, hospital discharge planners and the general public to determine bed availability and services throughout the state. Please access the survey at this link: survey. To view the dashboard access this link: dashboard.

If you have any questions about the survey, please contact the Long-Term Care Ombudsman Program via email LTCOmbudsman@health.mo.gov or call 800-309-3282.

This is a great opportunity to share what your facility has to offer!

DMH Free Webinars – Tools for Everyone

March 5, 2024: Registration
March 14, 2024: Registration
March 20, 2024: Registration

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.

 

Health Education Unit Instructor Info

The SLCR Health Education Unit will be conducting Instructor Information Meet Ups again.

March 5, 2024: Instructor Meet Up

Please see the CNA Registry webpage for past meetings and more information.

If you have questions, please call our office at 573-526-5686.

LeadingAge 2024 Healthcare Workforce Summit

May 9, 2024: All Boats Rise HealthCare Workforce Summit
Location: Renaissance at the Airport, St. Louis

LeadingAge Missouri, along with other Missouri association partners are pleased to announce the All-Boats Rise: 2024 Healthcare Workforce Summit. This Summit is about collaboration for high quality workforce solutions. The Summit’s programmatic goals are to present content that is insightful, thought provoking, innovative, and above all, actionable. Carefully curated topics will be probed by expert moderators, panelists, and speakers. Their willingness to share is hugely appreciated. We are also indebted to volunteer industry professionals and to the many sponsors highlighted in this program and from the Summit stage. All Summit participants are encouraged to thank and connect with these sponsors during multiple networking opportunities throughout the day. While you come to learn, we hope you take advantage of engagement opportunities that may foster relationships and lead to productive collaboration.

Director of Food and Nutrition Services Qualifications

We have recently received in influx of questions related to the qualifications for director of food and nutrition services in skilled nursing facilities. The federal regulation (F801) requires one of the following qualifications (if a qualified dietician or other clinically qualified nutrition professional is not employed full-time):

  1. A certified dietary manager; or
  2. A certified food service manager; or
  3. Has similar national certification for food service management and safety from a national certifying body; or
  4. Has an associate’s or higher degree in food service management or in hospitality, if the course study includes food service or restaurant management, from an accredited institution of higher learning; or
  5. Has 2 or more years of experience in the position of director of food and nutrition services in a nursing facility setting and has completed a course of study in food safety and management, by no later than October 1, 2023, that includes topics integral to managing dietary operations including, but not limited to, foodborne illness, sanitation procedures, and food purchasing/receiving.

CMS has noted that the approved certifications and course requirements would be the equivalent of a ServSafe Food Manager certification. Additional food manager courses we have found to meet the requirements include: AAA Food Handler, Learn2Serve, and State Food Safety.

DHSS Antibiotic Stewardship Survey

The Missouri Antimicrobial Stewardship Educational Collaborative is working with Washington University on an antibiotic stewardship project and are seeking input from Skilled Nursing Facility and other Long Term Care Facilities (Intermediate, Assisted, and Residential Care Facilities), in addition to MO hospitals. Please take a few minutes to complete their survey.

Washington University School of Medicine is performing a survey on behalf of the Missouri Department of Health and Senior Services, Hospital Associated Infections and Antimicrobial Resistance Program.

The survey can be found at the attached link here: Survey Link. It should take approximately 15 minutes to complete.

This survey is intended to evaluate the current state of antimicrobial stewardship activities at Missouri long-term care facilities. Please forwards it to whomever at your facility is most involved with the antimicrobial stewardship and the management of antimicrobial use, or if no such person exists your medical director or pharmacy leadership. We request this survey be completed by March 1, 2024.

For any questions regarding this facility antimicrobial stewardship survey, please submit a new email to mo.stewardship@wustl.edu; use “MO DHSS Antimicrobial Stewardship Survey” in the subject line.

We appreciate the time you take to complete these surveys!

2024 Missouri Immunization Conference

April 25-26, 2024: MO Immunization Conference: Building Immunity in Missouri Communities
Location: Holiday Inn Executive Center, Columbia

The Conference brings together bright minds to give talks that are action-oriented on a wide range of subjects related to immunizations to foster learning and inspiration, as well as provoke conversations that matter and actions that lead to increased vaccination rates for Missourians. We aim to empower the public health workforce by offering a stage for stakeholders to share innovative ideas, equitable solutions, and their personal experiences promoting immunizations.

VOYCE’s Upcoming Events

February 20, 2024: Put the Care in Caregiving

The pressures of caregiving, whether inside or outside the home, can lead to a lack of empathy and several physical symptoms, known as caregiver compassion fatigue or burnout. In the wake of a pandemic that claimed over 5.5 million lives, knowing your limits and what to do when you’ve reached them is essential. Learn the signs of caregiver compassion fatigue to identify them in yourself or others and explore options for relief.

February 29, 2024: Summit to Protect Older Adults and Adults with Disabilities

This summit is a conversation with the community, professionals, older adults, and others to learn what needs to be fixed in the adult protection system.

March 18, 2024: Navigating Long-Term Care Choices and Understanding Nursing Home Residents’ Rights

A Professional Care Manager helps to develop care plans while resolving family conflicts. Find out how a care manager can help you to have autonomy in your life. An Ombudsman Professional will be on hand to understand Residents’ Rights in the long-term care facility.

March 19, 2024: Community Education: Driving Yourself Lonely

Loneliness and lack of connection in older adults have recently been reported as a public health crisis in the United States, the consequences of such potentially being an increased risk of heart disease, stroke, dementia, and premature death. What role does transportation play in exacerbating this problem, and how is this being addressed in St. Louis? Get your questions answered in this webinar!

Administrator License Renewals

Missouri licensed administrators (NHA or RCAL) expiring June 30, 2024, are due for license renewal. If you plan to renew, visit our website at https://health.mo.gov/bnha for important information regarding continuing education and license renewal. Once your renewal has been successfully processed, you will be issued a current license via email. Please note if you fail to renew by June 30, 2024, you cannot practice as a licensed administrator after that date.

MC5 Webinar

March 6, 2024: The Validation Method:  Connect and Communicate with Older Adults
Presenter: Vicki deKlerk, Executive Director, The Validation Institute

Over 37 years ago, when reality orientation was the norm, Naomi Feil, a woman with unique empathy and insight into the world of disoriented elders, created the Validation Method, motivating older adults with cognitive decline to communicate more, relieve stress, and enhance dignity and happiness in their final stage of life.

Today, the validation method is practiced around the world, and her daughter, Vicki deKlerk, continues her work through the Validation Training Institute, providing education, quality standards and easy pathways for learning this evidence-based method.

Through the magic of Zoom, Vicki will join us from the Netherlands, using interactive exercises, she will describe, demonstrate and share 2 key prerequisite skills of the Validation Method. There will be an opportunity to share in conversation and engage in a Q & A with attendees.

Payroll-Based Journal (PBJ) Submission Deadline Reminder

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 10/1/23 through 12/31/23 is due February 14, 2024.

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

SNF Quality Reporting Program (QRP) Submission Deadline Reminder

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 February 15, 2024:

  • MDS data for 7/1/23 through 9/30/23;
  • NHSN data for COVID-19 Vaccination Coverage Among Healthcare Personnel for 7/1/23 through 9/30/23;

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

MLN Nursing Home Administrator Conference

May 21-23, 2024: 33rd Annual Nursing Home Administrator Conference
Location: Downstream Casino, Quapaw, OK

Elevate your leadership at the 33rd Annual NHA Conference hosted by the Missouri League for Nursing at Downstream Casino from May 21-23, 2024. Join MLN for a Quad-State Extravaganza that promises unmatched insights, networking, and celebration tailored to meet the unique challenges and opportunities in the realm of nursing home administration.

VOYCE Professional Development Webinar

March 7, 2024: Climb Out of the Cost Burden: Resources Available for Low-Income Housing Needs

Over 10 million households headed by someone 65 and older are cost-burdened, meaning they pay more than 1/3 of their income on housing. Service providers encountering clients needing low-income housing must be aware of the available programs and services to ensure smooth transitions. Join VOYCE to understand the current issues in St. Louis regarding low-income housing for older adults and what factors in individuals’ lives impact, and sometimes inhibit, their capacity to live independently in low-income housing. This presentation will explore St. Louis-based aid that can help people mitigate unique barriers to housing and locate their next home, including Show-Me Home, Missouri’s Money Follows the Person program.

DMH Free Webinars – Tools for Everyone

February 8, 2024: Registration
February 13, 2024: Registration
February 21, 2024: Registration
February 29, 2024: Registration

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.

Upcoming COMRU Training

Central Office Medical Review Unit (COMRU) is hosting a FREE webinar concerning the online Level 1 Pre-Admission Screening and Resident Review (PASRR) application process via Webex on February 8, 2024, from 10:00 am to 11:00 am. This webinar will cover the following topics:

  • common errors requiring applications to be returned,
  • what triggers a Level 2 screening on the application, and
  • how to check the status of an online application.

Complete the registration and meeting invitation will be forwarded to your email address the week of the webinar. To register to attend: https://www.surveymonkey.com/r/WF7BDZ5.