Missouri Long-Term Care Information Update

Essentials of the LTC Director of Nursing Role – Part 1

August 9 & 10, 2023: Essentials of the LTC Director of Nursing Role – Part 1
Virtual: August 9 (12:15pm-4pm) & August 10 (1pm-4pm)

LeadingAge Missouri in partnership with LeadingAge Iowa is pleased to announce a virtual series that will take place in three segments over the second half of 2023 that will aid in developing the Director of Nursing (DON) role in nursing homes. Elements of this series will focus on understanding CMS programs that impact reimbursement and quality assurance; survey processes and regulations; and human resources, customer service, and leadership.

Each segment of this series is designed to provide in-depth information and discussion on each topic without taking the series in a sequential order or taking all 3 sections of the series. By making each of the 3 segments standalone, you can better address succession planning by having individuals attend as their nurse leadership skills are identified. Additional sections in this series will be added to the events calendar in September and December.

Senior Day at the MO State Fair

August 16, 2023: Senior Day at the State Fair
Location: Mathewson Building, Missouri State Fairgrounds, Sedalia

The Annual Missouri State Fair is right around the corner! As in years’ past, Senior Day at the State Fair is sponsored by the Department of Health and Senior Services and Missouri Association of Area Agencies on Aging. This yearly tradition at the State Fair honoring Missouri’s most valuable resource, senior citizens, typically draws over 800 people.

LeadingAge Missouri Annual Conference & EXPO

September 18-20, 2023: The Greater Good
Location: The Chase Park Plaza, St. Louis

Welcome to the 2023 LeadingAge Missouri Annual Meeting + EXPO. We have incorporated some changes to our planning to support everyone’s mission of collaboration, networking, and sharing. You’ll find an open exhibit hall for ease of access for attendees, exclusivity times, CEU approval for exhibitor visits, a social reception for all, and the opportunity to be part of the Innovation Café. We have expanded education to be inclusive of the entire spectrum of long-term care in Missouri. The greater good is more than a theme, it’s part of a mission. We all continue to be the greater good through learning and collaboration; Missouri is a leader in the field of compassion, togetherness, and Midwest values.

This is where GREATER GOOD begins – and you need to be a part of it.

COMRU Return Codes

We have some good news and some bad news!

The bad news….due to a required change in the database platform, the COMRU online applications for Level 1/Level 2 (old DA124s) forms will no longer be accessible by your CURRENT RETURN CODES after Friday, July 14, 2023.

The good news…you can still access the online applications and COMRU can continue to process applications you submitted! However, as of MONDAY, JULY 17, a NEW RETURN CODE will be required to access all applications entered prior to July 17, 2023.

Please note – this change will not affect any application initiated after July 17, 2023. You will continue to receive a valid return code for all new applications submitted to COMRU after July 17, 2023.

What do I need to do?!

If you recently submitted the application (before July 17) – a new return code will be provided to you when COMRU reviews your application. Otherwise, if you need to make a change or need to receive the new code for applications initiated prior to July 14, 2023, please email the following to COMRU (COMRU@health.mo.gov):

Name of Individual
DCN or SSN
Name of Facility
Admission Date (if admitted to SNF)

We appreciate your patience during this transition process and apologize for any inconvenience.

NH Providers Login Credentials Maintenance

The purpose of this communication is to remind Nursing Home Providers to ensure you maintain accurate contact information and login credentials in the QIES system even though all Minimum Data Set (MDS) information is now being submitted via the Internet Quality Improvement and Evaluation System (iQIES) system. You will continue to receive important information regarding any findings of noncompliance with the requirement to report COVID-19 data to the Centers for Disease Control and Prevention (CDC) through the National Healthcare Safety Network (NHSN) in your CASPER Shared Folder. This means that facilities will need to continue to maintain two sets of login credentials, one set to access the CASPER Reporting application [CMS Network (CMSNet) and QIES Login credentials] and the HARP login credentials to continue submission of MDS records and accessing reports in iQIES.

Below is the link for the CASPER login. Please be sure that you are successfully logged into the CMS Network (CMSNet) prior to trying to access the CASPER link below.

https://web.qiesnet.org/qiesmds/mds_home.html

See below to find your CASPER Shared Folder:

Image 1. Welcome to CASPER

 

 

 

 

 

 

 

Image 2. CASPER folders.

 

 

 

 

 

 

 

 

 

iQIES Service Center

For questions regarding your CASPER Shared Folder, please contact the QIES/iQIES Service Center by phone at (800) 339-9313 or send an email.

CMS Memo: QSO-23-18-NH: Posting of Nursing Home Ownership/Operatorship Affiliation Data on Nursing Home Care Compare Website and data.cms.gov

Memorandum Summary

  • Posting Nursing Home Affiliation on Nursing Home Care Compare: CMS will include ownership and operatorship affiliation information on our Nursing Home Care Compare website.
  • Posting Aggregate Nursing Home Performance Data on data.cms.gov: CMS will publish combined inspection, staffing, quality, and other performance metrics across groups of nursing homes with shared ownership and operatorship on data.cms.gov.

Please see the full memo for complete details at https://www.cms.gov/medicare/provider-enrollment-and-certification/surveycertificationgeninfo/policy-and-memos-states/1519889558/posting-nursing-home-ownership/operatorship-affiliation-data-nursing-home-care-compare-website-and.

LeadingAge – Free Webinar

July 11, 2023: Mastering QAPI
Presenter: Ralph Peterson, owner and operator of Ralph Peterson, LLC, a Management Development Company that specializes in helping Senior Care organizations REINVENT the way they do business

LeadingAge Missouri in partnership with LeadingAge Nebraska are excited to bring a new webinar!  Ralph Peterson will be sharing with us a hands-on & practical webinar on developing a QAPI program in senior living.

DESCRIPTION: Are you looking to improve the quality of care at your senior care center? Do you want to create a culture of excellence that will enhance the lives of your residents and their families? If so, then our 60-minute webinar on creating an effective Quality Assurance, Performance Improvement (QAPI) program is perfect for you!

In this webinar, we will explore the key elements of a successful QAPI program and how it can benefit your senior care center. We will use storytelling and analogies to make the concepts more relatable and memorable, and we will provide you with real-world examples to help you implement the program in your own center.

During this session, you will learn:

  • The importance of creating a culture of quality and how it can enhance the lives of your residents
  • The key components of a QAPI program, including data collection, analysis, and improvement planning
  • How to identify areas for improvement in your center and develop a plan to address them
  • How to engage your staff in the QAPI program and create a collaborative team environment
  • How to use performance data to drive positive outcomes for your residents and your center

By the end of this webinar, you will have the knowledge and tools to create an effective QAPI program that will enhance the quality of care at your senior care center. You will also have the opportunity to ask questions and share your own experiences with the group.

Free Trainings from the Department of Mental Health

Tools for Everyone!

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. Please register at the links below.

July 6, 2023: 9:30 am https://stateofmo.webex.com/weblink/register/r7b512064c968d2329638c65be13b6c7e
July 13, 2023: 1:00 pm https://stateofmo.webex.com/weblink/register/r35a043c5b76d1f68f066862680747a4c
July 20, 2023: 1:00 pm https://stateofmo.webex.com/weblink/register/r2e46c3cc93a6135dc0c455b994ff1726
July 26, 2023: 10:00 am https://stateofmo.webex.com/weblink/register/r8e0a26526488dba1f1f8246349e59a9d
August 2, 2023: 9:00 am https://stateofmo.webex.com/weblink/register/r435dfdd07bee3f1eaa1e5754ce8e023e
August 10, 2023: 1:00 pm https://stateofmo.webex.com/weblink/register/r731db903594e3704ea91cfa7f406acc4
August 16, 2023: 10:00 am https://stateofmo.webex.com/weblink/register/r123055bad864686c0af10f7375a9a903

Additional Free Training:

Introduction to Trauma – Dr. Patsy Carter
Research has revealed that the prevalence of trauma is high particularly in specific target populations. This webinar will introduce viewers to the definition and prevalence of trauma, as well as examining the social, biological and health impact.

A Taste of Mental Health First Aid – Jermine Alberty and Rita McElhany
Have you ever wondered what it would be like to take a Mental Health First Aid Class? MHFA-USA National trainer, Jermine Alberty offers a brief “Taste Of Mental Health First Aid.”

Mental Health First Aid is a skills-based training course that teaches participants about mental health and substance-use issues.
If you would like to take the class or get more information visit mhfamissouri.org.

Updated Missouri Nurse Aid Candidate Handbook

The DHSS Health Education Unit and Headmaster D & S would like to announce some revisions to the skills portion of the CNA exam shown in the Candidate Handbook effective July 1, 2023. Please see the new updated version at Missouri Nurse Aide Candidate Handbook (hdmaster.com) for the changes.

Please contact the DHSS Health Education Unit at 573-526-5676 and/or Headmaster D & S at 800-393-8664 for any questions.

Dangerous Heat Warnings for Missouri

The National Weather Service has issued a heat advisory for portions of Missouri for Thursday, June 29 and Friday, June 30. As temperatures rise this summer, it is important to prioritize heat related safety measures. Heat-related illnesses can have serious consequences, but with some precautions and awareness, we can create a safer work environment.

Heat-related illnesses often affect the very young, the elderly and the chronically ill, but summer temperatures can also take a toll on healthy young and middle-aged adults. In 2022, 23 people died from heat exposure in Missouri, ranging in age from 2-83 years.

During prolonged periods of high temperatures, using air conditioning – either at home or by seeking shelter in a local cooling center – is the best preventive measure.

“Heat and humidity can place a lot of stress on the body,” said DHSS Director Paula Nickelson. “Heat exhaustion can come on suddenly, with little warning, and lead to heatstroke which becomes a very dangerous situation.”

During excessive heat, Nickelson urges Missourians to check on friends and neighbors, especially those who are elderly and chronically ill. To report a senior citizen or an adult with disabilities who is in need of assistance due to the heat, call the state’s toll-free abuse and neglect hotline at 1-800-392-0210, or make a report online. Medications, as well as use of drugs or alcohol, can impair a body’s response to heat, making one more vulnerable to the heat.

Never leave a child or pet alone in a vehicle. Four of Missouri’s heat-related deaths in 2022 were individuals in vehicles. Even on a cooler day, the temperature inside a vehicle can rise by 20 degrees in 10 minutes and pose a real threat to anyone left inside. Stress, distraction and being out of a normal routine can all contribute to forgetting a child in a car seat. Check the back seat each time you exit your vehicle.

There are a number of steps individuals can take to stay cool including:

  • Stay hydrated. Drink plenty of water regardless of your activity level, and do not wait until you are thirsty to do so. Avoid sugary and alcoholic beverages; these actually cause you to lose body fluids.
  • Wear appropriate clothing. Wear lightweight, breathable, and loose-fitting clothing that allows air circulation. When outside, consider wearing a hat and sunglasses to protect yourself from the sun.
  • Stay cool indoors. Stay in air-conditioned places as much as possible. Find a local cooling center if needed.
  • Schedule outdoor activities carefully. Try to plan outdoor activity for morning or evening hours when the temperature is coolest.
  • Pace yourself. Reduce exercise or physical activity during the hottest part of the day, and take frequent breaks in the shade or in an air-conditioned place.
  • Wear sunscreen. Sunburn affects your body’s ability to cool down and can make you dehydrated.
  • Prepare your home. Change air conditioner filters, and cover windows that receive morning or afternoon sun with drapes or shades.
  • Stay informed. Pay attention to weather forecasts and heat advisories. Stay informed about the local heat index and adjust safety measures accordingly.

Knowing the signs and symptoms of heat related illness and how treat them is also important. Signs of heat exhaustion may include muscle cramps; heavy sweating; cold, pale and clammy skin; dizziness; headache; nausea or vomiting; and fainting or passing out. If you think you or a loved one are experiencing heat exhaustion, you should stop physical activity move to a cool place – preferably air-conditioned, loosen clothing, and sip cool water. Seek medical attention immediately if you are throwing up, your symptoms get worse or symptoms last longer than one hour.

Signs of heat stroke may include high body temperature (103°F or higher); hot, red, dry or damp skin; fast, strong pulse; headache; dizziness; nausea; confusion; or loss of consciousness. If you think you or a loved one are experiencing heat stroke you should call 911 immediately. Heat stroke is a medical emergency. Move the person to a cool place – preferably air-conditioned. Help lower the person’s body temperature with cool cloths or a cool bath until medical personnel arrive. Do not give the person anything to drink.

For more information regarding heat-related illness and prevention, visit the websites of DHSS or the CDC.

Missouri Nursing Facility Strike Team and Infrastructure Reimbursement Opportunity

On March 1, 2023, the Missouri Department of Health and Senior Services (DHSS) released information about the Missouri Nursing Facility Strike Team and Infrastructure Award, a reimbursement opportunity available to Skilled Nursing Facilities (SNF) and Long Term Care and Other Nursing Facilities (LTC).

Beginning March 1, facility owners and operators may apply for reimbursement for expenses incurred between July 1, 2022 and August 31, 2023, directly related to preparing, preventing, and responding to the COVID-19 pandemic. The intention of this funding is to provide supplemental support to Missouri’s skilled nursing, other long-term care and other nursing facilities during their response to SARS-CoV-2 infections, and also to build and maintain the infection prevention infrastructure necessary to support resident, visitor, and facility healthcare personnel safety. If you operated a Skilled Nursing Facilities or Long Term Care and Other Nursing Facilities licensed with DHSS between July 1, 2022 and August 31, 2023, you are eligible for reimbursement for allowable expenses.

After the application period was opened March 1, 2023, the program was made aware of additional federal administrative requirements that impact the implementation of the program. These requirements do not change the eligibility criteria for facilities or the allowable cost categories but do identify that expenditures for activities that were previously paid or reimbursed by federal funds are not allowed for reimbursement through this award. Only expenses that have not been reimbursed by another federal fund source are allowable for reimbursement from this opportunity.

A very few additional facilities have also been made eligible for this opportunity. This does slightly impact the eligible amount per licensed bed for both skilled nursing facilities (SNF) and long-term care and other nursing facilities (LTC/Other), but the impact is less than a percentage point different in each type of facility.

Facility operators that have already applied for these funds do not need to do anything to adjust their applications, but do need to be aware of the additional guidance and revised amounts, and be prepared to assure that costs submitted for reimbursement meet the federal requirements. DHSS will provide additional information to existing applicants and will advise if any adjustments or additional information are needed on a case-by-case basis.

Updated guidance and eligible amounts are posted on the DHSS website for COVID-19 Health Care Professionals under the heading “Information for Long-Term Care Facilities” at the following link: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/professionals.php.

All questions should be directed to the DHSS Strike Team via email at LTCStrikeTeam@health.mo.gov.

This program is supported by the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award ending May 10, 2024 totaling $14,994,016 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.

MHCA Annual Convention

August 27-30, 2023: Celebrating 75 Years of Caring!
Location: Branson Convention Center, Branson

The Missouri Health Care Association is excited to bring you another year of the most requested and up-to-date educational sessions available. Each day is scheduled to offer a wide range of education to meet the needs of the entire staff. More information as well as a proposed schedule is included at the link above and a complete schedule with seminar details will be available soon. Don’t miss the opportunity to tour the Trade Show, widely regarded as the leading long-term care trade show in Missouri with over 150 booths.

2023 Provider Feedback Survey

The Section for Long-Term Care Regulation is again seeking input from providers we serve. We are asking for your help in identifying areas in our Section where excellent customer service is provided and areas where we need to focus on improving our customer service experience. Please take a couple minutes to complete our 2023 Provider Feedback Survey by July 5, 2023 at https://www.surveymonkey.com/r/6K86SF6.

Medicaid Spend-Down Limit Changes

Effective July 1, 2023, the Medicaid Resource (Spend-Down) Limit increased to $5,726.00. Please see the link https://dssmanuals.mo.gov/wp-content/uploads/2022/07/mhabd-appendix-j.pdf.

Please note that for Medicaid/Medicare certified facilities, F569 states the facility must notify each resident/legal guardian that receives Medicaid benefits when the amount in the resident’s account reaches $200 less than the SSI resource limit. This means certified facilities should notify the resident/legal guardian when the resident’s personal funds are $5,526.00 or higher.

Feel free to contact Lynn Gilmore, Lead Auditor, at 573-508-4150 if you have any questions.

Rule Change Effective June 30, 2023

19 CSR 73-2.130 Notice of Change of Contact Information and Missouri Administrator Employment

PURPOSE: This rule describes the conditions and procedures for reporting change of address.

(1) Each administrator shall notify the board office of his/her current contact information within ten (10) calendar days of change for any of the following:

(A) Personal contact information, which shall include administrator license number, personal mailing address, email, and telephone number(s); and
(B) Missouri administrator employment, which shall include, administrator license number, facility name, mailing address, telephone number(s), and employment dates.

AUTHORITY: section 344.070, RSMo 2016. *This rule was previously filed as 13 CSR 73-2.130. Original rule filed May 13, 1980, effective Aug. 11, 1980. Amended: Filed Oct. 17, 1985, effective March 14, 1986. Moved to 19 CSR 73-2.130, effective March 3, 2003. Amended: Filed June 15, 2011, effective Jan. 30, 2012. Amended: Filed Nov. 28, 2022, effective June 30, 2023.

A direct link to the Rules for the Missouri Board of Nursing Administrators can be found at https://s1.sos.mo.gov/cmsimages/adrules/csr/current/19csr/19c73-2.pdf. The rule referenced above is located on the last page.

World Elder Abuse Awareness Day | June 15

World Elder Abuse Awareness Day (WEAAD) is Thursday, June 15. The Department of Health and Senior Services invites you to wear purple on this day (and anytime throughout the month of June) to commemorate this important event and raise awareness of elder abuse, neglect, bullying, and exploitation in later life.

On June 15, 2006, the World Elder Abuse Awareness Day was introduced by the International Network for the Prevention of Elder Abuse and the World Health Organization at the United Nations. The day is in support of the United Nations International Plan of Action that recognizes the significance of elder abuse as a public health and human rights issue.

Ways You Can Participate:

  • Wear Purple and Take Photos: Wear purple on June 15 to raise awareness for WEAAD, take a photo and join the conversation by posting it on social media using #WEAAD hashtag. Share photos and stories on your social media platforms with #WEAAD. Attached is a social media guide. As you plan activities, feel free to use the WEAAD tool kit. If your organization or community hosts an event, please let us know!
  • Display a Yard Sign and/or Window Cling: This is your opportunity to protect seniors by raising awareness about this serious problem and empower all Missourians to take action to end elder abuse. Light up a landmark in your community purple or use a purple porchlight during the month of June. To order promotional materials, please visit Health.Mo.Gov/weaad.
  • Join the Webinar Series: Learn about adult abuse and neglect, its prevalence, reporting and the ways in which DSDS protects and supports vulnerable Missourians impacted by abuse, neglect, and/or exploitation. Please see attached flyer for details to attend these important sessions and help us promote by posting to your social media outlets, websites, bulletin boards, as well as sharing it with your customers, partners and stakeholders via listservs.

The theme for WEAAD is Building Strong Support for Elders. As we know, no community in the world is immune from the mistreatment of older adults. Sadly, every year an estimated five million older Americans are victims of elder abuse, neglect, bullying, or exploitation, and that’s only part of the picture. Experts believe that for every case of elder abuse or neglect reported; as many as 23 cases go unreported. In Missouri, during fiscal year 2022, the Department of Health and Senior Services received and investigated 42,319 reports of abuse, neglect, bullying, and exploitation involving seniors and adults with disabilities living in the community and in facilities. That amounts to an average of 116 reports every day. The number of cases is rising, but still vastly understates the extent of the problem because the victim often has an emotional bond with the perpetrator. Seniors and people with disabilities may be socially isolated and physically dependent on the perpetrator – often a son, daughter, or caregiver – making it nearly impossible for them to report for fear of losing their last vestige of independence.

Make a difference. Make the call.

To report adult abuse, neglect, bullying, or exploitation, call the department’s hotline (1-800-392-0210), 7 AM to 8 PM, seven days a week. People who are deaf or hard of hearing may utilize Relay Missouri 1-800-735-2966. You may also report online at Health.Mo.Gov/abuse. For more information on this issue, visit our website at http://health.mo.gov/seniors/abuse.php.

As the leader in promoting, partnering, and protecting the health of Missouri citizens we urge each and every Missourian to help educate our communities, organizations, businesses, and individuals about elder abuse.

Thank you for your partnership to raise awareness about this critical public health issue!

QIPMO’s Educational Events

The Quality Improvement Program for Missouri (QIPMO) is a cooperative service between the MU Sinclair School of Nursing and the Missouri Department of Health and Senior Services. The program is entirely separate from the state survey and enforcement process. Nursing facility participation in the program is voluntary and confidential.

The program puts together multiple meetings. For more information, see their webpages containing Past Educational Webinars & Recordings as well as Upcoming Educational Webinars.

Post PHE Modifications and Registration Information for the LTCF COVID-19 Module

Below is important information regarding Long-term care facilities (LTCF) and reporting COVID-19 data to NHSN once the Public Health Emergency has ended.

Long-term care facilities that are CMS certified will still need to report to the LTCF COVID-19 Module Surveillance Pathways (Resident Impact and Facility Capacity, Staff and Personnel Impact, and Therapeutics) and the COVID-19 Vaccination Module once the Public Health Emergency is declared over on May 11, 2023

In 2020, CMS published an IFC (CMS-5531-IFC) requiring all LTC facilities to report COVID-19 information using the Centers for Disease Control (CDC), National Healthcare Safety Network (NHSN) (42 CFR 483(g)). This requirement was extended through a final rule (CMS-1747-F) and is set to terminate on December 31, 2024. This excludes the requirements at § 483.80(g)(1)(viii), which will continue to support national efforts to control the spread of COVID-19.

Please note, the COVID-19 Module Surveillance Pathways (Resident Impact and Facility Capacity, Staff and Personnel Impact, and Therapeutics) and the COVID-19 Vaccination Module are two separate modules and data will need to be reported to both on a weekly basis. Reporting to only one module does NOT satisfy the CMS reporting requirements.

NHSN provides a pathway to report data but is not a regulatory or enforcement body. Please direct any questions and/or concerns regarding reporting requirements and penalties/fines to CMS for further information.

The COVID-19 Module Surveillance Pathways will undergo updates in response to the end of the Public Health Emergency, including:

  • Reducing vaccination elements to include only up to date status for residents with a positive COVID-19 test
  • Removal of influenza data field
  • Removal of staffing and supply shortages data fields
  • Removal of deaths in the Staff and Personnel Impact Pathway
  • Removal of the therapeutics pathway
  • Addition of a new data field, hospitalizations, in the Resident Impact and Facility Capacity Pathway to assess relevant outcome data on residents with a positive COVID-19 test.

New Updates to the NHSN LTCF COVID-19 Module Surveillance Pathways Webinars

Specific details regarding these changes will be reviewed during upcoming training webinars.

Registration Information for Upcoming Training Webinars

Please register in advance and plan to attend one of the training sessions to learn more about the new updates. Each webinar will cover the same information; therefore, you may only need to attend once.

When: Thursday, June 1, 2023, 02:00 PM Eastern Time (US and Canada)
Topic: New Updates to the NHSN LTCF COVID-19 Module Surveillance Pathways
Register in advance for this webinar: https://cdc.zoomgov.com/webinar/register/WN_lQ92SJReSe6gu3RlRbiqaA

When: Wednesday, June 7, 2023, 01:00 PM Eastern Time (US and Canada)
Topic: New Updates to the NHSN LTCF COVID-19 Module Surveillance Pathways
Register in advance for this webinar: https://cdc.zoomgov.com/webinar/register/WN_WO7zz66lSwyFGUfEx2bU7g

When: Thursday, June 8 & Thursday June 13, 2023, 02:00 PM Eastern time (US & Canada)
Topic: New Updates to the NHSN LTCF COVID-19 Module Surveillance Pathways
Register in advance for this webinar: https://cdc.zoomgov.com/j/1605578239?pwd=TWxwb202WW9tSUpoTi9aVWRNZXBUQT09

After registering, you will receive a confirmation email containing information about joining the webinar.

For questions about any of these updates, please send an e-mail to the NHSN Helpdesk at NHSN@cdc.gov with the subject line identifying the topic of the message.

SNF MDS 3.0 RAI v1.18.11 Guidance Training Program

REGISTRATION OPEN: The SNF MDS 3.0 RAI v1.18.11 Guidance Training Program

The Centers for Medicare & Medicaid Services (CMS is offering a virtual training program that provides instruction on the updated guidance for the Skilled Nursing Facility (SNF) Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) v1.18.11 Manual and Item Set. This training is part of a comprehensive strategy to ensure SNF providers have access to the educational materials necessary to understand and comply with the guidance changes. This guidance will affect reporting requirements associated with the SNF Quality Reporting Program (QRP) that will go into effect on October 1, 2023. A major focus of this training will be on the cross-setting implementation of the standardized patient assessment data elements to ensure more consistent reporting and evaluation across post-acute care settings.

The training program consists of two parts:

Part 1: LEARN Part 1 consists of pre-recorded training webinars that deliver foundational knowledge to assist in learning the new and/or revised items and associated guidance. A supplemental Capstone Case Study is also available to give providers additional practice in coding the new and/or revised items. These videos are intended to be viewed in advance of the Part 2 live event and are available now on CMS YouTube.

Part 2: PRACTICE Part 2 includes the live, virtual workshop sessions that provide practice coding scenarios on select data elements covered in the Part 1 training webinars. These live sessions will take place on June 21 between 12:30 p.m. and 5 p.m. ET. Registration is open and can be completed online through Zoom.

Additional training resources are located within a ZIP file in the Downloads section of the SNF Quality Reporting Program (QRP) Training page. These resources include an acronym list, Action Plan worksheet, Case Study documents, resource guide, and PDF versions of the training webinars.

If you have questions regarding access to the resources or feedback related to the training, please email the PAC Training Mailbox. Content-related questions should be submitted to the SNF QRP Help Desk.

VOYCE’s Upcoming Resident’s First Conference

June 15, 2023: Residents First Long-Term Care Conference
Location: St. Louis University’s Margaret McCormick Doisy LRC, St. Louis

Join VOYCE in recognizing the St. Louis region on World Elder Abuse Awareness Day for the Residents First Conference! VOYCE is a nonprofit organization that empowers and educates individuals and their families for quality living across the long-term care continuum. This year the focus will be on Residents First by providing attendees with vital information to support and inspire their journey as long-term care professionals.

VOYCE is determined to deliver education, empowerment, and advocacy so families can make informed decisions for long-term care. By working alongside professionals providing services, we can ensure residents are informed of their rights while living safely and with dignity.

Important DHSS Update on PPE and Test Kit Supplies

Notice for Non-State Agency Healthcare Partners: The DHSS PPE Warehouse will end distribution of PPE items from the state cache on June 30, 2023.

This change comes as the federal public health emergency comes to end today, May 11, the supply chain has stabilized resulting in adequate stock at suppliers, and COVID cases/outbreaks trend downward. The State of Missouri plans to maintain a PPE cache for future public health emergencies and enhance overall healthcare preparedness. Facilities should prepare for June 30th by working with multiple vendors to procure supplies and maintain adequate stock that accounts for potential order or allocation delays. DHSS will continue to ship COVID antigen test kits and COVID/FLU antigen test kits as requested. For questions related to the end of PPE shipping, please reach out to sns@health.mo.gov.

American Rescue Plan Act (ARPA) Funding Opportunity for RCFs and ALFs

It’s not too late! The Department of Health and Senior Services (DHSS) is still accepting applications for ARPA reimbursement to operators of Residential Care Facilities (RCFs) and Assisted Living Facilities (ALFs) who have not yet applied. Through Missouri’s State Fiscal Recovery Funds, operators may seek reimbursement for expenses incurred between April 1, 2021 and March 31, 2022 that were directly related to preparing, preventing, and responding to the COVID-19 pandemic.

If you operate an RCF or ALF and haven’t already applied for this funding opportunity, please ensure you are registered as a vendor to receive payment from the State of Missouri. Before operators can complete an application for this opportunity, they must register as a vendor with the state’s financial system – SAM II. If the operating entity is already registered as a vendor with the State of Missouri, you do not need to re-register.

The SAM II registration Vendor Input Form can be found at https://oa.mo.gov/sites/default/files/vendor_input_ach_eftd.pdf. The completed Vendor Input Form must be sent directly to the Office of Administration by fax at 573-526-9813 or by mail to Office of Administration/Accounting, PO Box 809, Jefferson City, MO 65102.

Operator Tips in Registering as a Vendor with the State of Missouri:

  • Be sure to register only the legal operating entity and not all individual facilities owned by the same operating entity.
  • Be sure the address used in the State’s financial system is the same address that will be used as the operator’s address on the application and any accounts payable documentation.

Once SAM II registration is submitted, an application for reimbursement must be submitted through the State of Missouri’s American Rescue Plan Act (APRA) Portal located at https://moarpa.mo.gov/. Frequently Asked Questions and an Application Checklist can be found on the “Apply Now” page under the “Operators of Residential Care / Assisted Living Facilities” Grant Program. Requests for additional information about this opportunity should be submitted to LTCARPAReimbursements@health.mo.gov.

Funding for this initiative has been made available through the American Rescue Plan Act (ARPA). Missouri’s ARPA funding opportunities are located here: https://moarpa.mo.gov/available-funding-opportunities/.

2023 SLCR Annual Provider Meetings

Sponsored by the Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation

Advanced registration is not required. There is no cost to attend any of these meetings. Please see the flyer.

Earn up to 6 CEUs (3 Admin/3 PC).

September 6, 2023: Region 7
Location: Crowne Plaza St. Louis Airport, Bridgeton

September 7, 2023: Region 2
Location: Drury Plaza Hotel & Convention Center, Cape Girardeau

September 13, 2023: Region 1
Location: Oasis Hotel & Convention Center, Springfield

September 14, 2023: Region 6
Location: Special Olympics Missouri, Jefferson City

September 27, 2023: Region 5
Location: Moberly Municipal Auditorium, Moberly

October 4, 2023: Region 4 Agenda
Location: Stoney Creek Hotel, St. Joseph

October 5, 2023: Region 3 Agenda
Location: Adams Pointe Conference Center, Blue Springs

Handouts
Handouts will not be provided at the meetings. You may choose to either have them available during the meeting on an electronic device or print them.

1. Quality Improvement and Evaluation System (QIES), Certification and Survey Provider Enhanced Reports (CASPER) & SNF Quality Reporting Program (QRP)
2. Free from Abuse & Neglect – Peeling back the Regulatory Layers for Investigating and Reporting Abuse
3. Section Update
4. Oral Health for Older Adults
5. Guardians, Resident Rights, DPOAs, and Discharges
6. Emergency Preparedness
7. Environmental Considerations in LTC
8. Artifacts of Culture Change – More than a Measurement Tool