Missouri Long-Term Care Information Update

MANHA Seminar

Born Naked: Rethinking Behavior Management in Long-Term Care

October 3, 2023: Oasis Hotel, Springfield
October 11, 2023: Macon Comfort Inn, Macon
October 26, 2023: Ameristar Casino, St. Charles

Presenters: Wendy Boren, RN, BSN, QIPMO and Crystal Plank, RN, BSN, RAC-CTA, QIPMO

It’s time to bring behavior management into the future. As the population demographics of our residents shifts and our need to meet census increases, it’s time to look beyond the traditional roles of managing behaviors in our homes. This workshop will focus on getting to the root of behaviors based on where they started; how to manage those behaviors in a diagnosis-driven focused treatment regimen; and performing an assessment of your facility and services in order to appropriately meet behavioral health needs.

2023 Care of the Older Adult

November 3-4, 2023: 2023 Care of the Older Adult
In-Person Location: MU School of Medicine, Columbia
Live Virtual: EventsAir

Health care providers need the opportunity to gain knowledge in interdisciplinary approaches to clinical management and ethical treatment of older adults. This conference provides a forum to discuss complex care issues common to all who care for the older adult, and an awareness of innovative models of geriatric care delivery. The focus is on promoting excellence in gerontology health care by keeping abreast of the latest evidence-based practice.

COVID Rise in LTC Facilities

COVID infections are on the rise in Missouri’s long-term care facilities. A few things to remember…

Follow CDC Guidance:

Skilled Nursing Facilities: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhcp%2Flong-term-care.html

  • Place a patient with suspected (e.g., those with runny nose, cough, sneeze) or confirmed SARS-CoV-2 infection in a single-person room. The door should be kept closed (if safe to do so). Ideally, the patient should have a dedicated bathroom. If cohorting, only patients with the same respiratory pathogen should be housed in the same room.

Residential Care and Assisted Living may follow community guidance – https://www.cdc.gov/coronavirus/2019-ncov/your-health/covid-by-county.html?CDC_AA_refVal=h

Report Positive Cases

Facilities performing their own COVID-19 testing (antigen testing) must report positive results through one of the following portals:

  1. Missouri Disease Reporting Online Portal (MODROP)
  2. In bulk via HL7 or CSV file using the DHSS- Electronic Lab Reporting process
  3. National Healthcare Safety Network (NHSN) or the Association of Public Health Laboratories (APHL) Informatics Messaging Services (AIMS) Platform.

Facilities using an external laboratory (PCR testing) must enter positive case information into MODROP.

The Missouri Disease Reporting Online Portal (MODROP). MODROP can be accessed directly from https://modrop.health.mo.gov/ or by using the existing ECD-1 link at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/case-reporting.php and selecting the MODROP button.

NOTE: The recommended browser for use of MODROP is Google Chrome. Other browsers may cause issues with MODROP.

Facilities will need to register for a MODROP account the first time they use the new portal. MODROP allows reporting of only COVID-19 cases. Reports of other reportable conditions may be faxed to 573-751-6417.

If you have any questions or encounter any issues utilizing MODROP or for questions about HL7 or CSV reporting, please reach out to the EpiTrax Help Desk via e-mail at epitrax@health.mo.gov.

Please see the FAQ and thank you for your efforts to provide complete and accurate COVID-19 data to public health.

The ICAR Team Can Help!

QIPMO has formed an Infection Control and Assessment and Response (ICAR) team with a primary goal to assist Missouri Long-Term Care Facilities navigate the challenges of the COVID-19 pandemic and other infectious diseases.

Members of the ICAR Team are available for voluntary, no cost visits (virtual and/or in-person) to any residential care, assisted living, and skilled nursing facility in Missouri. These visits are intended to consultative and collaborative in nature with a non-regulatory focus to evaluate inflection control practices. Visits will consist of:

  • completion of a standardized assessment of infection control processes, focusing on highly-transmittable infectious diseases
  • observations of infection control practices
  • preliminary feedback with supplemental educational resources

See flyer for full details.

2023 Health Ethics Conference

October 5, 2023: MU Ethics of Equity and Inclusivity in Healthcare
In-person: Stoney Creek Hotel, Columbia, MO
Live Virtual: EventsAir virtual conference platform

Health inequities lead to poorer health outcomes among people of color, low-income families, non-cisgender, and families living in rural communities. This year’s conference will focus on navigating ethical questions surrounding a move towards creating more inclusive healthcare environments and closing equity gaps that unduly impede access to quality care. Participants will explore how to optimize ethical response at the bedside as well as cultivate educational experiences that prepare future clinicians to care for diverse patient populations in real-world settings.

FREE Resource! Center of Excellence for Behavioral Health In Nursing Facilities

The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) was established in September 2022 by the Substance Abuse and Mental Health Services Administration (SAMHSA) in collaboration with the Centers for Medicare and Medicaid Services (CMS). It provides mental health and substance use training, customized technical assistance and resources to certified Medicare and Medicaid nursing facility staff who care for residents with a variety of behavioral health conditions at absolutely no cost to certified nursing facilities. They help nursing facilities to improve the quality of life and care provided for residents who are experiencing a variety of behavioral health disorders, with a focus on Serious Mental Illness (SMI), Substance Use Disorder (SUD), Co-Occurring Disorders (COD) and Serious Emotional Disturbance (SED).

Online resources are also available free for other providers too! Find out more: Home – COE-NF (nursinghomebehavioralhealth.org)

Improving Resident Relationships in Long-Term Care (IRRL): A Train-the-Trainer Opportunity

The IRRL is an evidence-based intervention to prevent resident-to-resident aggression (RRA). The program educates staff on recognizing and managing behaviors. It empowers staff to help prevent RRA to create a safer community for residents and reduce staff stress.

Join to learn the tools needed to support staff to recognize, manage, and reduce negative resident interactions.

September 27, 2023: https://bit.ly/IRRLsep27session
September 28, 2023: https://bit.ly/IRRLsep28session

Please see the flyer for more details.

The SNF MDS 3.0 RAI v1.18.11 Guidance Training Program

Post-event materials are now available for the SNF MDS 3.0 RAI v1.18.11 Guidance Training Program.

Available Resources:

  • The recordings of the Part 1 pre-recorded training webinars and the Part 2 live, virtual coding workshop sessions are available on CMS YouTube.
  • See “2023_May_SNF Guidance Training Program_Part 1 (ZIP)” in the Downloads section of the SNF QRP Training page for Part 1 training materials.
  • See “2023_May_SNF Guidance Training Program_Part 2 (ZIP)” in the Downloads section SNF QRP Training page for Part 2 training materials.
  • See “2023_May_SNF Guidance Training Program_Supplemental Materials (ZIP)” in the Downloads section SNF QRP Training page for supplemental training materials.
  • See “2023_August_SNF Guidance Training Program_Q&A” in the Downloads section of the SNF QRP Training This document contains responses to questions asked throughout the training program.

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

Call for Nominations for MC5 Board

Do you share MC5’s vision of supporting a continuum of adult care in Missouri that is satisfying, individually meaningful, and person centered, striving toward person directed?

Would you like to be a part of the team working to make this vision a reality for providers and advocates of aging services in Missouri?

Consider joining the board of MC5. Nominations for board positions are open through September 1, 2023.

To submit your name for consideration, send your resume along with responses to the following questions to MissouriMC5@gmail.com.

  • What does MC5’s mission mean to you, and how do you see yourself contributing to it?
  • What relevant experience and skills do you bring to the MC5 board?
  • What do you believe providers need from MC5?

HQIN Vaccination Campaign

In our continued effort to support the well-being of older adults, the Health Quality Innovation Network (HQIN) has launched a campaign to promote and increase adult vaccinations (including the COVID-19 vaccine) that are proven to lower the risk of illness, hospitalization and death.

The “Your Health Can’t Wait, Vaccinate!” campaign features a variety of free resources to help encourage community members, healthcare providers and older adults to get and stay current with their vaccinations. These resources include social media messaging (images and sample posts), informational pocket cards, customizable letters, sample email signatures and flyers.

Bookmark the HQIN Resource Center and visit often to access the latest additions. New tools are added as information becomes available from nationally recognized agencies and organizations (CDC, ACIP, etc.).

Please join us in spreading the word about lifesaving vaccines. Attached is a sample newsletter article that can be used in electronic or print communications, or even on your organization’s website.

Administrator Update Information Changes

New Rule Change – effective 06/30/23

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

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

Please visit https://health.mo.gov/bnha/contactupdate.php for the online form for BNHA.

Please note: The Board of Nursing Home Administrators and the Section for Long Term Care Regulation (SLCR) each have requirements for reporting a Change of Administrator/Manager in a Long Term Care Facility. Please be sure to follow the requirements for each Section.

For SLCR, please submit the change of administrator or manager via a letter or by using the online form. Forms/letters can be submitted via email to LTCApplication@health.mo.gov or by mail to Department of Health and Senior Services, Section for Long-Term Care Regulation, Licensure and Certification Unit, PO Box 570, 920 Wildwood, Jefferson City, MO 65102.

VOYCE’s Upcoming Education Events

VOYCE Community Education Series

September 19, 2023: Guidance on Guardianship and Public Administration
October 17, 2023: Dealing with Dementia: When is it Time to Take the Keys Away?
November 16, 2023: Put Yourself First While Planning the Last Chapter
December 12, 2023: Aging in Place Part 1: What’s in it for Me?
January 16, 2023: Aging in Place Part 2: Comparing Programs and Financials

VOYCE believes it is essential for long-term care residents, their loved ones, and the professionals who care for them to have up-to-date knowledge on topics affecting their community. That is why VOYCE’s Education Program is vital to fulfilling its mission. VOYCE provides free education to empower individuals and families to make better-informed decisions about the continuum of care and better understand those personally and professionally connected to aging adults. Join VOYCE for free webinars monthly on imperative topics affecting individuals and their families across the continuum of care.

 

August 30, 2023: For the Love of Quality Care: Implementing Innovative Education

Advocates for quality care, caregivers, family and friends, and aging care professionals; this webinar is truly for everyone! Training and education on dementia, meaningful activities, and person-centered care should be practice-focused and brief. Join VOYCE to learn about the practice videos and modules available and how to disseminate them, and you’ll be one step closer to ensuring quality care for all! Saint Louis University’s Geriatric Workforce Enhancement Program, along with Memory Care Home Solutions, has developed brief practice videos and modules on topics important for professionals in long-term care and other care settings. They include topics like loneliness and isolation, polypharmacy, infection, meaningful activities, geriatric assessment, dementia, and more. This presentation will provide insight into the use of these resources and the positive impact they have on training and outcomes for consumers. This event is free and open to all who are interested.

 

October 10, 2023: Summit to Protect Older Adults and Adults with Disabilities

VOYCE will host a series of four stakeholder summits to hear from the community and professional stakeholders about their experiences with Missouri’s abuse response system. October’s summit is the second in the series. The summits are open to everyone, as we are all stakeholders in responding to abuse, neglect, and exploitation. We hope to use this time to gather pain points from the community and learn how the system can be improved. The input received from the Stakeholders Summit will be used to create our final project- a strategic plan for restructuring and improving the system. Please register in advance to join.

 

October 12, 2023: Professional Development: Residents’ Rights Regarding Sex and Intimacy

Sexual rights are human rights at all stages of life. This presentation will shed light on the challenges older adults face regarding sexuality, including physical changes, personal and societal stigmas around older adults’ sexual activity, isolation, changes in brain functioning, and the loss of a partner. Those who provide services must understand their role in treating sexual expression as a right and serving all patients holistically and with dignity.

Last Call for Strike Team and Infrastructure Reimbursement Applications

Last Call for Applications – Missouri Nursing Facility Strike Team and Infrastructure Reimbursement Opportunity

This is the last call for new applications from Long Term Care and Skilled Nursing Facilities in Missouri to receive reimbursement funding from the Missouri Nursing Facility Strike Team and Infrastructure Reimbursement opportunity. Applications will be accepted up to August 31, 2023 for COVID expenses incurred between July 1, 2022 and August 31, 2023.

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.

To apply for this reimbursement opportunity and more information on this grant can be found on the Health Care Professionals page on the DHSS website in the Information for Long-Term Care Facilities tab.

Questions and concerns can be sent to LTCStrikeTeam@health.mo.gov.

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 4/1/23 through 6/30/23 is due August 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

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 August 15, 2023:

  • MDS data for 1/1/23 through 3/31/23;
  • NHSN data for COVID-19 Vaccination Coverage Among Healthcare Personnel for 1/1/23 through 3/31/23;

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

VOYCE’s Upcoming Education Events

August 30, 2023: For the Love of Quality Care: Implementing Innovative Education

Advocates for quality care, caregivers, family and friends, and aging care professionals; this webinar is truly for everyone! Training and education on dementia, meaningful activities, and person-centered care should be practice-focused and brief. Join VOYCE to learn about the practice videos and modules available and how to disseminate them, and you’ll be one step closer to ensuring quality care for all! Saint Louis University’s Geriatric Workforce Enhancement Program, along with Memory Care Home Solutions, has developed brief practice videos and modules on topics important for professionals in long-term care and other care settings. They include topics like loneliness and isolation, polypharmacy, infection, meaningful activities, geriatric assessment, dementia, and more. This presentation will provide insight into the use of these resources and the positive impact they have on training and outcomes for consumers. This event is free and open to all who are interested.

 

October 10, 2023: Summit to Protect Older Adults and Adults with Disabilities

VOYCE will host a series of four stakeholder summits to hear from the community and professional stakeholders about their experiences with Missouri’s abuse response system. October’s summit is the second in the series. The summits are open to everyone, as we are all stakeholders in responding to abuse, neglect, and exploitation. We hope to use this time to gather pain points from the community and learn how the system can be improved. The input received from the Stakeholders Summit will be used to create our final project- a strategic plan for restructuring and improving the system. Please register in advance to join.

 

Monoclonal Antibody and Oral Antiviral Treatment of COVID in Nursing Homes

The American Medical Association has released information related to use of Monoclonal Antibody and Oral Antiviral Treatment of COVID in Nursing Homes. The study shows that although oral antiviral use has been found to be greater in nursing homes than the community, overall use among nursing home residents has been low and may not be commensurate with residents’ elevated risk. See the attached information from the AMA and this article from US News.

Nursing Homes Used COVID Meds Less Than Expected During Pandemic (usnews.com)

Solving our Workforce Challenges by Successfully Recruiting and Retaining Immigrant Healthcare Staff

August 23, 2023: Solving our Workforce Challenges by Successfully Recruiting and Retaining Immigrant Healthcare Staff
Presenters: Bill Lowe, President & CEO, Chicago Methodist Services; Chona Lucila, John Knox Village; and Joe Mulligan, Managing Director, Cain Brothers

With the workforce crisis continuing and our aging population growing, organizations are having to look beyond our borders to find the caregiving workers needed. Please join LeadingAge during this webinar to learn how visa-acquired healthcare workers are an answer and how you may become involved in recruiting and retaining them within your organization. Hear trends and data about the workforce shortage impact, forecast, and what you can do to weather the storm. This session will cover various work visa categories and the employer-sponsored visa application process.

2023 MALA Fall Conference

October 15-17, 2023: Smooth Cruising with MALA
Location: Margaritaville, Osage Beach

The conference agenda and registration is now available and includes several speakers and presentations over a three-day period. The option to attend all or just one day is included on the registration form.

Please see the conference link for further details.

COMRU Survey Access Code

COMRU is providing the following guidance regarding the online application entitled “Application started prior to 07-16-2023” (the green link).

COMRU will be providing you with a “Survey Access Code”; please note this is different from the return code.

  • The “Survey Access Code” will allow the submitter to access the application to check the status.
  • If the submitter clicks “Submit- Ready for Processing by COMRU” or “Save and Return Later”, the submitter will be provided with a “Return Code”. At this point, the “Survey Access Code AND the “Return Code” will be needed to access the application in the future.
  • Please do not click the “Start Over” button, as this will DELETE the Entire Application. (COMRU will not be able to retrieve the application if this occurs).

Please do not hesitate to contact COMRU at 573-522-3092 for any questions.

Missouri Nursing Facility Strike Team and Infrastructure Reimbursement Opportunity

The Strike Team has made an informative webinar for SNF/LTC and Other facilities describing the Missouri Nursing Facility Strike Team and Infrastructure Reimbursement Opportunity. This webinar reviews; how to get to the site where they can find the application, the Application Guidance and Frequently Asked Questions, steps needed to apply, and other useful information. This webinar has been posted to the Health Care Professionals page on the DHSS website.

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.