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QIPMO Monthly Webinar Recording – recording and handouts available for download If you missed the webinar on Sepsis, the recording and handouts are now available to review! Recording | Handouts **IMPORTANT INFORMATION FOR MO LNHAs WHO ATTENDED THE WEBINAR***The automated GoToWebinar “thank you for attending” email that you will receive has a...

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QIPMO has updated our Infection Preventionist Zip Kit! Download the latest version (February 2024) HERE!!!

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QIPMO Monthly Webinar Recording – recording and handouts available for download If you missed the webinar on Involuntary Discharges – Rules, Regulations, and Strategy, the recording and handouts are now available to review! Recording | Handouts **IMPORTANT INFORMATION FOR MO LNHAs WHO ATTENDED THE WEBINAR***The automated GoToWebinar “thank you for attending” email...

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 In December 2021, FDA authorized Paxlovid for emergency use for the treatment of adults and pediatric patients (12 years of age and older weighing at least 40 kg) who are at high risk for progression to severe COVID-19, including hospitalization or death. In May 2023, FDA approved Pfizer’s new...

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IN THIS ISSUE Click HERE for the newsletter! February 2024

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IN THIS ISSUE Click HERE for the newsletter! November 2023

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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...

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CMS is committed to reinvesting civil money penalty (CMP) funds for projects to support the quality of care and life for nursing home residents in a consistent and equitable manner. Therefore, we are revising the structure of the CMP Reinvestment Program (CMPRP), including: Allowable Uses of CMP projects –...

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Revisions to the Special Focus Facility (SFF) Program (9/27/23). Click HERE to access the full QSO.

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Memorandum Summary Access the document HERE.

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Connecting Communities to Substance Use Services: Practical Approaches for First Responders This guide includes evidenced-based strategies and resources that first responder agencies, their partners and communities can use to link people who use drugs (PWUD) to substance-use services. The guide also examines things to consider when implementing approaches to...

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Promote infection control and prevention among nursing home staff with this poster to encourage and recognize Hand Hygiene Heroes. Click HERE for the flyer from TMF.

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How long are you contagious with flu, COVID-19, pneumonia or RSV? Nursing homes can use this football-themed flyer to promote reasons for fall immunizations. Click HERE for the flyer from TMF.

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September 8, 2023 – The PDF file labeled “MDS3.0RAIManualv1.18.11R.Errata.September.8.2023” 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 pages in Chapter 4 of the MDS 3.0 RAI Manual version (v)1.18.11R that better align the...

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MO HealthNet has decided it will NOT opt-in to the OSA on October 1, 2023. MHD made their decision not to opt-in to the OSA based on data analysis, the state’s intended timeline to transition to PDPM, MHCA feedback, and individual provider feedback. From our friends at MHCA: “The...

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Builds on President Biden’s Historic Commitment to Create a Long-Term Care System Where People Can Live with Dignity Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), issued a proposed rule that seeks to establish comprehensive staffing requirements for...

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CMS: SNF QRP Provider Training – Questions From June 2023 Guidance Training Program Click HERE to access the document. Current as of August 2023

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HQIN Stakeholder Newsletter Article Vaccination Campaign Encourages Everyone to Put Their Health FirstTo promote and increase adult vaccinations, and celebrate August asNational Immunization month, Health Quality Innovators (HQI) haslaunched the Your Health Can’t Wait, Vaccinate! campaign.As the CMS-designated Quality Innovation Network-Quality ImprovementOrganization for Missouri, HQI collaborates with healthcare providers...

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IN THIS ISSUE Click HERE for the newsletter!

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Skilled Nursing Facility 5-Claim Probe and Educate Review, Targeted Probe and Educate (TPE) CMS Info Page | CMS Q&As

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QIPMO Monthly Webinar Recording – recording and handouts available for download If you missed the webinar on Trauma Informed Care, the recording and handouts are now available to review! Recording | Handouts **IMPORTANT INFORMATION FOR MO LNHAs WHO ATTENDED THE WEBINAR***The automated GoToWebinar “thank you for attending” email that you will...

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Memorandum Summary Click HERE for the full memo.

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Frequently Asked Questions Prospective Reimbursement Plan for Nursing Facility and HIV Nursing Facility Services SFY 2023 | Effective 7/1/2022 Reimbursement Methodology Implementing Acuity Adjustments and Value-Based Purchasing Click HERE for the document.

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QIPMO Monthly Webinar Recording – recording and handouts available for download If you missed the webinar on PHE Updates, Info, and Resources, the recording and handouts are now available to review! Recording | Handouts **IMPORTANT INFORMATION FOR MO LNHAs WHO ATTENDED THE WEBINAR***The automated GoToWebinar “thank you for attending” email that...

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QIPMO Monthly Webinar Recording – recording and handouts available for download If you missed the webinar on What’s Special About Special Focus?, the recording and handouts are now available to review! Webinar Recording | Slides | Toolkit **IMPORTANT INFORMATION FOR MO LNHAs WHO ATTENDED THE WEBINAR***The automated GoToWebinar “thank you...

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Memorandum Summary Click HERE for the full QSO.

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Summary of Recent Changes Updates as of May 8, 2023 Access the information HERE.

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On April 4, 2023, the Centers for Medicare & Medicaid Services (CMS) posted the Fiscal Year (FY) 2024 Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule for public inspection. The payment news is good—a 3.7 percent ($1.2 billion) aggregate increase in fee-for-service (FFS) Medicare Part A payments...

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QIPMO Monthly Webinar Recording – recording and handouts available for download If you missed the webinar on Addressing the Impact of Restorative Programming on your Case Mix, the recording and handouts are now available to review! Webinar Recording | Handouts **IMPORTANT INFORMATION FOR MO LNHAs WHO ATTENDED THE WEBINAR***The automated GoToWebinar “thank...

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Apr 03, 2023 What to Expect with the Minimum Data Set (MDS) Transition to iQIES on April 17, 2023 On April 17, 2023, the Centers for Medicare & Medicaid Services (CMS) will transition to the Internet Quality Improvement and Evaluation System (iQIES) for Minimum Data Set (MDS) record submissions and...

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QIPMO Monthly Webinar Recording – recording and handouts available for download If you missed the webinar on Clinical Considerations for Improving Rehospitalizations and ER Visits in LTC, the recording and handouts are now available to review! Webinar Recording | Handouts **IMPORTANT INFORMATION FOR MO LNHAs WHO ATTENDED THE WEBINAR***The automated GoToWebinar...

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IN THIS ISSUE Click HERE for the newsletter! February 2023

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QIPMO Monthly Webinar Recording – recording and handouts available for download If you missed the webinar on Oh No-Not Again! Taking a Fresh Look at Your Fall Prevention Program, the recording and handouts are now available to review! Webinar Recording | Handouts **IMPORTANT INFORMATION FOR MO LNHAs WHO ATTENDED THE WEBINAR***The...

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DHSS will pause shipping operations on January 31, 2023 for up to 30 days to complete inventory and transition warehouse operations to a new platform. PPE Optimization for PPE and Flow Flex Antigen Test Kits will need to be placed prior to January 27, 2023 for shipment on January...

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Memorandum SummaryQuality in Focus: CMS developed a series of short (10–15 minutes), Quality in Focus interactive videos tailored for specific provider types. The series aims to increase the quality of care for people with Medicare and Medicaid by reducing the deficiencies most commonly cited during the CMS survey process,...

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Memorandum SummaryAdjusting Quality Measure Ratings: CMS will be conducting audits of schizophrenia coding in the Minimum Data Set data and, based upon the results, adjust the Nursing Home Care Compare quality measure star ratings for facilities whose audits reveal inaccurate coding.Posting Citations Under Dispute: To be more transparent, CMS...

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A Collaboration Between MO DHSS and QIPMO As many of you may know, the Quality Improvement Program for Missouri’s Nursing Homes (QIPMO) partnered with the Missouri Department of Health and Senior Services (MO DHSS) in response to the novel Coronavirus known as COVID-19. In doing so, an Infection Control...

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QIPMO Monthly Webinar Recording – recording and handouts available for download If you missed Monday’s webinar on How Well Do You Know Your Residents, the recording and handouts are now available to review! Webinar Recording | Handouts **IMPORTANT INFORMATION FOR MO LNHAs WHO ATTENDED THE WEBINAR***The automated GoToWebinar “thank you for...

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IN THIS ISSUE Click HERE for the newsletter! November 2022

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QIPMO Monthly Webinar Recording – recording and handouts available for download If you missed Monday’s webinar on MDS Survey Tags, the recording and handouts are now available to review! Webinar Recording | Handouts **IMPORTANT INFORMATION FOR MO LNHAs WHO ATTENDED THE WEBINAR*** The automated GoToWebinar “thank you for attending” email that...

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CDC Releases Updates to COVID-19 Infection Prevention and Control Guidance The CDC today released updates to three guidance documents now available on its website. AHCA has provided a high-level summary of the changes and linked to each guidance for additional information. Many of these changes reflect the tireless work...

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QSO-20-38-NH UPDATED CMS is committed to taking critical steps to ensure America’s healthcare facilities continue to respond effectively to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE). On August 25, 2020, CMS published an interim final rule with comment period (IFC). This rule establishes Long-Term Care (LTC) Facility...

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QIPMO Monthly Webinar Recording – recording and handouts available for download If you missed Monday’s webinar on ADLs, UTIs, Antipsychotics, Ability to Move, the recording and handouts are now available to review! Webinar Recording | Handouts **IMPORTANT INFORMATION FOR MO LNHAs WHO ATTENDED THE WEBINAR*** The automated GoToWebinar “thank...

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September 1, 2023 NOW AVAILABLE-Draft Nursing Home Comprehensive (NC) Item Set The draft Minimum Data Set (MDS) Nursing Home Comprehensive (NC) Item set version 1.18.11 is now available HERE. CMS plans to release the final version of the MDS Item Sets later in 2022, which will be effective beginning...

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Guidance for codes used with Federal Regulatory Groups for Long Term Care Facilities. This F-Tag listing has the regulations with the June 2022 changes highlighted in yellow. See the full document HERE.

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QIPMO Monthly Webinar Recording – recording and handouts available for download If you missed Monday’s webinar on QMs/Five-Star, the recording and handouts are now available to review! Webinar Recording | Handouts **IMPORTANT INFORMATION FOR MO LNHAs WHO ATTENDED THE WEBINAR*** The automated GoToWebinar “thank you for attending” email that...

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IN THIS ISSUE Another Gem Added Monkeypox ICAR Corner Coming Soon… New Surveyor Guidance And more!! Click below to access the full newsletter! MDS Tips and Clinical Pearls (Volume 9, Issue 4)

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The full errata document (effective July 15, 2022) can be found HERE!

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Rescission of the January 25, 2022 memo regarding Vaccination Expectations for Surveyors Performing Federal Oversight (QSO-22-10-ALL) and removal from its guidance repository CMS is rescinding and hereby removing the January 25, 2022 Memo regarding Vaccination Expectations for Surveyors Performing Federal Oversight (QSO-22-10-ALL) from HHS’s guidance repository. Read the full...

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Surveys for compliance with Omnibus COVID-19 Health Care Staff Vaccination Requirements (QSO-22-17-ALL) CMS is committed to taking critical steps to protect vulnerable individuals to ensure America’s health care facilities are prepared to respond to the Coronavirus Disease2019 (COVID-19) Public Health Emergency (PHE). Survey oversight of the staff vaccination requirement...

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The University of Missouri has developed an ECHO to support providers and administrators at PAC/LTC facilities and organizations. This new PAC/LTC ECHO establishes a virtual learning community to promote delivery of high-quality, evidence-based care that improves patient health outcomes. The ECHO’s collaborative and interactive online learning sessions focus on...

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MLN article on the Medicare FFS response to the PHE on COVID-19. This MLN Matters® Special Edition Article is for physicians, providers and suppliers who bill Medicare Fee-for-Service (FFS). You can find the document HERE! Originally released 9/21; updated 4/22.

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NASEM’s National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff full report has been released! The Committee on the Quality of Care in Nursing Homes began their work in the fall of 2020 at a pivotal time when a bright light had been...

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QIPMO Monthly Webinar Recording – recording and handouts available for download If you missed Monday’s webinar on The MDS – I Have to Do What?, the recording and handouts are now available to review! Webinar Recording  |  Handouts **IMPORTANT INFORMATION FOR MO LNHAs WHO ATTENDED THE WEBINAR*** The automated GoToWebinar “thank you for attending” email...

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Update to COVID-19 Emergency Declaration Blanket Waivers (QSO-22-15-NH & NLTC & LSC) Memorandum Summary CMS continues to review the need for existing emergency blanket waivers issued in response to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE). Over the course of the COVID-19 PHE, skilled nursing facilities/nursing facilities...

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Summary of recent changes (last updated October 6, 2023): The updated 2023–­2024 formulation of Novavax COVID-19 Vaccine is recommended for people ages 12 years and older as follows: Initial vaccination: 2 doses of updated (2023–2024 Formula) Novavax COVID-19 Vaccine Previously vaccinated with any Original monovalent or bivalent COVID-19 vaccine...

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Memorandum Summary CMS will begin posting the following information for each nursing home on theMedicare.gov Care Compare website: Weekend Staffing: The level of total nurse and registered nurse (RN) staffing on weekends provided by each nursing home over a quarter. Staff Turnover: The percent of nursing staff and number...

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CMS has released an errata document concerning the non-therapy ancillary (NTA) component of the Patient-Driven Payment Model (PDPM). On pages 6-30 and 6-31, the NTA Comorbidity Score Calculation table needed to be updated to clarify that the presence of any, a combination, or all of Items M1040A, M1040B, and...

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UPDATED – Nursing home surveys are conducted in accordance with survey protocols and Federal requirements to determine whether a citation of non-compliance appropriate. Consolidated Medicare and Medicaid requirements for participation (requirements) for Long Term Care (LTC) facilities (42 CFR part 483, subpart B) were first published in the Federal...

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CMS is committed to taking critical steps to ensure America’s healthcare facilities continue to respond effectively to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE). On August 25, 2020, CMS published an interim final rule with comment period (IFC). This rule establishes Long-Term Care (LTC) Facility Testing Requirements...

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This guidance summarizes the core infection prevention and control practices for nursing homes during the SARS-CoV-2 pandemic. Some of these recommendations can be modified in response to COVID-19 vaccination. Those modifications, which will be regularly updated, are posted in CDC’s Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection...

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NHSN COVID-19 Vaccination Data Collection Forms for Healthcare Personnel will be Revised this fall! What are the changes? Data on the current healthcare personnel categories for question #1 will no longer be collected. New categories will now include: Employees: Staff on facility payroll Licensed independent practitioners: Contracted physicians, advanced...

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Memorandum Summary CMS is hereby removing the July 7, 2017 Memo (S&C 17-37-NH) from its guidance repository. Discussion CMS is hereby removing the July 7, 2017 Memo (S&C 17-37-NH) from its guidance repository. In that memo, CMS instructed CMS Locations (formerly “Regional Offices”) to impose civil monetary penalties for...

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MO DHSS: On Wednesday (7/21/21), we were excited to announce the launch of a statewide COVID-19 vaccination incentive program, MO VIP, to further encourage vaccination among all Missourians age 12 and up. Over the next three months, 900 previously or newly vaccinated Missourians will win cash or education savings account...

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Community Corps Members: Throughout the COVID-19 pandemic, staff in nursing homes have been providing ongoing care to our nation’s most vulnerable. It’s on trusted messengers like you to make sure we’re reaching people who need to be protected from the COVID-19 virus. Building vaccine confidence among Long-Term Care Facility...

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The ETS was officially filed in the Office of the Federal Register on June 17, 2021, and it became effective when it was published on June 21, 2021. OSHA – COVID-19 Healthcare ETS

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DHSS has updated its guidance (HERE) to reflect recent changes to CMS’ visitation guidance and to clarify and provide examples of those considered outside health care workers, which includes hospice workers (all disciplines). The changes include: Visitor Vaccination Status When both the resident and all of their visitors are...

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The COVID-19 pandemic has brought overwhelming grief to many families. At FEMA, our mission is to help people before, during and after disasters. We are dedicated to helping ease some of the financial stress and burden caused by the virus. Under the Coronavirus Response and Relief Supplemental Appropriations Act...

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Updated Guidance from CMS and CDC on Testing, Visitation, and Activities in Response to COVID-19 Vaccination (AHCA/NCAL) The Centers for Medicare and Medicaid (CMS) and the Centers for Disease Control and Prevention (CDC) updated guidance for long term facilities today in response to COVID-19 vaccination. The following key changes...

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Memorandum Summary – Ref: QSO-21-17-NH (4/8/21) CMS continues to review the need for existing waivers issued in response to the Public Health Emergency (PHE). Over the course of the PHE, nursing homes have developed policies or other practices that we believe mitigates the need for certain waivers. Therefore, CMS...

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As COVID-19 vaccines continue rolling out across the country, CMS is taking action to protect the health and safety of our nation’s patients and providers and keeping you updated on the latest COVID-19 resources from HHS, CDC and CMS. With information coming from many different sources, CMS has up-to-date...

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A plan of correction (POC) must be submitted within 10 calendar days from the date the facility receives its Form CMS-2567. According to the State Operations Manual (SOM) §7317, an acceptable POC must: Address how corrective action will be accomplished for those residents found to have been affected by...

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Ongoing Vaccination Efforts These options presented are to allow flexibility for communities to establish the best path forward. There are several decision points that will need to be made in making this decision. The primary decision communities will need to make is which vaccine will be utilized. There are...

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Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes (updated 3/29/21) Summary of Recent Changes Two prior guidance documents, “Responding to COVID-19 in Nursing Homes” and “Performing Facility-wide SARS-CoV-2 Testing in Nursing Homes” were merged with this guidance. The criteria for health department notification was...

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As COVID-19 vaccines continue rolling out across the country, CMS is taking action to protect the health and safety of our nation’s patients and providers and keeping you updated on the latest COVID-19 resources from HHS, CDC and CMS. With information coming from many different sources, CMS has up-to-date...

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On March 10, 2021, the Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), issued updated guidance for nursing homes to safely expand visitation options during the COVID-19 pandemic public health emergency (PHE). CMS has released a graphic to further...

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Listen, Learn, Explore Episode 3: Urinary Incontinence: No, We’re not Kidding, Let’s Talk about It! Dr. Rosemary Laird is a board-certified geriatrician who knows that collaboration and communication are critical to managing intricate issues of aging. She graduated from the Georgetown University School of Medicine. She completed her advanced...

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AMDA – The Society for Post-Acute and Long-Term Care Medicine, is recommending a “measured, stepwise approach” to resuming visitation and group activities in post-acute and long-term care settings while acknowledging gaps in clinical knowledge about COVID-19. “Effective vaccines and therapeutics against COVID-19 are a significant step towards a post-pandemic...

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Direct care workers participating in a new study believe their organizations prepared them to care for residents and clients during the pandemic. A new research brief from the LeadingAge LTSS Center @UMass Boston documents the impact of COVID-19 on direct care workers. COVID-19: Experiences of Direct Care Workers in...

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Nursing Home Resident and Staff COVID-19 Cases After the First Vaccination Clinic A new study from CHPE, as reported by AHCA/NCAL, shows that COVID-19 cases decreased at a faster rate among both residents and staff at nursing homes that had completed their first vaccine clinic, compared to nursing homes...

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Visitation at Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs) and Psychiatric Residential Treatment Facilities (PRTFs) Ref: QSO-21-14-ICF/IID & PRTF CMS is committed to continuing to take critical steps to ensure America’s healthcare facilities are prepared to respond to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE)....

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MHCA’s monthly newsletter last week included many links to COVID vaccine related educational information and websites.  MHCA cannot stress enough how important it is that everyone get vaccinated.  Please continue to educate your staff and residents on the vaccine and do all you can to encourage them to get...

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COVID-19 Vaccines: CDC Long-Term Care Facility Toolkit Click HERE to access

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The Quality Improvement Program for Missouri’s Nursing Homes (QIPMO) is partnering with the Missouri Department of Health and Senior Services (DHSS) in response to the novel Coronavirus known as COVID-19. In doing so, QIPMO has formed a new Infection Control Assessment and Response (ICAR) Team with a primary goal...

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IMPORTANT UPDATES AND LATEST INFORMATION REGARDING MISSOURI’S COVID-19 VACCINATION PROGRAM (MHCA Update 12/11/20) As we reported last week, the roll out of the vaccination program continues to be fluid. We have been working closely with the state throughout the week and will update you on the latest information we...

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QIPMO Selected as a Health Quality Innovator of the Year 2020 Columbia, MO—November 19, 2020—Quality Improvement Program for Missouri (QIPMO), has been recognized as a 2020 Health Quality Innovator of the Year. The Health Quality Innovator Awards are sponsored by the Health Quality Innovators’/Health Quality Innovation Network’s (HQIN) during...

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COVID-19 Vaccine Information This website contains useful facts about the vaccine that may be shared with residents, families and staff: https://covidvaccine.mo.gov/

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The Centers for Medicare & Medicaid Services (CMS) is committed to being transparent with the public about changes in publicly reported information related to long term care facilities (i.e., nursing homes) through the COVID-19 public health emergency (PHE). Changes to the Nursing Home Compare Website and Five Star Quality...

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Health and Human Services (HHS) has provided a list of healthcare staffing agencies that can be considered to fulfill staffing needs. The list includes positions/facilities of focus for each agency including long-term care, nursing, aides, administrative, therapy, etc. Long-term care facilities are not required to utilize agencies on this...

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Federal and State COVID-19 Vaccination Programs (updated 11/6/20) The Federal Government and the Missouri Department of Health and Senior Services have developed COVID-19 vaccination distribution programs and we strongly encourage you to enroll your community in both programs. The federal program focuses on residents and the Missouri program focuses...

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OSHA is committed to protecting the health and safety of America’s workers. This guidance is designed specifically for nursing homes, assisted living, and other long-term care facilities (LTCFs) (e.g., skilled nursing facilities, inpatient hospice, convalescent homes, and group homes with nursing care). LTCFs are different than other healthcare settings...

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CMS’ New One-Stop Nursing Home Resource Center Assists Providers, Caregivers, Residents Today, the Centers for Medicare & Medicaid Services (CMS) launched a new online platform – the Nursing Home Resource Center – to serve as a centralized hub bringing together the latest information, guidance and data on nursing homes...

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Certified Nurse Assistant Testing Changes for December 2020 The Department of Health & Senior Services, Health Education Unit is pleased to announce the implementation of the new CNA testing process in December 2020. We signed an agreement to work with Headmaster D&SDT, who will manage our CNA testing and...

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Regulation Update Notice House Bill (HB) 1387, known as the “Authorized Electronic Monitoring in Long-Term Care Facilities Act” will become law on August 28, 2020. As a result, the Section for Long-Term Care Regulation has drafted emergency and proposed rules based on that legislation. The emergency and proposed rule...

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Electronic COVID-19 Reporting of Point of Care Test Results to DHSS Many long-term care facilities (LTCFs) have received or will receive COVID-19 antigen point of care (POC) testing machines and supplies from the federal government to help facilitate timely testing of residents and facility staff. Through the distribution of...

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Discordant Results between COVID-19 Point of Care Antigen and PCR Tests in Nursing Homes The Center for Health Policy Evaluation in Long-Term Care has issued, “Preliminary Report: Discordant Results between COVID-19 Point of Care Antigen and PCR Tests in Nursing Homes”. Discordant results include situations when an antigen test...

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Compliance with Residents’ Rights Requirement related to Nursing Home Residents’ Right to Vote (CMS Memo: QSO-21-02-NH) Memorandum Summary The Centers for Medicare & Medicaid Services (CMS) is affirming the continued right of nursing home residents to exercise their right to vote. While the COVID-19 Public Health Emergency has resulted...

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COVID-19 Testing Supplies Available – Swabs and Media There are several coordination points that are necessary in order to have a successful testing plan. This includes having access to testing kits (both swabs and media – must have both), the ability to collect the specimens onsite, and establishing an...

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CMS Memo: QSO-20-41-ALL Guidance related to the Emergency Preparedness Testing Exercise Requirements- Coronavirus Disease 2019 (COVID-19) Memorandum Summary Emergency Preparedness Testing Exemption and Guidance – CMS regulations for Emergency Preparedness require specific testing exercises be conducted to validate the facility’s emergency program. During or after an actual emergency, the...

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CMS has created a process to enable states to approve requests to purchase tents for outdoor visitation and/or clear dividers (e.g. Plexiglass or similar product) to create a physical barrier to reduce the risk of transmission during in-person visits. The parameters are detailed in the instructions portion of the...

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The Centers for Medicare & Medicaid Services has issued new guidance for visitation in nursing homes during the COVID-19 pandemic. The guidance lays out a framework for nursing homes to facilitate in-home visitation, Vice President Mike Pence said during a roundtable discussion Thursday. A memo sent today to state...

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QSEP has two new courses available for Long-Term Care staff about COVID-19! One course is geared towards front-line staff, and the other is geared towards management. The courses are: Targeted COVID-19 Training for Frontline Nursing Home Staff Targeted COVID-19 Training for Nursing Home Management Please see more information about...

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House Bill (HB) 1387, known as the “Authorized Electronic Monitoring in Long-Term Care Facilities Act” will become law on August 28, 2020. As a result, the Section for Long-Term Care Regulation has drafted emergency and proposed rules based on that legislation. The emergency and proposed rule sets forth requirements...

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Interim Final Rule (IFC), CMS-3401-IFC, Updating Requirements for Reporting of SARS-CoV-2 Test Results by Clinical Laboratory Improvement Amendments of 1988 (CLIA) Laboratories, and Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (Ref: QSO-20-37-CLIA, NH) CMS is committed to taking critical steps to ensure America’s...

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Today, the Centers for Medicare & Medicaid Services (CMS) announced sweeping regulatory changes that require nursing homes to test staff and offer testing to residents for coronavirus disease 2019 (COVID-19). Laboratories and nursing homes using point-of-care testing devices will be required to report diagnostic test results as required by...

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Today, the Centers for Medicare & Medicaid Services (CMS) released guidance for nursing homes and clinical laboratories to assist in enhancing their abilities to prevent the spread of the coronavirus disease 2019 (COVID-19) to nursing home residents and their front line staff. Nursing homes are particularly vulnerable to the...

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Throughout the COVID-19 response, the Battelle CCDS system has been an important part of lengthening the life of N95 masks, safely. Missouri users will continue to have access to decontamination through Battelle for the foreseeable future, however, some changes are coming for those who use the Battelle CCDS site...

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This toolkit catalogs the many innovative solutions designed at the state level to protect our nation’s vulnerable nursing home residents during the Coronavirus disease 2019 (COVID-19) pandemic. Please see the full document HERE.

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Many long-term care facilities have begun reporting COVID-19 data into the CDC’s NHSN Long-term Care Component. In an effort to have a more complete representation of COVID-19 data for the State of Missouri, we are asking facilities who are not yet reporting (SNF, ICF, ALF, RCF, ICF/IID) to consider...

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Electronic COVID-19 Case Reporting – Now Available (updated 8/12/20) The Department of Health and Senior Services (DHSS) is pleased to announce the availability of Electronic COVID-19 Case Reporting. All entities currently required to complete a Communicable Disease Case Report (CD-1) should begin reporting positive COVID-19 cases via the new...

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A Frequently Asked Questions document is now available on the NHSN LTCF COVID-19 Module website. The document was developed to answer the most common questions received from facility and group users participating in the NHSN LTCF COVID-19 Module. The questions are organized by the four COVID-19 Module pathways, as...

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The Centers for Medicare & Medicaid Services today released its first monthly update of data that provides a snapshot of the impact of COVID-19 on the Medicare population. For the first time, the snapshot includes data for American Indian/Alaskan Native Medicare beneficiaries. The new data indicate that American Indian/Alaskan...

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Thousands of nursing homes across the country will be given “point of care” COVID-19 tests by the administration starting next week, officials announced Tuesday. Access the information HERE.

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The Department of Health and Senior Service has contracted with Healthcare Quality Innovators (HQI) to offer IDR services to Missouri Long Term Care Communities. HQI is Missouri’s designated Medicare Quality Improvement Organization and is based in Richmond, Virginia. HQI staff responsible for the IDR process are familiar faces, as...

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Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19). Click HERE for more info.

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The IMPACT Act of 2014 requires the Secretary to implement specified clinical assessment domains using standardized (uniform) data elements to be nested within the assessment instruments currently required for submission by LTCH, IRF, SNF, and HHA providers. The Act further requires that CMS develop and implement quality measures from...

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The Centers for Medicare & Medicaid Services (CMS) is committed to transparency about changes in publicly reported information on nursing homes during the COVID-19 public health emergency.Changes to the Nursing Home Compare Website and Five Star Quality Rating System: Staffing Measures and Ratings Domain: On July 29, 2020, Staffing...

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The Centers for Medicare & Medicaid Services (CMS) announced plans to end the emergency blanket waiver requiring all nursing homes to resume submitting staffing data through the Payroll-Based Journal (PBJ) system by August 14, 2020. The PBJ system allows CMS to collect nursing home staffing information which impacts the...

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The Graduate Certificate in Care Management educates health care professionals to improve health outcomes, enhance care quality, and reduce health care costs. Upon completion of the graduate certificate students will be prepared to provide care coordination to diverse people across the lifespan using care management principles and approaches that...

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THIS GUIDANCE is for facilities wanting to allow communal dining and group activities. Any prior guidance issue by the department will be updated to reflect the guidance below. Each facility will make the final decision to allow communal dining and group activities. Facilities may want to consider having a...

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THIS GUIDANCE is for facilities wanting to allow outdoor visits and visits through an open window for residents who are bedbound or who cannot otherwise leave their room. Any prior guidance issue by the department will be updated to reflect the guidance below. Each facility will make the final...

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Facility-wide testing for all residents and staff is included in the most recent DHSS guidance (https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/ltcf.php) for communities that have a positive COVID-19 case. We are encouraging all communities to be prepared for this possibility so that should this occur, there will be no delay in testing implementation. There...

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CMS announced on the QTSO website (https://qtso.cms.gov/news-and-updates/how-nursing-homes-will-receive-important-information-cms) that they will utilize the CASPER shared folders to communicate important information regarding 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). This includes the...

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The Centers for Medicare & Medicaid Services (CMS) is committed to taking critical steps to ensure America’s nursing homes are prepared to respond to the threat caused by the COVID-19 pandemic. Nursing Home COVID-19 Information: CMS will post COVID-19 data submitted by facilities via the Centers for Disease Control...

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The Centers for Medicare & Medicaid Services (CMS) is committed to taking critical steps to ensure America’s nursing homes are prepared to respond to the threat caused by the COVID-19 pandemic. Nursing Home Inspections: CMS will post health inspection (i.e., surveys) results that were conducted on or after March...

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Long-term care facilities (LTCFs), including nursing homes, skilled nursing facilities, and assisted living facilities, take care of some of the most vulnerable populations, including elderly people and those with chronic medical conditions. This, coupled with the proximity in which the residents live, staffing shortages, and often poor infection control...

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CMS says the move will enable beneficiaries to get telehealth services in physician’s offices, hospitals, nursing homes, rural health clinics – and their homes. Click HERE for the full article. Click HERE for the Medicare Telemedicine Health Care Provider Fact Sheet.

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Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19 CMS announced it is granting exceptions from reporting requirements and extensions for clinicians and providers participating in Medicare quality reporting programs with respect to upcoming measure reporting and data submission for those programs....

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Childcare Needs Form – Critical Public Health or Public Safety Staff Childcare Needs Form If you are an employee whose job duties are critical to protecting public health and/or public safety and are in need of childcare in order to work due to school closures please fill out the...

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Assistant Secretary for Preparedness and Response (ASPR); Department of Health and Human Services (DHHS): COVID-19 Healthcare Planning Checklist Centers for Disease Control (CDC): Healthcare Workers: Information on COVID-19 COVID-19 Resource Page Information for Healthcare Professionals Sequence for Putting on/Safe Removal of Personal Protective Equipment (PPE) What healthcare personnel should...

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Suspension of Survey Activities Memo #: QSO-20-12-All Posting Date: 2020-03-04 Fiscal Year: 2020 CMS is committed to taking critical steps to ensure America’s health care facilities and clinical laboratories are prepared to respond to the threat of the COVID-19 and other respiratory illness. Specifically, CMS is suspending non-emergency inspections...

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Traumatic experiences are linked to behavioral and chronic physical health conditions. They impact not just your clients, patients, or residents’ health and well-being but staff, and family members as well. Trauma-informed care is an evidence-based approach to delivering health care that recognizes the long-term health effects of trauma. It...

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NEW Help Desk Email Address Beginning 2/10/2020 Feb 05, 2020 This message is to inform you that we are updating our system to provide you with an improved user experience. As part of these changes, after February 10, 2020, we will no longer manage emails sent to help@qtso.com. Beginning...

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On Jan. 17, the Missouri Department of Health and Senior Services (DHSS) distributed a health update to health care providers and partners regarding an outbreak of a 2019 novel coronavirus (2019-nCoV) in Wuhan City, Hubei Province, China that began in December 2019. Currently, there are no confirmed cases of...

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Electrical Receptacle Testing In Long-Term Care Facilities The outlet testing can be completed by facility staff as long as they have the knowledge and equipment to perform the tests. NFPA 99; 2012 edition: What tests are required? 6.3.3.2 Receptacle Testing in Patient Care Rooms 6.3.3.2.1 The physical integrity of...

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Swingtech is the new company sending out informational messages to SNFs that were not meeting the SNF QRP APU threshold on a quarterly basis ahead of each submission deadline. Swingtech has stated that anybody who is already signed up with CORMAC does not have to sign up again with...

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“Trump Administration Empowers Nursing Home Patients, Residents, Families, and Caregivers by Enhancing Transparency about Abuse and Neglect – Administration delivers on ‘Transparency’ pillar of a five-part approach to ensuring nursing home safety and quality, giving patients unprecedented information about nursing home quality”. CMS is adding a ‘consumer alert” to...

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Patient-Driven Payment Model begins 10/1/19. A few frequently asked questions and clarifications. How do I mark A0300a “Optional State assessment” for setting up my transitional IPA assessment? A0300a would be NO- the assessments in this item are for optional assessments that may be required by case-mix states or for...

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In July 2018, CMS finalized a new case-mix classification model, the Patient Driven Payment Model (PDPM), that, effective beginning October 1, 2019, will be used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for classifying SNF patients in a covered Part A stay. This site includes a...

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About the Civil Money Penalty Reinvestment Program (CMPRP) Overview As part of its continued commitment to the nation’s most vulnerable populations, the Centers for Medicare & Medicaid Services (CMS) has launched the Civil Money Penalty Reinvestment Program (CMPRP), a three-year effort to reduce adverse events, improve staffing quality and...

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The enhanced Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) review and correct reports are now available, on demand in the Certification and Survey Provider Enhanced Reporting (CASPER) application. In addition to enhanced sorting functionality, this report now includes patient-level data and automated CSV file creation functionality that contains...

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Memorandum Summary April 2019 Improvements to Nursing Home Compare include: Ending the Freeze on Health Inspection Star Ratings – In April 2019, the Centers for Medicare & Medicaid Services (CMS) will end the freeze on the health inspection domain of the Five Star Quality Rating System. We will resume...

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Memorandum Summary Core Appendix Q and Subparts -Appendix Q to the State Operations Manual (SOM), which provides guidance for identifying immediate jeopardy, has been revised. The revision creates a Core Appendix Q that will be used by surveyors of all provider and supplier types in determining when to cite...

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March 5, 2019: Ref: QSO-19-08-NHThis memo provides information about the end of the Freeze of the Health Inspection Star Rating, Quality Measure Domain Improvements and Staffing Domain Improvements to occur in April 2019. Find the document HERE.

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CMS released an Errata document related to the following items in Section J. J0200: Should Pain Assessment Interview Be Conducted? J2000: Prior Surgery Link for the updated MDS 3.0 RAI Manual Errata document: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Downloads/MDS-30-RAI-Manual-v1-16-R-Errata-v1-1-February-13-2019.pdf

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Newly Released CMS Quality Reporting Manual Earlier this month, CMS released a NEW version of the MDS 3.0 QM User’s Manual V12.0 on their page: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIQualityMeasures.html Two files related to the MDS 3.0 QM User’s Manual have been posted: MDS 3.0 QM User’s Manual V12.0 contains detailed specification for...

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Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN) MLN Matters Number: MM10567 Revised   |  Related Change Request (CR) Number: 10567 Related CR Release Date: January 11, 2019   |    Effective Date: April 30, 2018 Related CR Transmittal Number: R4198CP   |   Implementation Date: April 30, 2018 We revised...

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Training and Consumer Education Materials (Consumer Voice) Transfer and Discharge – These materials can be used for training and consumer education for Ombudsman program representatives, members of resident and family councils, and community education. Prezi – video, with voiceover Prezi – clickable, without voiceover Prezi script PowerPoint Fact Sheet:...

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ShowMeVax – https://health.mo.gov/living/wellness/immunizations/showmevax/ Missouri’s immunization registry, ShowMeVax, offers healthcare professionals, schools, and child care organizations a one-stop shop for tracking an individual’s immunization history and status and allows providers to monitor vaccine inventory.

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IN THIS ISSUE Wanted: RN Coverage The Revolving Door of MO Nursing Home Administrators CPR – Let’s Do It or NOT Alzheimer’s and Dementia Resources for Infection Control Caring for a Resident with a Pacemaker Committees? Tasks? Click HERE for the newsletter! August 2018

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The most common condition physician and practitioners encounter in potentially avoidable hospitalizations in the nursing facility is infection. Pneumonia, UTIs, and cellulitis are often treated safely and effectively in the nursing facility, which provides for a better patient experience, decreased risk of hospital iatrogenic complications, and lower costs. by...

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Transition to Payroll-Based Journal (PBJ) Staffing Measures on the Nursing Home Compare tool on Medicare.gov and the Five Star Quality Rating System Memo # 18-17-NH Posting Date 2018-04-06 Fiscal Year 2018 Summary Transition to Payroll-Based Journal (PBJ) Data – Starting in April, 2018, CMS will use PBJ data to...

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Center for Medicare Advocacy With support from the John A. Hartford Foundation, the Center for Medicare Advocacy provides the following Fact Sheet to help Medicare nursing home beneficiaries and their families respond to unfair Medicare denials based on an erroneous “Improvement Standard.” The Fact Sheet emphasizes language from the...

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Quality Improvement Team Development is one part of the Performance Management Series. The work of a QI project is accomplished by a team of individuals, which is known as a QI Team. The purpose of the team is to design, manage, and monitor performance improvement activities to achieve the...

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CDC Report on Antibiotic Resistance CDC’s most recent Vital Signs report highlights the importance of rapid identification of new or rare resistance. This is the critical first step in CDC’s Containment Strategy to stop the spread of antibiotic resistance (AR). Once AR spreads, it is harder to control. Finding...

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Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN) This article informs you about Change Request (CR) 10567, which advises you that the Centers for Medicare & Medicaid Services (CMS) has revised the Skilled Nursing Facility Notice of Non-coverage (SNF ABN), Form CMS-10055. With this revision, CMS is...

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Yesterday (2/28/18), the Centers for Medicare & Medicaid Services (CMS) changed the survey domain methodology of the Five-Star rating system. In the previous methodology, CMS used a center’s most recent three survey cycles in calculating the survey rating. In the updated methodology, CMS will use the most recent two...

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CMS has posted an updated Q and A regarding the new survey process. The wording in the red font is new. You can find it here! Updated 2/6/18

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CMS has extended the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) deadlines for the calendar year (CY) 2017. Minimum Data Set (MDS) assessment data for January-December (Q1-Q4) of CY 2017 are due May 15, 2018. However, providers are encouraged to verify their MDS submissions on at least a...

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A calculation error has been identified for the three assessment-based quality measures reported on the SNF QRP Facility- and Resident-Level QM report and the SNF QRP Review and Correct reports (NQF #0678, NQF #0674, and NQF #2631). Duplicate stays and invalid admission dates can appear on these reports. View...

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CMS’s Targeted Probe and Educate (TPE) program is designed to help providers and suppliers reduce claim denials and appeals through one-on-one help. The goal: to help you quickly improve. Medicare Administrative Contractors (MACs) work with you, in person, to identify errors and help you correct them. Many common errors...

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Here you will find an updated scope and severity grid. Updated 1/18/18.

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