Skip to content

Category Archives: SLCR Guidance

Cardiopulmonary Resuscitation (CPR) in Nursing Homes – Guidance Clarification Update

Guidance Clarification Update February 21, 2014

CMS Memo S&C: 14-01-NH

The Section for Long-Term Care Regulation (SLCR) wants to make certified providers aware that updated guidance from CMS (S&C: 14-01-NH) now requires “certification” of some nursing home staff as part of the nursing home’s compliance with regard to CPR.  Previously, if a question arose during a federal regulatory process regarding whether someone could perform CPR properly, a surveyor may have needed to ask for an explanation of appropriate technique from some available staff member to verify compliance with that requirement, but verifying the certification of a particular staff member typically was not necessary.

This most recent memo states that “certification” of some staff members is mandatory, but the memo does not clarify which certifying agencies are acceptable (i.e., American Heart Association).  SLCR and the Kansas City Regional CMS office requested a clarification of this point.

We have now received guidance indicating that the purpose of this memo was to, “…ensure that facilities do not implement facility-wide ‘no CPR’ policies and that facilities have CPR-certified staff available at all times,” but that CMS does not intend to review or approve all certification agencies.

A wide range of organizations offer CPR certification – some are based online and some are conducted in-person.  To this point, CMS has clarified that while S&C: 14-01-NH does not require the use of any specific certifying agency, there are two components that are required with regard to CPR certification:

  • The certification must be designed for healthcare providers (therefore, CPR courses for laypersons which teach chest compressions, but not mouth breathing, are not sufficient); and
  • Nursing home policies should address how staff members should maintain and document their CPR certification.

The American Heart Association certification is acceptable under this guidance, but it is not the only acceptable certification.  Many homes in Missouri are currently obtaining CPR certification through the American Safety & Health Institute (ASHI), which is also acceptable, as are others, as long as they are designed for professional healthcare providers.

You may view the memo here: CMS Memo S&C: 14-01-NH, or visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions.html.

Emergency Preparedness Winter Weather Special Update February 4, 2014

LTC Information Special Update  February 04, 2014 

The Section for Long-Term Care Regulation is sending the following weather-related reminders in light of Missouri’s considerable snowfall and ice accumulation across the state.  Please take time to familiarize yourselves with your home’s emergency plan, double-check your emergency reserves of food and other disaster-related preparedness items, and know that your service to the elderly in all types of weather is appreciated.

Winter Weather Information

http://health.mo.gov/emergencies/ert/naturaldisasters.php

http://stormaware.mo.gov/

http://www.nws.noaa.gov/view/states.php?state=MO

Emergency Protocol for Long-Term Care Homes

The Emergency Protocol was developed in 2007 for communication between long-term care homes and the Section for Long-Term Care Regulation, in the event a disaster occurs that results in a loss of a necessary service.  (Electricity, water, gas, telephone, etc.)  This protocol was established to streamline communication so that homes can focus on what is most important – the safety and well-being of the residents.

This protocol provides the cellular telephone number corresponding to the region in which your home is located if you experience a loss in a necessary service that has the potential to affect resident safety or well-being.  You are encouraged to contact the regional main office telephone number during normal business hours, as survey staff carry the emergency cell phone and may be conducting a survey or inspection during working hours and may not answer immediately.

Please remember, this protocol is NOT to be used to self-report incidents normally reported to the Elderly Abuse & Neglect Hotline (1-800-392-0210).

Region Main Office Emergency Only Cell Number
#1 Springfield (417) 895-6435 (417) 425-8780
#2 Poplar Bluff (573) 840-9580 (573) 778-6495
#3 Kansas City (816) 889-2818 (816) 719-0089
#4 Cameron (816) 632-6541 (816) 632-9371
#5 Macon (660) 385-5763 (660) 651-1468
#6 Jefferson City (573) 751-2270 (573) 619-3338
#7 St Louis (314) 340-7360 (314) 623-2852

Missouri regional map: http://health.mo.gov/seniors/nursinghomes/providerinfo.php – click on Long Term Care Regions

Disaster and emergency planning resources: http://health.mo.gov/emergencies/

If you have any questions about the Emergency Protocol for Long-Term Care Homes, please contact the Section for Long-Term Care Regulation at 573-526-8524.

Ensure Your Local EMD has a Copy of Your Home’s Current Emergency Plan

Missouri is again experiencing extreme weather conditions, and there is a chance of even more inclement weather in the forecast.  The Section for Long-Term Care Regulation would like to remind you there are emergency preparedness representatives in your community to help you with emergency planning and are there to help in the event of a disaster.

You can find your local emergency management director (EMD) on the State Emergency Management Agency’s (SEMA) website at www.sema.dps.mo.gov.  Scroll down to Contact Your Local Emergency Management Agency and choose your county.

State regulations require all long-term care homes to provide a copy of their emergency plan to their local EMD.  Please reference the following regulations:

19 CSR 30-85.022 (33) and 19 CSR 30-86.022 (5)(A) All facilities shall have a written plan to meet potential emergencies or disasters and shall request consultation and assistance annually from a local fire unit for review of fire and evacuation plans.  If the consultation cannot be obtained, the facility shall inform the state fire marshal in writing and request assistance in review of the plan.  An up-to-date copy of the facility’s entire plan shall be provided to the local jurisdiction’s emergency management director.

For additional information regarding emergency preparedness, please contact Melissa Hope, Planner II, Division of Regulation and Licensure at melissa.hope@health.mo.gov.

Resources are also available on the Department of Health and Senior Services website, http://health.mo.gov/emergencies/readyin3/adultcare.php.

New Generations Quarterly Newsletter – Winter 2014

The Section for Long-Term Care has published New Generations – Volume 12, Issue 1, Winter 2014.  This issue is now available on our website, along with an archive of previous newsletters.  Please visit http://health.mo.gov/seniors/nursinghomes/providerinfo.php.

Most Frequently Cited Deficiencies Report – Fourth Quarter 2013

Please view the quarterly report from the Section for Long-Term Care Regulation here:  Most Frequently Cited Deficiencies Fourth Quarter 2013

MDS and Flu Season

CMS posts the public Quality Measures on Nursing Home Compare, and consumers are able to view the percentage data that your nursing home offered and administered the flu vaccine during the current or most recent influenza season.

The 3.0 Resident Assessment Instrument (RAI) manual does not provide specific dates for influenza season.  This has prompted Missouri facilities to ask what dates are considered the influenza season in Missouri, in order to correctly code the MDS, which will be reflected in their Quality Measures.  Seasonal flu monitoring and reporting to the CDC in Missouri begins in early October and extends well in to the month of May.

For MDS coding purposes, if the resident is not in the facility between October 1 and May 31, you should code in Section O:  “Resident not in facility during this year’s flu season.”  For residents who are in the facility from October 1 through the last week of May, the facility is required to offer the flu vaccine as long as it is “reasonably available,” which means that it is still available to be ordered from your local pharmacy or supplier.

If you have any questions, you may contact Joan Brundick, State RAI Coordinator, at 573-751-6308 or email joan.brundick@health.mo.gov.