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Spring 2021 Newsletter
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TO: Administrators
FROM: Sally McKee, Board Coordinator
DATE: July 13, 2020
RE: 2021 License Renewal Changes
In response to the COVID-19 situation and the limited options of in-seat continuing education (CE) programs, the Missouri Board of Nursing Home Administrators (MBNHA) recognizes the need for Missouri administrators to have flexibility in completing the required CE clock hours for the 2021 license renewal. Administrators that are due to renew their license by June 30, 2021,
have the option to complete any and/or all CE clock hours online through a MBNHA approved training agency or approved by NAB/NCERS.
Please note:

  • This notice does not pertain to any future renewal cycles. This only pertains to those administrators with a license expiration date of June 30, 2021. Payment options and submission criteria of a current renewal are outlined in the License Renewal Checklist available on our website at and select NHA or RCAL License Renewal.
  • NAB/NCERS approved CE programs are available at the following website –
  • The MBNHA approved training agencies list is available on our website and click on Continuing Education Sponsors.

Please do not hesitate to contact MBNHA via email at or via phone at (573) 751-3511.
Summary Strategies to Optimize the Supply of PPE during Shortages
CDC developed a quick reference table summarizes CDC’s strategies to optimize personal protective equipment (PPE) supplies in healthcare settings and provides links to CDC’s full guidance documents on optimizing supplies. These strategies offer a continuum of options using the framework of surge capacity when PPE supplies are stressed, running low, or absent.
New IDR Contract
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 they are the same staff that worked under the previous contract. HQI has begun contacting those communities with pending IDR requests. All new IDR requests will be submitted to HQI.

Contact information for HQI is:  Email:

Phone: (573) 514-8501 (may leave voicemail message)  Fax: (804) 289-5324

Mailing Address: Health Quality Innovators  Attn: MO IDR

9830 Mayland Drive  Suite J  Richmond, VA 23233
CMP Application Process for Communicative Technology
CMS has created a process to enable states to approve requests for communicative technology that meet CMS parameters. The parameters are detailed in the instructions portion of the attached application template. This template and process will reduce the amount of time for approval of CMP funds for technology that allows residents to engage in virtual social and telehealth visits as restrictions have been placed on visitors to prevent the spread of COVID-19.  The application is for nursing homes certified to participate in Title 18 and Title 19 of the Social Security Act. We encourage companies that operate more than one home to complete one application for all certified homes to the extent possible. This will reduce the number of applications and will help expedite the approval process. Applications should be submitted to Questions regarding the application process may be sent to this address as well. Once an application is approved, SLCR will contact each applicant to explain the payment process.
CMS QSO Memo Regarding Prioritization of Survey Activities

CMS is prioritizing surveys by authorizing modification of timetables and deadlines for the performance of certain required activities, delaying revisit surveys, and generally exercising enforcement discretion for three weeks. During this three-week timeframe, beginning March 20, 2020, only the following types of surveys will be prioritized and conducted:

  • Complaint/facility-reported incident surveys: State survey agencies (SSAs) will conduct surveys related to complaints and facility-reported incidents (FRIs) that are triaged at the Immediate Jeopardy (IJ) level. A streamlined Infection Control review tool will also be utilized during these surveys, regardless of the Immediate Jeopardy allegation.
  • Targeted Infection Control Surveys: Federal CMS and State surveyors will conduct targeted Infection Control surveys of providers identified through collaboration with the Centers for Disease Control and Prevention (CDC) and the HHS Assistant Secretary for Preparedness and Response (ASPR). They will use a streamlined review checklist to minimize the impact on provider activities, while ensuring providers are implementing actions to protect the health and safety of individuals to respond to the COVID-19 pandemic.

CMS is disseminating the Targeted Infection Control Survey checklist developed by CMS and CDC so facilities can educate themselves on the latest practices and expectations. CMS expects facilities to use this new process, in conjunction with the latest guidance from CDC, to perform a voluntary self-assessment of their ability to prevent the transmission of COVID-19. The checklist is attached.

Though the contents of the memo and checklist are provided by CMS, DHSS is adhering to the same requirements for all facilities. All facilities should complete the infection control self-assessment.


  • SN95 Respirator Decontamination Process – Battelle Critical Care Decontamination System

Thanks to a contract awarded by the Defense Logistics Agency (DLA) on behalf of the U.S Department of Health and Human Services (HHS) and the Federal Emergency Management Agency (FEMA), Battelle is able to provide N95 decontamination at no charge to health care personnel. We encourage all long term care communities to take advantage of this service to assist with PPE conservation. The attached presentation outlines the process for utilizing this system (please note Missouri will be using a drop off/pick up process indicated below rather than shipping outlined in the presentation). The first step is to enroll with Battelle. Each healthcare and first responder provider must do so through Following that enrollment process, packaging your contaminated masks as per Battelle’s instructions and transporting those N95s to the drop-off/pick-up sites is the next step. Healthcare providers and first responders are allowed to transport their own N95s to the collection points without a special license or contractor. A map of the established drop-off/pick-up sites is attached. These sites will be staffed seven days per week from 7:00 a.m.-7:00 p.m. daily beginning Sunday, April 26 at 7:00 a.m.  Please note, the Jefferson City Armory is not able to receive N95s, that entire operation is devoted to the decontamination equipment and staff.  The Battelle CCDS did arrive in Missouri last week, set-up and preliminary testing is underway. Battelle anticipates beginning to process masks by Tuesday, April 28.  Information about the Battelle CCDS system and process is located at as well as the Battelle website denoted above.


CMS QSO Memo Release – QSO 20-28-NH

Nursing Home Five Star Quality Rating System updates, Nursing Home Staff Counts, and Frequently Asked Questions

  • Nursing Home Compare website & Nursing Home Five Star Quality Rating System: The inspection domain will be held constant temporarily due to the prioritization and suspension of certain surveys, to ensure the rating system reflects fair information for consumers.
  • Posting of surveys: CMS will post a list of the surveys conducted after the prioritization of certain surveys, and their findings, through a link on the Nursing Home Compare website.
  • Nursing Home Staff: CMS is publishing a list of the average number of nursing and total staff that work onsite in each nursing home, each day. This information can be used to help direct adequate personal protective equipment (PPE) and testing to nursing homes.
  • Frequently Asked Questions (FAQ): CMS has released a list of FAQs to clarify certain actions we have taken related to visitation, surveys, waivers, and other guidance.