Register Now – 2018 Geriatric Symposium: Texas Taking the Next Step

Texas Health and Human Services, in collaboration with The University of Texas at Austin School of Nursing, is hosting a two-day, free event for healthcare professionals and family members who work with older adults.

Dates and Location:
Aug. 13-14, 2018
Sheraton Austin Georgetown Hotel and Conference Center
Georgetown, Texas

Day One: “Celebrating the Power of Nurses in Long-Term Care”
An education filled day by nurses, for nurses where you will gain an understanding of the unique needs of older adults, focusing on topics that affect the quality of life and quality of care of the geriatric population.

Day Two: “Evolution and Advancement in the Aging Community”
The final day of the symposium provides all healthcare disciplines, family caregivers and consumers with information about caring for older adults, including those with dementia. Day two will focus heavily on the integration of alternative treatments, with topics such as “Enriching Lives with the Arts”, “Advancements in the Technologies for the Care and Treatment of Alzheimer’s Disease”, and “Engage the Ages: Creating Effective Intergenerational Programs for all Ages and Abilities”.

Registration is now open, and seating is limited. For more information visit the conference web page. Email questions to

PASRR in the Nursing Facility: Putting the Pieces Together – Additional Training Dates Available in July 2018

Register now for PASRR in the Nursing Facility: Putting the Pieces Together. This free, two-day training event will provide nursing facilities with information and resources that detail the complexities of caring for residents with intellectual and developmental disabilities, mental illness or both.

Participants will learn to identify the requirements of the Preadmission Screening and Resident Review tool, describe the people that PASRR affects, list the laws related to PASRR, and describe the different types of settings that can serve people affected by PASRR.

Dates and Locations:

  • July 11-12, 2018 – Houston
  • July 18-19, 2018 –Richardson (Dallas area)

Register now. Visit the conference web page or email for more information.

Register Now for Meaningful Engagement to Increase Quality of Life

Hosted by HHSC, in collaboration with Natalie B. Davis, AA, CDP, CADDCT, this training is designed for all nursing facility staff, including activity directors, licensed nurses, certified nurse aides and ancillary staff. Ms. Davis will provide attendees with evidence-based best practices to help them implement individualized activities to reflect each resident’s preferences, customary habits and lifestyle. Participants will also learn how to develop person-centered activity programs that are both meaningful and relevant. 

Dates and Locations: 
June 12, 2018 - San Antonio
June 29, 2018 - Corpus Christi
July 11, 2018 - Houston
July 19, 2018 - Fort Worth
July 24, 2018 - Abilene

Register Now

As part of this training, participants have the opportunity to nominate their NF for a complementary customized activity program. HHSC will select only 20 facilities for this opportunity, taking place between August 2018 and January 2019. To participate in the nomination process, a facility staff member MUST attend one of the five regional trainings 

Visit the conference web page for more information. Email questions to

Texas OASIS HCBS Dementia Training Academy

The Texas OASIS HCBS Dementia Training regional conferences have been completed. The curriculum will now be converted to a computer-based training and will be available on the HHSC web site. More information will be released soon.

Email questions to

Save the Date - CNA Advanced Training Academy

This free two-day training will be offered beginning in Aug. 2018. It will provide comprehensive training for nursing facility CNAs, helping them to understand their role in the nursing facility and learn more about how to care for the geriatric population.
Topics to be covered are empowerment, communication, time management, organizational skills, stress and burnout, professionalism along with understanding geriatric residents and those with IDD, MI and complex medical needs. The training also covers competencies such as hand washing, perineal care, nutrition, safety and transfers. Participants will be provided the latest resources and tools to enable them to provide the best possible care and quality of life for residents.
The training will be provided in 10 regional locations around the state. Registration opens in June 2018. For more information, email

Center for Excellence in Long-Term Care Update

Plans are progressing for Phase V of the Center for Excellence. When launched, Phase V will address infection prevention and control in long-term care facilities. This will include web based training modules to provide education and resources to providers at multiple levels such as physicians, licensed nurses, direct care staff and family caregivers. Topics that will be addressed in Phase V will include:

  • An introduction to infection prevention and control in long-term care facilities
  • An overview of state and federal regulations related to infection prevention and control in long-term care settings
  • Evidence-based practices and guidelines for infection prevention and control
  • Developing and implementing facility specific policies and procedures, based on a facility infection control risk assessment and program evaluation
  • Developing and operationalizing surveillance programs, including mapping and tracking the spread of infections in a long-term care facility
  • Best practice protocols for implementing and discontinuing transmission-based precautions
  • Developing and operationalizing antimicrobial stewardship programs
  • Hand hygiene programs, including staff training and competency evaluations
  • Protocols for immunization programs in long-term care settings, based on the Centers for Disease Control and Prevention’s recommendations for resident and staff immunizations
  • Processes for monitoring the effectiveness of the infection prevention and control program in the long-term care setting and methodology for reporting the findings

In addition, the Center for Excellence will develop an evidence-based educational program for infection preventionists in long-term care facilities. This web-based program will address the training necessary for a person to manage a long-term care facility’s infection prevention and control program.

Phase V will launch in the summer of 2019. Visit the Center for Excellence website to access the educational resources currently available.

Infection Control – Who’s at Risk for Pneumococcal Diseases?

Pneumococcal vaccines are the best defense against infections caused by Streptococcus pneumoniae. These common bacteria cause a variety of illnesses, ranging from mild sinus or middle ear infections to more severe infections such as pneumonia or meningitis. Some of these illnesses can even be life-threatening.

Who is most at risk for these illnesses?

  • Young children under 2 years old
  • Adults 65 years and older
  • People with other health conditions
  • Adults who live in long-term care facilities

For more information about pneumococcal disease and the available vaccines, read “Who’s at risk for pneumococcal diseases?” a bilingual brochure developed by the Texas Department of State Health Services. To download the pdf, visit, and search for publication number 11-15086. You can also order hard copies that can be mailed to anyone in Texas for free.

PRN Orders for Psychotropic Medications

In certain situations, psychotropic medications may be prescribed on a PRN basis, such as while the dose is adjusted, to address acute or intermittent symptoms, or in an emergency. However, residents must not have PRN orders for psychotropic medications unless the medication is necessary to treat a diagnosed specific condition. The attending physician or prescribing practitioner must document the diagnosed specific condition and indication for the PRN medication in the medical record.

Summary of Limitations:

  • PRN orders for psychotropic medications (excluding Antipsychotics) are limited to 14 days. Exception: Order maybe extended beyond 14 days if the attending physician or prescribing practitioner believes it is appropriate to extend the order. Required Actions: The attending physician or prescribing practitioner should document the rationale for the extended time period in the medical record and indicate a specific duration.
  • PRN orders for antipsychotic medications are limited to 14 days. Exceptions: None. Required Actions: If the attending physician or prescribing practitioner wishes to write a new order for the PRN antipsychotic, the attending physician or prescribing practitioner must first evaluate the resident to determine if the new order for the PRN antipsychotic is appropriate. 

State Operations Manual Appendix PP - Guidance to Surveyors for Long Term Care Facilities

New PASRR Process for Negative PL1s – Retiring Form 1013

Form 1013 assists NFs with resident reviews when a new diagnosis for mental illness, intellectual or developmental disabilities or both were noted. Recently, there has been an increase in the number of 1013 forms submitted for review. There are various reasons for the increases and HHSC is in the process of reviewing those factors.

HHSC is instructing NFs to stop submitting Form 1013 effective May 31. That is the last day HHSC will accept the forms. Any 1013s faxed to HHSC after that date will be returned to the NF.

HHSC PASRR provided this guidance during the PASRR Technical Assistance Call (PTAC) held May 8. You can find the recorded webinar of this call on the SimpleLTC site. Look for the May 8 link to the recording and the slides and handouts.

After May 31, NFs should complete new positive PL1s for cases where IDD is discovered and the previous PL1 is negative. NFs should also complete a new positive PL1 for cases where MI has been discovered and the previous PL1 was negative. Dementia without a MI diagnosis does not require a positive PL1 as it is not a MI.

Please note that a review should be done to ensure that the PE has not been done for the condition before you submit a new PL1. For example: The PL1 is negative for IDD. HHSC and the LIDDA noted that IDD should have been identified and a positive PE was submitted for IDD. If the NF submits a positive PL1 after this, the PE will be inactivated and services delayed.

It is important to always check the PL1 for any associated PE. Please contact PASRR if you see a PE already in the system to discuss before you enter a PL1.

More information about the new process will be released soon.

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