Archive March 2021

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MHCA is offering the NHA Preceptor Training on June 24th!

This Board-Approved Preceptor Training was created for licensed Nursing Home Administrators or Multi-Level Facility Administrators (in Maine) who would like to serve as a Preceptor for an Administrator-In-Training (AIT). Among other things, it includes a review of the current long-term care State regulations. For details about who can serve as a Preceptor, please refer to the NHA Licensing Board Rules.

This training will be hosted online (via Zoom) on June 24, 2021 from 1:00PM to 3:00PM. For more information – including prerequisites (for new Preceptors), registration information, and more – we encourage you to visit the event page on our website.
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Unusual state budget process begins

Democratic legislators put forth a plan this week that includes early adoption of a "baseline" State Budget that will take effect on July 1, 2021.  A vote on this is scheduled for as soon as next Tuesday.  This process is a departure from previous budgets and has been met with resistance from the minority Republicans. 
If the baseline budget is adopted next week, legislators will turn their attention to new initiatives for the remainder of the session.  We believe that these votes will require a two-thirds majority, and therefore some level of bipartisan agreement.
MHCA was encouraged when we were informed that cost of living adjustments for nursing homes and residential care facilities, along with nursing home rebasing, will be included in the baseline budget.  It is likely that other proposed initiatives we support will be part of the second phase of budget review. This will include COVID-19 relief measures.  
MHCA will continue to monitor the budget process and interject on our members' behalf.  Look for updates from us, as these initial budget decisions may move more quickly than we are accustomed to seeing.


AHCA/NCAL announces reform agenda for LTC

On Monday, the American Health Care Association, representing more than 14,000 nursing homes and other long term care facilities across the country that provide care to approximately five million people each year and LeadingAge, the association of more than 5,000 aging services providers including nursing homes, released a reform agenda, the Care For Our Seniors Act, to address long-standing challenges affecting the quality of care provided in America’s nursing homes. 
The COVID-19 pandemic has exposed and exacerbated systemic issues impacting the nursing home sector, such as workforce shortages, aging physical plants, and underfunded government reimbursements for care. Many of these issues were raised for years prior to COVID but were never fully addressed by policymakers. Through the Care For Our Seniors Act, AHCA and LeadingAge are calling on lawmakers once again to help resolve systemic challenges, as well as reflecting on ways nursing home providers themselves can improve. 

The Care For Our Seniors Act has four main reform principles with policy proposals in each of the key areas:
  • Clinical: Enhance the quality of care in nursing homes by developing clearer standards for infection preventionists, requiring that each nursing home have a registered nurse on-staff, 24 hours per day, and requiring a minimum 30-day supply of personal protective equipment in all nursing homes. 
  • Workforce: Strengthen and support our frontline caregivers by implementing a multi-phase tiered approach to attract, retain and develop more long term care professionals leveraging federal, state and academic institutions. 
  • Oversight: Implement improvements establishing a more resident-driven system by developing an effective oversight system and processes that support better care and protect residents. This would include implementing a process to help turn around or close facilities that are chronic poor performers and adding customer satisfaction to the government’s five-star rating system to help monitor the quality of a facility for family members and guide consumer choice. 
  • Structural: Modernize nursing homes by conducting a national study on how to shift to more private rooms, which promote resident privacy, autonomy and dignity, as well as support infection control best practices. 
The nursing home sector has been facing a financial crisis for years due to low Medicaid reimbursements, the primary coverage for nursing home residents. With providers dedicating extensive resources in response to COVID and a significant drop in new residents moving in, the financial shortfalls have only worsened. Each policy proposal in the Care for Our Seniors Act must include government resources, and AHCA and LeadingAge propose several interrelated investment strategies to help reinvest in America’s nursing homes to ensure quality care, including:
  1. Enhanced Federal Medical Assistance Percentages (EFMAP): Increased federal Medicaid funds are provided to states to pay for the mandatory nursing facility benefit, with requirements that additional federal funds be used for nursing facility rates. 
  2. Federal Framework for “Allowable Cost” or “Reasonable Cost”: Establish federal guidelines for state allowable cost definitions.
  3. Medicaid Rate Adequacy Requirement: Medicaid rates are brought up to equal the cost of care and subsequently updated regularly to keep pace with increases in costs of care.
  4. State Nursing Facility Value-Based Purchasing (VBP) Committee & Required Design Report: The state will be required to form and maintain a state health plan and nursing facility VBP committee with specific guidelines and deadlines to submit reports. This offers the potential for additional resources.
“With a growing elderly population soon needing our services, the moment is now. We must pay tribute to all those who lost their lives to this vicious virus and resolve to bring forth a brighter future,” concluded Mark Parkinson, president and CEO of AHCA. “We have already seen what progress can be made when policymakers come together to make long term care residents a priority and through these reforms, we can significantly improve the quality of care for our current residents and generations to come.” 

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Common questions members are asking about visitation: 03/25/2021

Does federal CMS or MeCDC/DHHS Licensing limit the number of visitors we can let in our home at one time?
There is no limitation in guidance on the number of visitors allowed per visit; however, facilities may need to schedule and coordinate visits to manage visitor flow. Facilities should continue to be flexibility especially in end-of-life situations when more than two family members feel it is important to be present. Facilities could manage their scheduling of visits to accommodate occasions like this. 

Do we need to supervise visitation?
There is no requirement in guidance that indoor visits be supervised. 

Can we screen visitors for vaccination status and discourage entrance when unvaccinated?
In federal CMS guidance there is no requirement that visitors be vaccinated or that they be able to show a negative COVID test.  If a resident is fully vaccinated and wears a well-fitted mask, they can have a visit from anyone, as long as the visitors are screened for symptoms, wear a well-fitted mask and practice hand hygiene and social distancing.

Can children visit?
There is no restriction on the age of visitors.  Children and infants are allowed to visit, masked as appropriate by age, and they can have close contact with a fully vaccinated resident (i.e.., a grandchild (unvaccinated) sitting on a grandparent’s (vaccinated resident) lap).

Can residents who are fully vaccinated leave the facility?

Do they need to quarantine upon return?
No, fully vaccinated residents are allowed to leave the facility for medical appointments or for an outing with family without having to quarantine upon return.   There is no requirement that the people taking residents out be vaccinated or tested. 

Can we allow communal dining and group activities again?
Communal dining and group activities are permitted, with appropriate safety protocols, for residents who are not in quarantine or isolation. 
Does a resident need to be actively dying to allow a compassionate care visit?
No, compassionate care visits are not defined only by the stage of the resident decline. The allowance of a compassionate care visit is dependent on the resident need and should be a multidisciplinary team decision.
Can a fully vaccinated resident go out to a restaurant with their family?
Please refer to the specific table guidance for your home in reference to vaccinated residents leaving the facility. Situations should be considered on a case-by-case basis and facilities are encouraged to direct questions like this to licensing as directed on the DHHS medical director call of 03/23/2021. According to CMS guidance fully vaccinated residents can go out for whatever reason and not have to quarantine upon return with masking and social distancing being recommended. 
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Sen. Collins sponsors key Medicare rate amendment

As you may recall, the Medicare sequester was suspended during the pandemic resulting in a temporary 2% increase to our Medicare Fee for Service rates.  This increase was set to expire on March 31st.  Senate leaders now appear to have reached an agreement to try to pass legislation this week that would temporarily suspend Medicare sequestration for various provider types. There is now a goal is to adopt it by unanimous consent or under a time agreement later this week before the Senate adjourns.
Senators Jeanne Shaheen (D-NH) and Susan Collins (R-ME) offered the amendment that extends the relief through December 31, 2021.  The good news is that it now appears that there has been a path created for the provision to be paid for.  AHCA, along with several other post-acute associations, have been actively lobbying this issue.  We are advised that this is not a done deal at this time, but that there is a growing optimism that this can pass before the current expiration date.

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Are your Social Workers at risk of burnout, stress & high turnover?

Self-care is an essential part of social work practice, but it is rarely addressed in practical terms. Without strategies for maintaining personal health and well-being, while caring for others, social workers are at risk for burnout, stress, and high turnover. We can help!
On May 25 & 26, 2021 (from 1–3:00pm), we will be hosting a webinar series called, Self-Care as an Ethical Obligation: Surviving the Pandemic & Beyond. This two-part program tackles the role of self-care in social work practice including stewardship, ethical responsibility, self-care practices, personal assessment, strategies for prioritizing self-care, and more. For more details, visit the event page on our website.
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CEUs earned for the 2020 license renewal can be carried over to 2021!

We have great news!  Kristina Halvorsen, Administrator of the Nursing Home Administrator Licensing Board, confirmed (in a recent email) that CEUs earned for the 2020 license renewal period can be carried over to 2021. Here's what that means: 

  • When you submit your application for licensure (in June, 2021), to check the box indicating that you have completed the required number of CEUs, NH Administrators must have proof that they have earned 24 CEUs – and AL Administrators, 12 CEUs – from July 1, 2019 to June 30, 2021. 

  • If you have not completed the required number of CEUs, leave the box unchecked (and provide an explanation in the space below it) to request a hardship waiver. If it is due to COVID-19, make sure you include that in your explanation. 

If you have additional questions, you may email Kristina directly at or reach her by phone at 207.624.8420. 
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MHCA Collaborating with Maine CDC on LTC Vaccination

MHCA is working with Maine CDC on a vaccination plan for new residents and staff now that the federal LTC Pharmacy Partnership Program has concluded. The Association surveyed members this week to determine unmet need for vaccination of eligible residents and staff. We have shared this information with Maine CDC who is deploying Public Health Nursing (PHN) to begin vaccinating residents and staff as early as next week. PHN will have the necessary EUA documents and consent forms. We ask members to be patient as CDC coordinates this statewide process that could take several weeks. The goal is to efficiently provide vaccination without wasting limited supply of vaccine. If you have eligible residents and staff to be vaccinated, please email as soon as possible. Be sure to differentiate between resident and staff needs. MHCA appreciates the State’s ongoing commitment to our vulnerable population and views this an opportunity to further strengthen Maine’s long term care vaccination rates.

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MHCA Thanks Members for Dedication During Pandemic

Going above and beyond the call of duty carries a new meaning in a pandemic. MHCA members worked tirelessly to provide health, safety and well-being for residents and each another. Throughout the challenging times, there were also many rays of sunshine and acts of humanity. Take a moment to see what we see in long term care’s response to the pandemic in this video, sourced from MHCA and member social media publications. It is a celebration of your ingenuity, perseverance and resilience that have inspired each of us at MHCA. Please share it with your dedicated team members with our gratitude!

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Updated List of Excluded Individuals and Entities (LEIE) Database File - February 2021

The US Department of Health and Human Services, Office of Inspector General (OIG) has released its updated List of Excluded Individuals and Entities (LEIE) database file, which reflects all OIG exclusions and reinstatement actions up to, and including, those taken in February 2021.
The updated files are posted on OIG's website at, and healthcare providers have an “affirmative duty" to check to ensure that excluded individuals are not
Instructional videos explaining how to use the online database and the downloadable files are available at As a best practice, long term care providers should check the LEIE on a regular basis.

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