Archive May 2021

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Changes to NON-NIOSH approved respirators

Today Friday May 28, 2021, MHCA received updated guidance from Federal CDC & FDA with regard to N95 supply and supply strategies. See below for guidance updates.

Situational update as of May 2021: The supply and availability of NIOSH-approved respirators have increased significantly over the last several months. Healthcare facilities should not be using crisis capacity strategies at this time and should promptly resume conventional practices. Check the 
NIOSH Certified Equipment List to identify all NIOSH-approved respirators.

Healthcare facilities should stop purchasing non-NIOSH approved respirators for use as respiratory protection and consider using any that have been stored for source control where respiratory protection is not needed. Respirators that were previously used and decontaminated should not be stored. We do not know the long term stability of non-NIOSH approved respirators and respirators that have been decontaminated, and if these will be recommended for use in the future. Healthcare facilities should return to using only NIOSH-approved respirators where needed.

In addition, the FDA has also posted a letter about transitioning from non-NIOSH-approved and decontaminated disposable respirators:

MHCA provides input on use of federal funds for AL

On Tuesday, the Maine Health Care Association participated in a listening session with the Maine Department of Health & Human Services regarding the American Rescue Plan Act’s (ARPA) temporary home- and community-based services (HCBS) federal medical assistance percentage (FMAP) increase. 
ARPA included a one-year, 10% enhanced FMAP on HCBS, defined in the Act to include HCBS waiver programs, state Medicaid plan services such as home health and personal care services, and certain mental health and substance use services. The corresponding state savings must be used to enhance, expand, or strengthen HCBS and must be used by March 30, 2024. 
MHCA believes that PNMI Appendix C facilities and Adult Family Care Homes fall under the broad category of Home & Community Based Services.  At Tuesday’s session, DHHS officials concurred on this, while pointing out that CMS ultimately makes those eligibility decisions.
Maine DHHS must submit its plan for using the special funding to CMS?in June. MHCA will now submit written comments on how funds can be best utilized according to these guidelines:  
  • Initiatives enhance, expand or strengthen HCBS;
  • Initiatives can be completed by 3/30/24, with shorter-term completion preferable;
  • Initiatives not completed by 3/30/24 are sustainable after the special FMAP funds end;
  • Initiatives align with the Department’s HCBS reform plans; and
  • All areas that are eligible to receive the additional FMAP will benefit from the use of the funds. 
In our comments, MHCA joined other home and community based providers in citing the workforce shortage as today’s most pressing issue. 

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MHCA Planning for Popular Events

As we continue moving toward a post-pandemic environment, MHCA is planning for several popular events and programs. We will soon be launching the Mike McNeil Scholarship Program, both the application process and the fundraising calendar. Applications will be due August 1, 2021, new promotional materials are at the printer now and Cash Calendars will be coming soon. We are also looking forward to partnering once again with the Maine Long Term Care Ombudsman Program to present Excellence in Long Term Care Awards to your staff, all of whom deserve recognition for their commitment during this challenging year. Applications will launch in June and we expect to be back at the Blaine House in September, date and details to be determined. We hope you will share our enthusiasm for these events – we are looking forward to connecting with members in these efforts!

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MHCA Database Update Includes Discipline-Specific Request

MHCA updates its membership database annually. Members recently received the form to complete to ensure we have the right contacts for your facilities/organizations. New to the process this year, is our request for facility staff contact information by discipline. We intend to use this information to create discipline-specific distribution lists for the purposes of providing information, educational opportunities or soliciting input on issues directly related to the disciplines. This will not be published publicly. Please complete and return the survey by June 30, 2021. For more information, please contact

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Guide: Building Vaccine Trust and Increasing Rates Among CNAs

Download the new, research-based guide and toolkit that speaks directly to the challenges nursing homes have expressed about the COVID-19 vaccine. Created by the Center for Public Interest Communications for the AHRQ ECHO National Nursing Home COVID-19 Action Network, it offers practical tools for building vaccine confidence in nursing homes. Find it on #GetVaccinated website or learn more.

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Facilities over 10+ Residents can have a vaccine clinic!

Maine's Department of Health & Human Services announced Thursday May 27, 2021 that any facility or organization with 10+ confirmed patients is now eligible to host a COVID-19 vaccination clinic!

Signup link > COVID-19 Vaccination Clinic Application
If your organization continues to struggle with a high vaccine-hesitancy rate among your staff, and/or you simply have 10+ staff seeking vaccination, one way to reduce barriers to vaccination is to make the vaccination process as convenient as possible. It would be difficult to get more convenient than hosting your own clinic, provided for by the State of Maine!
Please follow the signup link above to learn more and to register. Thank you for contributing to the protection of everyone in Maine - it's been a long pandemic, and your vaccination clinic will help us to move forward in safety and health.

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Senator Collins addresses LTC staffing and reimbursement

As recently reported in the McKnight’s Senior Living publication, Senator Susan Collins had strong words on long term care staffing for the Senate Committee on Health, Education, Labor, and Pensions this week.  The hearing focused on workforce shortages in all of healthcare, but Sen. Collins singled out worker shortages in facilities.

According to Sen. Collins, “These shortages have serious consequences.  The situation is particularly acute in our nursing homes, where low Medicaid reimbursement levels often translate into low wages. … We need to break that cycle at a time where our nation is aging and more and more people are living longer with increasing health needs.”

American Health Care Association & National Center for Assisted Living President Mark Parkinson thanked Sen. Collins for bringing attention to the particular shortage of workers within the nursing home sector and how low Medicaid reimbursement rates hamper the ability to compete for medical professionals and caregivers.  He went on to say that “We are also encouraged that members of the committee recognize the need for an increased focus on geriatric medicine, given the rapid growth of our elderly population.”

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Save the dates for MHCA's 2021 Fall Health Care Conference & Expo!

Dear Members,
MHCA is thrilled to announce that we have entered the planning phase for our annual Fall Health Care Conference & Expo. This year's conference will be a hybrid event, giving you the ability to participate in the LIVE sessions either in-person or virtually. The in-person event will be hosted at the lovely Samoset Resort in Rockport, Maine on October 5, 6 & 7, 2021. While we iron out our plans, here are a few important details we'd like to draw your attention to:
  • Are you hoping to purchase an exhibit booth? We expect the exhibitor packet to go out to vendors by the end of June. If you would like to be added to the mailing list, send your contact information to Dianne Chicoine at You can also check the Fall Conference page on our website for the latest updates.
  • Are you interested in presenting? We are accepting proposals for breakout sessions through the end of June. If you've implemented a new process, system or idea that's had some success in your community and/or have an expertise to share with your colleagues, we encourage you to submit a proposal. Please visit our website for information about how to submit a proposal
  • Will you need hotel reservations for this event? Please hold off on contacting the Samoset to reserve a room because we are not able to accept reservations at this time. We are working with the hotel to fine tune the reservation process for our event. Watch for details about how/when to make your reservation to be included in the Attendees Registration Packet this summer. Until then, the entire inventory is on reserve for MHCA and will not be released for pickup until further notice.   
More information about this year's conference will be forthcoming. If you have questions or concerns, feel free to contact MHCA at 207.623.1146.
Best regards,
Karen Michaud
Director of Education
Maine Health Care Association

Free Webinar Discusses Skilled Nursing’s Pandemic-Related Regulatory Risks

HealthCap® and the American Health Care Association hosted a webinar in April highlighting the most significant regulatory and enforcement changes implemented by the federal authorities throughout the pandemic that impact skilled nursing facility providers. The 70-minute session is titled As the World Recovers, Regulatory & Enforcement Environment. 

Presenters identified regulatory risk areas based on current government initiatives and, in turn, proactively implement processes aimed at reducing the pandemic-related risks skilled nursing providers will likely continue to sustain into the future. 
Registration is required to view this free  recorded webinar.  

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Vaccine Reporting Requirements: CMPs to start June 14

Earlier this month, the Centers for Medicare & Medicaid Services (CMS) published an Interim Final Rule on COVID-19 Vaccine Requirements. This rule applies to residents, clients, and staff of Skilled Nursing Facilities (SNF) and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs-IID). CMS also published a QSO memo to state survey agencies on how to operationalize this new requirement. 
This rule specifies that facilities must develop and implement policies and procedures to: 
  • Educate all residents and staff about COVID-19 vaccines; 
  • Offer vaccination to all residents and staff; and 
  • Report to the CDC via the National Health and Safety Network (NHSN) vaccination status for residents and staff as well as use of any therapeutic treatments (e.g., monoclonal antibody). This requirement does not apply to ICFs-IID.
The rule was scheduled to go into effect on May 21, 2021. However, CMS has publicly stated that it will not enforce compliance until June 14. 
AHCA/NCAL recommends that facilities implement several important steps before June 14 to ensure compliance with this new requirement.

1. Develop a policy and procedure on offering and educating staff on the COVID-19 vaccine. AHCA/NCAL has developed a 
template policies and procedures for facilities to use to facilitate compliance with this new rule. In addition, AHCA/NCAL has developed a template declination form for facilities who want to use a declination form to help track staff and residents who decline the vaccine. Note that use of a declination form is not required by CMS. 
2. Track all staff and resident vaccination status. Providers must know their staff and resident vaccination status to comply with this rule. For residents, this should be documented in their medical record and include:
  • Education provided to the resident or resident representative regarding the benefits and potential risks associated with the COVID-19 vaccine (including date and name of representative); and
  • Each dose of the COVID-19 vaccine administered to the resident; or 
  • If the resident did not receive the COVID-19 vaccine due to medical contraindications or refusal.
 For staff, you will need to develop a process to document that includes:
  • Staff were provided education regarding the benefits and potential risks associated with the COVID-19 vaccine (include date);
  • Staff were offered the COVID-19 vaccine or information on obtaining the COVID-19 vaccine; and
  • The COVID-19 vaccine status of staff and related information as indicated by NHSN.
Your database should also include which vaccine they received and the date of both shots, in case of the need for boosters later that are based on when and what vaccine a person received. To assist providers, AHCA/NCAL has developed a template staff vaccination logPlease note, under this rule, staff is defined as any individuals who work (including contractors or consultants) or volunteer in the facility once per week. 
If you have not started tracking staff vaccination status, you can ask staff their vaccination status and for a copy of their vaccination card. Per the 
Equal Employment Opportunity Commission, you can ask the employee directly for proof of vaccination, but not their medical information. The requirement also indicates that “if a staff member is not eligible for COVID-19 vaccination because of previous immunization at another location or outside of the facility, the facility should request vaccination documentation from the staff member to confirm vaccination status.

3. Document education provided to staff and residents. Facilities should be prepared to provide samples of the materials they are using to educate staff and residents on the safety of the COVID-19 vaccine to surveyors. This must include a link to the Food and Drug Administration’s Emergency Use Agreement Fact Sheet for the vaccine(s) being offered:
4. Re-educate and offer the COVID-19 vaccine to all staff and residents who previously declined. While the QSO Memo and IFR are unclear, the intent is to make sure all staff and residents who are not vaccinated have been educated and offered the vaccine. We believe this is a good opportunity to re-educate and offer the COVID-19 vaccine to all staff and residents who previously declined. This will allow you to document your education attempts, their refusal, and show the surveyors that you are making good faith efforts to comply with this rule.  
5. Start submitting to the NHSN today. Facilities should NOT delay in submitting their vaccination data to NHSN. Facilities are required to submit data via NHSN by June 13 at midnight in order to avoid penalties. However, submitting vaccination data at the last minute will very likely lead to challenges with the submission process that will not be resolved before the deadline. Facilities should start submitting data this week to the two modules to make sure they learn how to do it correctly. Providers do NOT need to upgrade to SAMS Level-3 access to submit vaccination data. Please read this 
vital blog post for additional info on submitting this to NHSN.

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