Archive February 2022

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HRSA to Make More than $560 Million in PRF Payments

The Health Resources and Services Administration (HRSA) is making more than $560 million in Provider Relief Fund (PRF) Phase 4 General Distribution payments this week. Providers will receive an email notification today, Thursday, February 24, if their application was among those processed in this latest batch. 

HRSA is working to review all remaining applications as quickly as possible. Approximately 86 percent of all Phase 4 applications have now been processed. Remaining applications will continue to be processed throughout early 2022. 

Learn More: As individual providers agree to the terms and conditions of Phase 4 payments, it will be reflected on the public dataset
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Legislative Session Highlights for the Week of February 21st

Maine Health Care Association provided testimony on two bills this week.

MHCA provided testimony in support of LD 1807, An Act to Expand Nursing Education Programs. Sponsored by Senator Daughtry of Cumberland, this bill seeks to provide $2.5 million in ongoing funds to the Maine Community College System to expand nursing education. No work session has been scheduled yet.
In addition, MHCA delivered testimony in support of LD 1973, An Act to Support Frontline Health Care Workers By Waiving Professional Licensing Fees. This legislation is sponsored by Senator Jackson of Aroostook and would waive professional licensing fees for emergency medical services persons, registered nurses, licensed practical nurses, respiratory care practitioners, midwives. The licensing fees would be waived for the period of March 1, 2020 to December 31, 2022. It would require any licensing fees paid by these individuals for the period be refunded. An amended version of the bill would also add Physician Assistants to list of provider types. No work session has been scheduled yet.
Several bills that MHCA previously testified on have been scheduled for work sessions. 

On Thursday, Feb. 24, the Health and Human Services Committee will hold a work session on LD 1791, An Act Directing the Department of Health and Human Services To Provide Notice to Hospitals of Nursing Facility Closures.

MHCA convened a stakeholder meeting with the Maine Hospital Association (MHA), the Maine Long Term Care Ombudsman’s Program (LTCOP), and the Division of Licensing and Certification (DLC) to reach an agreement that does not require legislation. The consensus recommendation will be presented to the HHS Committee for their consideration, and we anticipate this will result in an ought not to pass outcome on LD 1791.
Finally, LD 1867, An Act to Codify MaineCare Rate System Reform work session has been rescheduled for Wednesday,  March 2nd. This bill would formalize the MaineCare provider reimbursement rate system reform, specifies rule making requirements for rate adjustments, and establishes a technical advisory panel. MHCA testified neither for nor against the bill.
Looking ahead to next week, public hearings will begin on the Governor’s Supplemental Budget (LD 1995) on Monday. Highlights of the proposed supplemental budget:
  • Approximately $100 million in total funding ($35.8 Million General Fund) to fully implement 125% of minimum wage, accelerating COLAs, etc. across many provider types.
  • $7.6 Million in partial restoration of the Supplemental Wage Allowance for 1/1/22 through 6/30/22.
  • One-time $25 Million (all funds; $7.6 million General Fund) supplemental payment in FY 2023 for nursing homes and residential care facilities.
  • One-time $5.3 million (General Fund) add-on payment for FY 2023 for high MaineCare utilization in PNMI-Cs. It is anticipated that the Department will structure this similar to the nursing home high MaineCare utilization.
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Are you ready to celebrate National Skilled Nursing Care Week?

It's almost time to celebrate National Skilled Nursing Care Week! (NSNCW). The 2022 NSNCW Planning Guide and Product Catalog are good tools that members can access online here. Get ideas about NSNCW events and activities and check out the great selection of Creating and Nurturing Connections themed products available this year. You will also find downloadable graphics, sample social media posts and more!

Don’t forget to “Like” the National Skilled Nursing Care Week Facebook page here for updates and to share your ideas and see what other centers are planning during this special week, May 8-14, 2022, and be sure to use the hashtag, #NSNCW in any social media posts related to the observance. We look forward to NSNCW and celebrating the work you do every day.

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CMS releases Skilled Nursing Facility Web Pricer

CMS has released the Skilled Nursing Facility Prospective Payment System Web Pricer for fiscal years 2020–2022. 

For the best experience, access the Web Pricer through Google Chrome. You may also use Microsoft Edge or Mozilla Firefox but not Microsoft Internet Explorer.

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Life Safety Code and Fire Safety Tips from AHCA/NCAL

We would like to share some helpful tips from our national association AHCA/NCAL on Life Safety Code and Fire Safety.

Keep in mind there is still time to register for the
MHCA Life Safety Boot camp on March 9 & 10, 2022. MHCA has partnered with the Maine Fire Marshals’ Office and national emergency preparedness experts All Clear Emergency Management Group to develop an intensive two-day program focused on the requirements of NFPA 101 Life Safety Code and NFPA 99 Health Care Facilities Code for skilled nursing centers.

Here are some helpful tips from our national partners:

In a time when a pandemic continues to consume our planning efforts and response, fire safety remains a critical component of emergency preparedness to ensure a safe home and workplace. 

Fires still occur regularly in health care facilities.  Fortunately, they are commonly contained to the room of origin by an automatic sprinkler system.  However, even small fires can lead to significant events.  Often, staff not only have to execute their fire procedures, but also their building evacuation plan.  Like many emergency situations, a fire can result in the implementation of multiple components of an organization’s emergency preparedness plan. 
The importance of the three key components of emergency preparedness come to mind when considering any potential fire or disaster: 
  • Planning
  • Training; and
  • Testing. 
Here are a few specific items to consider when assessing your current fire safety program: 

Sprinkler systems save lives.  However, these systems require on-going testing, inspection and maintenance.  CMS has permitted many providers to pause inspection, testing and maintenance of their sprinkler systems during the pandemic.  While the waiver permitting this is still in place, it may be appropriate to allow sprinkler system vendors back into your buildings.  If you have continued to pause your sprinkler system maintenance, it may be worth conducting a risk assessment to determine when to re-engage with your sprinkler system vendor.   

While sprinkler systems often control the flames, a significant amount of smoke can develop even from a relatively small, controlled fire.  Health care facilities are designed to contain fire and smoke to the room of origin.  However, that requires the room door to be shut and to remain shut.  Do your staff fire procedures focus on smoke containment?  Procedures that highlight extinguishment or instruct staff to gather fire extinguishers may have the wrong focus.  The most important focus for staff is to remove anyone from the fire room, close the door and keep it closed.  Is this the focus of your fire procedures? 

Procedures may work on paper, but they are only as effective as the staff implementing them.  Fire drills can be the most effective method of staff education.  Do you just walk through the motions during a fire drill or do staff actively close doors, clear hallways, communicate and discuss the factors that may require further evacuation?  Participating in hands-on, critiqued fire drills can lead directly to competent and confident staff actions during a true emergency.   

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Welcome new member!

Join us in welcoming Curt Knutsen, General Manager, BELFOR Property Restoration, 60 Gray Road, Suite H1, Falmouth, ME 04105. Tel: 207-800-1377
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Notice of Agency Rule-making Adoption: 10-144 C.M.R. Ch. 101, MaineCare Benefits Manual, Chapter VII, Section 5, Estate Recovery

This adopted rule implements P.L. 2021, ch. 398, Part A, §A-1, pg. 99 to modify MaineCare estate recovery rules to conform with the minimum mandatory federal requirements, which are set forth in 42 U.S.C. 1396p(b). These rule changes were originally implemented via an emergency rule, effective November 24, 2021; routine technical emergency rules are effective for 90 days. This final adopted rule permanently changes the Department’s estate recovery claim so that it is limited to the amount paid by MaineCare for all nursing facility services, home and community-based services, and related hospital and prescription drug services paid on behalf of the Member. The effective date of this change is November 24, 2021, since that is when the emergency rule was implemented.

 Additionally, this adopted rule clarifies the definition of life estate, including how life estates are valued.

 Finally, this adopted rule removes language regarding CMS’s pending approval of changes that are approved and includes minor typographical corrections.

For rules and related rulemaking documents click

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MHCA Legislative updates for the week of February 14th

On Tuesday, February 15, MHCA testified in opposition to LD 1791, An Act Directing the Department of Health and Human Services To Provide Notice to Hospitals of Nursing Facility Closures.
This bill as originally drafted would require the Department of Health and Human Services to provide notice of a nursing facility’s voluntary closure to all hospitals located in the same county or in an adjacent county within 25 miles. The Department would be required to provide the notice within two business days after receiving the notice of closure from the nursing facility. A subsequent amendment proposed by the Maine Hospital Association struck the geographic restrictions and would require notice to all hospitals in the state.
MHCA testified against this bill citing concerns over the timing and the undue stress to residents, families, and guardians if a premature closure notice is made before they are notified by the facility. MHCA is meeting with stakeholders to discuss possible alternatives in advance of the work session scheduled for February 24th.
In other news, the Health and Human Services Committee and the Appropriations and Financial Affairs Committee met jointly on Thursday, February 17th for a briefing by the Department on MaineCare rate increases. The presentation included an overview of the 125% minimum wage increases and cost of living increases for multiple provider types, including nursing facilities and PNMI-C providers. Rate letters are anticipated to be released by the end of this month and rates will be retroactive to January 1, 2022. Subject to legislative approval, Sections 67 and 97, Appendix C providers will also see the partial restoration of the Supplemental Wage Allowance (SWA) as a rate add-on.
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MHCA in the news

MHCA continues to advocate for members at the legislature and in the media. Please see links below to some recent press coverage of long term care issues:  Staff contact:

Senator Collins introduces bill to ease PRF requirements facing overwhelmed providers

Senators Susan Collins (R-ME) and Jeanne Shaheen (D-NH) introduced legislation that builds on their bipartisan work to bolster the Provider Relief Fund (PRF), which has served as a lifeline to frontline health care providers who’ve experienced revenue losses and increased demand for their services during the pandemic. Their new bill, the Provider Relief Fund Improvement Act, strengthens support for overwhelmed providers by delaying complex PRF reporting requirements until after the end of the public health emergency and extending the use of PRF dollars to enhance workplace safety.
“Over the course of the pandemic, the Provider Relief Fund has been a lifeline to hundreds of Maine hospitals, nursing homes, assisted living centers, and physician practices—particularly in rural areas—that have been on the verge of closing their doors permanently. As health care providers continue to struggle with staffing shortages, financial difficulties, and other challenges, the last thing we should be doing is adding to their burden by imposing onerous paperwork requirements,” said Senator Collins. “I am pleased to once again partner with Senator Shaheen to strengthen the Provider Relief Fund so that medical professionals have the resources they need to focus on delivering quality care to their patients.”
Hospitals, nursing homes, assisted living providers, clinics, and other health care providers have relied on the Provider Relief Fund to help weather the financial difficulties created by the pandemic. In rural areas in particular, the PRF has prevented facilities that struggled before and during the pandemic from falling into bankruptcy or closing entirely.
Specifically, the Provider Relief Fund Improvement Act helps health care providers by:
  • Extending current reporting and use-of-funds deadlines to the end of the pandemic;
  • Ensuring that workplace safety improvements – such as security personnel, risk assessments and physical improvements, including panic buttons and security cameras – are an allowable use of PRF dollars;
  • Directing HRSA to distribute any funds remaining in the PRF by either the end public health emergency or by March 31, 2022, and;
  • Creating an application process for certain providers to receive funds returned in compliance with previous deadlines.
To date, the PRF has allocated more than $178 billion in payments to over 410,000 providers across the country. Maine has received nearly $700 million for more than 2,000 providers.

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