Archive October 2022

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National Quality Awards Intent to Apply Deadline Coming up on November 15, 2022

The Quality Award Program’s intent to apply (ITA) deadline is quickly approaching on November 15, 2022. We encourage applicants who plan to apply for a 2023 Quality Award to submit an ITA by logging in to the Quality Award Portal before the deadline. While not mandatory, applicants who submit an ITA will save money on their overall application fee. 
Below are three ways in which you can get involved with the Quality Award Program: 
  1. National Quality Award Intent to Apply - November 15: Applicants who submit an Intent to Apply will save money on their overall application fee. No paperwork or application is needed. You can access help documents for the Quality Award Portal here.  Submit your ITA payment by logging in to the Quality Award Portal.
  2. Examiner Application - November 10: One of the best ways to understand the demands of the criteria is to serve as an Examiner. The Quality Award Program is looking for individuals interested in learning more about quality improvement and performance excellence to serve as Examiners. Benefits of volunteering with the program include in-person and online training on the Baldrige Performance Excellence Criteria, CEUs, opportunities for professional development, and networking with other industry professionals. Click here to learn more.
  3. Quality Award Board Nominations – November 10: The Quality Award Board is seeking self-nominations for their upcoming election process. The 12-member board has oversight over key functions and the strategic direction of the program. For more information, please visit the board website
Here is what other providers are saying about their experience.   For questions, please contact the AHCA Quality Award Team at  

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MHCA Provides Testimony to DHHS on Proposed MaineCare Rate Determination Schedule

Pursuant to Public Law 2021 Chapter 639, the Department must annually develop a schedule of rate determination in consultation with the MaineCare Rate Reform Expert Technical Advisory Panel (TAP). The Department must then post the proposed rate determination schedule on its publicly accessible website, provide an opportunity for the public to review and comment on the rate determination schedule, and make available a summary of these comments on its publicly accessible website.
MHCA President/ CEO Angela Westhoff testified on the proposed schedule noting that nursing homes (Section 67) and private non-medical institutions (Section 97-C) are on the schedule for Calendar Year 2023. Ms. Westhoff’s testimony noted that currently rates to do not keep pace with the cost of providing long term care services and that there was a $46 million dollar shortfall identified in a recent analysis of the 2021 as filed cost reports for nursing facilities in Maine.
She stated, “Facilities are struggling to make ends meet and remain open. We saw six facility closures over the past year, and many long-term care facilities are at risk of closing in the future. In addition to the lagging reimbursement rate, inflation is skyrocketing, minimum wage rises every year creating wage compression throughout the workforce, and the pandemic’s long shadow continues to loom ominously over facilities. These factors are driving up the costs of providing skilled nursing care to those who need it the most.”
She asked that as the Department approaches the rate determination process that overall rates increase to ensure access to long term care and that opportunities for provider input are robust.
Questions on the Rate Determination Schedule can be sent to Amanda Lee, Rate Setting coordinator at
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AHCA/NCAL Reacts to Biden Administration’s Plan to Strengthen Oversight of Poorest-Performing Nursing Homes

Recently, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), representing more than 14,000 nursing homes and assisted living communities across the country that provide care to approximately five million people each year, released a statement in reaction to the Biden Administration’s announcement on strengthening oversight of the Center for Medicare and Medicaid Services’ (CMS) Special Focus Facilities program for nursing homes.
Mark Parkinson, president and CEO at AHCA/NCAL noted, “We appreciate some of the steps the Biden Administration is making today to address the small portion of chronically, poor performing nursing homes as well as grant opportunities to help address our long term care labor crisis. However, we remain concerned that the rhetoric surrounding these reforms is degrading to the millions of nursing home caregivers who are committed to caring for their residents like their own family and have risked their lives serving on the frontlines during this pandemic.
“Residents are not victims of the nursing home industry. Too many were victims of a vicious virus that targets the elderly as well as terrible public policy decisions—made by both parties—that failed to support and prioritize our most vulnerable. We hope to work with the Administration to fully appreciate the role of nursing homes in our nation’s health care system, the dedication that our caregivers have to their residents, and the need for policy that pushes improvement, not punishment.”
“The Special Focus Facilities program is supposed to identify facilities in need of improvement and assistance. Escalating citations and penalties have neither helped turn these facilities around nor prevented other facilities from becoming chronic poor performers. Last year, we proposed substantial reforms, including a five-step process on how to address chronic, poor performing nursing homes. The survey system needs to adopt this process to make meaningful changes for the residents in these facilities.” 
“Meanwhile, much more is needed if we wish to rebuild and expand the long term care workforce. Nursing homes have experienced the worst job losses of any health care sector. Analysts have projected that it will require billions of dollars to hire more than one hundred thousand more nurses and nurse aides if a federal staffing minimum moves forward. Long term care needs a concerted and considerable investment to recruit and retain more frontline caregivers and address access to care issues for millions of seniors.”  
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Important Information on MDS for Residential Care and Adult Family Care Homes

MHCA has received important information from the Case Mix Manager and State RAI Coordinator in Maine regarding coding and scoring of item E1 on the MDS-RCA and MDS-ALS in the State of Maine. Please review the information from the MDS manual that all residential care facilities are required to follow and please consider making the appropriate updates to your software.
Based on the licensing rules and the MDS ALS/RCA Manual, facilities are required to code Section E1 items, based on a 28-day lookback period.  If the coding is found to be incorrect during a case mix quality review audit, the facility is at risk for being placed into sanctions which could result in a financial recoupment of 2%, 5%, or 10% of all MaineCare funds received for a three-month period of time. 
Here is an excerpt from the MDS-ALS/RCA Manual, June 2022

MDS-ALS/RCA Manual, page E-1
E1. Indicators of Depression, Anxiety, Sad Mood
Intent: To record the frequency of indicators observed and reported in the last 28 days (or since admission if less than 28 days), irrespective of the assumed cause of the sign or symptom (behavior). (6/1/17)
The change above was implemented 6/1/17, as noted above. 
MDS-ALS/RCA Manual, page E-3 and E-4
Coding: For each indicator apply one of the following codes based on interactions with and observations of the resident in the last 28 days. Remember to code
regardless of what you believe the cause to be. (3/1/18). For E1o and E1p, there must be documentation in the clinical record to support the coding of E1o and E1p as a clearly noted change. (6/2/22)
CODING: (3/1/18)
0. Indicator exhibited less than one day each week in last 28 days
1. Indicator exhibited one to five days per week during the past 28 days. Behavior must have occurred at least one day every week.
2. Indicator exhibited daily or almost daily (6 to 7 days each week) during the past 28 days or the average of the four weeks is 6.0 or greater.
NOTE: Average is defined as the total of the values for each week in the look back period divided by number of weeks in the look back period.
A screen shot from the E1 Calculator tool has been distributed to all facilities, and is available on our website, is distributed with all trainings and is available on Adobe Connect during the quarterly forum calls.  The instructions clearly define how the facilities are to be coding the E1 Indicators of Depression, Anxiety, and Sad Mood. 
If you have questions, please contact Suzanne Pinette RN, RAC-CT, Case Mix Manager/ State RAI Coordiantor at 207-287-3933 or via email at:
Staff contact:

Maine College of Health Professions LPN Cohort Enrollment

The Maine College of Health Professions' admission deadline for Licensed Practical Nursing (LPN) is November 4, 2022. The goal of MCHP’s one year LPN program is to graduate professionals who are well educated and who demonstrate the knowledge, abilities, and skills required to be a successful LPN. LPN students attend a variety of classes and take care of patients of diverse ages and cultures.

Click here to learn more about the program and admissions process.

2022 Legislative Champion Awards

The MHCA Board of Directors recognized two legislative champions at our 2022 Fall Conference. 
Both of these individuals have been unyielding advocates for long term care facilities and our residents.
The Legislative Champion awards recognize individuals who have demonstrated a commitment to improving the lives of residents in long term care settings.

  1. Senator Troy Jackson, Senate President, representing District 1 in Aroostook County. Senator Jackson has long been an advocate and champion for long term care and Maine’s seniors. For years, he has sponsored legislation to address lagging reimbursement for long term care facilities as well as key legislation to increase wages for direct care workers. Senator Jackson has worked tirelessly with us to address budgetary shortfalls, without which more long term care facilities would have closed, and to ensure that long term care providers were supported during the pandemic through supplemental payments and temporary rate increases. Those achievements would not have been possible without Senator Jackson.  His leadership and steadfast commitment are to be commended. It is for these reasons we are pleased to present Senator Troy Jackson with a 2022 Legislative Champion Award.
  1. Senator Jeffrey Timberlake, representing District 22 in Androscoggin County. Senator Timberlake has sponsored key legislation on a myriad of topics to improve access to care for long term care residents. The senator has worked on issues like increasing MaineCare reimbursement and supplemental payments for nursing facilities with high MaineCare utilization, and he introduced legislation on behalf of MHCA to try and classify health insurance as a fixed cost for MaineCare reimbursement. Year after year, Senator Timberlake has kept long term care residents and facilities at the forefront of issues in Augusta. He has delivered budget and pandemic funding for workers that has kept long term care facilities doors open.  Senator Timberlake continues to support initiatives that provide access to quality long term care and we are pleased to present him with a 2022 Legislative Champion Award. 

HHS Invests $13 Million to Grow and Strengthen the Nursing Workforce

The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), awarded $13 million to bolster nursing education and training to grow the nursing workforce and improve access to nursing education. Today’s awards are part of a series of Biden-Harris Administration investments across HHS and the Department of Labor to support pathways into good-quality nursing jobs. Investing in the nursing workforce pipeline is a key pillar of President Biden’s action plan to improve the safety and quality of care in the nation’s nursing homes.

“Nurses are an essential part of our nation’s health care system,” said HHS Secretary Xavier Becerra. “We are committed to growing the next generation of nurses and ensuring the education and training they receive prepares them to provide high-quality culturally competent care. Supporting nurses and other frontline health professionals providing care in our communities is critical to improving our nation’s health and wellbeing.”

For the full press release, please click here

Deadline to register for RAC-CT is November 1st!

The upcoming Virtual RAC-CT program is at risk of cancellation due to low enrollment. This important program is offered only once per year or every other year. If you have been considering taking the course, please consider registering at your earliest convenience. 

Don't forget, you can take this program for FREE by utilizing funding available from the Maine Community College Workforce Development Compact. For more details on this incredible resource, please click here.

Increase your knowledge of clinical assessment and care planning, completion of the MDS, the regulations surrounding the RAI/MDS process, and managing the PDPM by attending an AAPACN Resident Assessment Coordinator—Certified (RAC-CT) certification workshop. Having the RAC-CT credential behind your name shows that you are a knowledgeable and capable MDS professional.

This certification is the most widely-recognized and respected MDS 3.0 certification available in the long-term care profession, as well as the mark of nurses who understand more than a paper form—they understand resident assessment.

When: November 16, 17, and 18, 2022, 8:00am-5:00pm
Where: Zoom Virtual Platform
Instructor: Andrea Otis-Higgins, MBA, RN, MLNHA, RAC-MT, CHC

For more information and to register, please visit the website. Please reach out to Ashley Ellis, Director of Education with any questions.

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Maine Fire Marshal team share: Navigating The Life Safety Code

The Maine Fire Marshal team would like to share a video resource with MHCA members. The video serves as an introduction to the organizational structure of NFPA 101, The Life Safety Code and how to navigate through it. Please click here to view.

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Memo from LTCOP: Please complete brief vaccination survey

In early October, the Maine Long-Term Care Ombudsman Program (LTCOP), in partnership with Ethos, Maine CDC, DHHS Office of Aging and Disability Services and Licensing and Certification launched the Power of Care campaign.
The objective of the campaign is to increase vaccination rates for both COVID-19 and influenza among direct care staff employed in long-term care facilities and home care.

LTCOP wants to assist in your efforts to promote vaccination among your staff. The Power of Care campaign will utilize social media and peer to peer support to reach direct care staff across long-term services and supports settings providing information about the importance of vaccination.
We are asking providers to please take a moment to tell us about vaccination rates for your staff who provide direct care. Your survey responses will provide a baseline that will allow us to determine the effectiveness of this campaign.

We ask that you complete this quick, two minute survey:
Please complete by Friday 11/04/2022
If you have any questions please contact Trinity Baker, Project Manager, with The Maine Long-Term Care Ombudsman Program. 207-621-1079,       

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