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Archive January 2023

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Contact CMS: Minimum Staffing Requirements for Skilled Nursing Facilities

AHCA/NCAL recently hosted a webinar to discuss the importance of and tips on contacting CMS to weigh in on proposals the agency is writing for SNF minimum staffing requirements. Presenters included AHCA/NCAL President and CEO Mark Parkinson and Senior Director, Grassroots Program Matthew Smyth.

The recorded webinar is now available for AHCA/NCAL members. Please log in and register for the webinar in order to view it.
Email educate@ahca.org if you need assistance with registering or have any questions.

Click here to access the webinar.  

Summary of the webinar:

Mark Parkinson says the staffing minimum requirement is the worst public policy idea he has seen in the past 12 years. CMS is going to issue a staffing proposal around May 1.
 
AHCA's goal is to shape the proposal before it comes out on May 1. 
  • AHCA asks we submit a comment by February 28. 
  • All NF staff, including frontline workers, are encouraged to submit comments
They want us to contact CMS to weigh in on their upcoming proposal. 
  • Make comments personalized to drive home message.
    • Use own circumstances and examples
  • Focus on our patients and residents 
Talking points
  • Explain who you are
    • What you do & how long you have been in this line of work
    • Why you work in LTC
    • Describe your building
      • Location, # of units. profile of your residents’ needs
  • Your commitment to quality
    • Mention any AHCA Quality Award or other award you have received
    • Explain what your residents mean to you and your team 
  • Workforce not available
    • Explain how difficult it is to get workers
    • Recruitment challenges
      • How many open positions
      • Inability to fill shifts
  • Asks of CMS 
    • Don’t do this.
      • Or if they do it, then phase it in as the workforce comes back 
    • Any requirement must be paid entirely by Medicaid and Medicare
    • Include a broad definition of staff under the requirement
      • Staff other than nurses still offer valuable care to our residents
    • Note that LTC sector still trying to recover from the COVID pandemic 
How to do it: AHCA/NCAL encourages sending comments through their website. AHCA/NCAL will use their messaging database to ensure all other relevant officials also get our note. 
 
Staff contact: bhawkins@mehca.org

QSO Memo: Audit of Schizophrenia Diagnosis & Antipsychotic Use; Posting Citations Under IDR/IIDR

On January 18th, CMS posted QSO-23-05-NH and there are several key areas to highlight:
  • Adjusting Quality Measure Ratings Based on Erroneous Schizophrenia Coding: The quality measure for long-stay residents who are receiving antipsychotic drugs allows for an exclusion of any residents with a diagnosis of schizophrenia, Huntington’s disease, or Tourette syndrome. CMS is concerned that facilities are erroneously coding residents as having schizophrenia, to exclude residents from counting towards the metric. CMS will be conducting audits of schizophrenia coding in the Minimum Data Set data and, based upon the results, adjust the Nursing Home Care Compare quality measure star ratings for facilities whose audits reveal inaccurate coding.
If CMS finds inaccurate MDS coding, the facility star rating will be negatively impacted:
  • The overall QM and long stay QM ratings will be downgraded to one star for six months (this drops the facility’s overall star rating by one star)
  • The short stay QM rating will be suppressed for six months, and the long stay antipsychotic QM will be suppressed for 12 months.
  • CMS will monitor audited data to identify if facilities with coding inaccuracies have addressed the issues. Follow up audit may be conducted to confirm issue is corrected.
What do we know about the audits?
  • Audits will be conducted offsite.
  • Facilities selected will receive a letter explaining audit purpose, process, instructions for providing supporting documentation.
  • Facility has opportunity to ask questions and seek any clarification needed.
  • CMS is examining evidence for appropriately documenting, assessing and coding diagnosis in MDS (Such as, comprehensive psychiatric evaluation(s), Behavior documentation).
  • At conclusion of audit, facility will have opportunity to discuss audit results with CMS.
  • Facilities have the opportunity to forgo audit by admitting errors and committing to correct the issue. If done prior to start of audit, CMS will consider lesser action related to their star ratings, such as suppression of QM ratings (rather than downgrade).
 
 
  • Posting Citations Under Informal Dispute Resolution and Independent Informal Dispute Resolution (IDR/IIDR):
    • Beginning on January 25, 2023, CMS will post deficiency citations under IDR/IIDR in each section of Nursing Home Care Compare that currently displays citations, and will indicate if a citation is under dispute.
    • CMS cites that the resolution process can take up to 60 days therefore the consumer is unaware of this information until after the process is complete. CMS also states that this will provide transparency to consumers, especially when deficiencies are identified as Immediate Jeopardy.
    • The results will not be included in the star rating calculation until the IDR/IIDR is resolved.
    • If, based on the results of the IDR/IIDR process, the citations are upheld, they will remain posted and will be included in the calculation of the facility’s star rating if applicable.
    • If the citations are overturned (i.e., removed), they will be removed from the website.
    • If the level of scope or severity of a citation is reduced, the citation will be displayed at the reduced level.
To read the full QSO-23-05-NH click here.  
 
Staff contact: awesthoff@mehca.org

Reminder: Nursing Home and Residential Care Facility Rate Reform Virtual Stakeholder Meeting Coming Up on February 1st

The Maine Department of Health and Human Services and its vendor will hold a virtual public meeting for interested stakeholders on Wednesday, February 1, 2023. Nursing home providers (section 67) and residential care facilities/ PNMI-Appendix C providers (Section 97) are urged to attend. The objectives of the meeting will be to introduce the project team and review project goals, workplan, and timeline for rate review and rate determination.

MHCA member input will be very important during this project. We encourage you to participate in these meetings as we work towards NF and RCF rate reform. Included in this reform work will be a Long-Term Services and Supports (LTSS) needs assessment and mapping by county, which will assist in the planning for current and future service and capacity needs in Maine.  

Please contact Bryan Lumbra, MaineCare’s Rate Setting Project Manager, with any questions related to this rate reform initiative.

MEETING DATE/TIME: 

Providers of Section 67 Nursing Facility and Section 97, Appendix C Residential Care Facilities, Rate Study Kickoff Meeting

Date/Time: Wednesday, February 1, 2023, 9:00AM – 11:00 AM

ZOOM: 
https://mainestate.zoom.us/j/87885419641?pwd=SXdtK0pWbzZ4b05xS3lFRTRHamhydz09 

Staff contact: awesthoff@mehca.org

Deadline to submit nominations for 2023 Remember ME program extended

We have extended the deadline to submit nominations to Friday, February 3.

To nominate your resident, please go to the following link, which will take you to the online nomination form. To avoid losing your work, copy and paste full narrative from Word. Submissions must be completed in one session. Partial nominations will not be saved.
 
Remember ME 2023 Nomination Form
 
We are looking for pioneering, innovative residents who meet any of the following criteria:
  • Residents with historically significant backgrounds;
  • Residents who have had unique or interesting accomplishments either while living in the facility or prior to admission;
  • Residents who have overcome either personal or health-related obstacles to achieve;
  • Residents who have served community, state or country (through volunteerism, civic organizations or US military); OR
  • Residents who are considered pillars of the local community.
In fairness to all, we ask you to nominate only one resident from a facility. When considering a candidate, please be sure the resident is willing to be photographed by our professional vendors if he or she is selected. We understand there may be unforeseen circumstances, like illness, that may preclude getting a current photo when the time comes, but residents/families/POAs should be agreeable to the photography heading into the project. We will follow all applicable infection control procedures to ensure a safe photo shoot, i.e. masking, social distancing, etc. This will include requiring residents to be as close to entry points and natural light as possible to avoid having photographers move throughout your communities.

Join us again in recognizing some of our wonderful and inspirational long term care residents. Please be sure to submit your nomination online by February 3, 2023
 
Staff contact: dchicoine@mehca.org  

MHCA Wage & Fringe Benefit Survey sent out - please complete by March 3

On Friday, January 20, the survey was emailed directly to administrators, as well as human resource and business office managers whose email addresses we have on file. MHCA has modified the timeline for completing the annual Wage & Fringe Benefit survey to better align with our advocacy efforts at the Maine Legislature. Your input is vital and we ask you to please complete and return the survey to MHCA by March 3, 2023. As always, individual responses will remain confidential. 

If you need a copy of the survey sent to you (or other staff member), please contact Dianne at the Association office (207.623.1146, ext. 201)
 
Staff Contact: dchicoine@mehca.org

Planning underway for Spring educational calendar

Planning is underway for the Spring educational calendar. We anticipate offering several web-based educational programs between now and the end of June. In addition, we may offer in-person educational opportunities at some point this year. As soon as we finalize details for each event, we will update the Event Calendar on our website. 

If you have specific requests, please don't hesitate to reach out. You have until January 31st to complete the Educational Needs Survey and we'd love to hear directly from your team concerning educational needs unique to your community. 
 
Looking forward to connecting with you soon. If you have questions, I can be reached by phone at 207.623.1146 (ext. 216) or by email.   
 
Staff Contact:  kmichaud@mehca.org

MHCA Announces New Director of Quality and Regulatory Affairs

After an extensive search, Maine Health Care Association is pleased to announce that 
Maureen Carland MA, RN-BSN, NHA has been hired as the new Director of Quality and Regulatory Affairs.  
 
Maureen has over 30 years of experience working in long-term care and healthcare settings. She is a multi-level nursing home administrator at Maine Veterans Homes Scarborough. In her role, she has been responsible for state, federal, JCAHO and CARF surveys. She has functioned as a Compliance officer as well as a HIPAA officer. Maureen led her team to the first AHCA/ Baldridge based Gold Quality award in the State of Maine and has developed and implemented a person centered and resident directed culture. She is also a master gold examiner for AHCA/NCAL and serves as a subject-matter expert on a multidisciplinary committee tasked with evaluating gold quality award applications. She conducted site visits, analyzed application materials, and wrote feedback reports. She holds a Master of Arts degree in leadership as well as a bachelor’s degree in nursing. Prior to long term care, Maureen worked extensively in the behavioral health setting and in staff development and she has incorporated those principles into her practice. 
 
We are thrilled to welcome Maureen to the team! Her first day in the office will be February 21st.
 
Staff Contact: awesthoff@mehca.org

Quality Award Deadline Reminder

Thursday, January 26, is the Quality Award submission deadline for the 2023 AHCA/NCAL National Quality Award program. This deadline is the final deadline for all submissions, and all centers are encouraged to apply regardless of their previous submission of an Intent to Apply.

All Quality Award submissions are due by 8:00 pm ET on January 26. Information about how to submit an application, resources to support the application process, and the portal to submit an application can be found online at the Quality Award website. Questions in advance of the deadline can be directed to quality-award@ahca.org.

Staff contact: awesthoff@mehca.org

Please help us pin down the educational needs of your community!

Dear Members,
 
Happy New Year! As you may recall from a recent E-News article, I recently returned to Maine Health Care Association to step back into the role of Director of Education.  
 
I’m looking forward to connecting again and, through educational opportunities, helping your care center fulfill your mission, navigate change, celebrate excellence, fine tune the skills/competencies of your team, align with industry best practices, maintain financially stability, and promote the best possible care for our most vulnerable residents. 
 
These are challenging times!  I want to affirm our ongoing commitment to serve you in the best way possible. One of the ways we do that is by offering educational content that is both necessary and meaningful for you and your team. 
 
Where I’ve been away from the industry for a time, would you 
please complete this survey to share some of the challenges that are unique to your care center and offer some insight on your educational goals for the coming year? Any information you are willing to share would be so appreciated.
 
We will accept responses until January 31, 2023. 
 
Thank you in advance for your time.
 
Warm regards,
Karen

Welcome New Member!

Join us in welcoming the following new Associate Personal member:
 
Catherine Johnson
322 Maple Street
Rumford, ME 04276
Tel: 207-357-8705
 
Staff contact: dchicoine@mehca.org
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