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Archive February 2023

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CMS Proposed Rule on Nursing Home Ownership Transparency

Earlier this week, CMS posted a proposed rule to increase ownership, managerial, and other information required to be disclosed by Medicare and Medicaid funded nursing homes. The proposed rule would implement provisions of the 2010 Affordable Care Act requiring disclosure of information about nursing home ownership and oversight. CMS states that this additional data would give a more complete background on the organizations and individuals that own, oversee, and facilitate the operations of nursing homes.
 
The reporting would be required upon initial enrollment and revalidation or as a part of any change of ownership. Medicare and Medicaid facilities would use CMS Form CMS-885A. For Medicaid-only nursing facilities, the data would be reported using a state-established method.
 
CMS is further proposing several definitions to assist nursing homes in furnishing the requested data. This includes, for purposes of Medicare enrollment, definitions of private equity company and real estate investment trust. 
 
CMS intends to make the reported data publicly available if this rule is finalized. However, it would provide more information after the final rule is published regarding the timing, vehicle, and content of this publication. 
 
CMS’ fact sheet? includes additional information on the proposal. AHCA will continue to review the proposed rule and engage relevant member groups in our comment development as well as any other follow-up determined necessary.
 
Staff contact: awesthoff@mehca.org

MHCA Legislative Update for February 16

MHCA’s legislative work at the state house continues. Last week, the Appropriations and Financial Affairs Committee voted unanimously to approve the $25 million in one-time COVID Supplemental Payments in the Governor’s Supplemental Budget (LD 206).
 
MHCA also asked the Committee for an extension on the use of the current $25 million in supplemental payments to be used through June 30, 2024 so if approved both allocations will be available to facilities to use through June 30, 2024.
 
LD 206 was voted out Ought to Pass as Amended. This is an emergency bill so with a 2/3 vote of each chamber, the bill would take effect the date of the Governor signs it. MHCA will keep members updated on this.
 
Public hearings on the Biennial Budget (LD 258) are already underway. Sections pertaining to long term care are scheduled for Wednesday, February 22nd (subject to change).  
 
On February 14, the Health and Human Services Committee held work sessions on two bills of note to long term care providers. LD 99, An Act to Clarify the Allowable Temperature Range in Certain Long-term Care Facilities was voted out Ought Not to Pass with a report back to the committee by January 2024. The Division of Licensing and Certification will be tracking resident complaints on temperature and will report back to the Committee.
 
The committee also held a work session on LD 251, A Resolve, to Classify Employee Health Insurance as a Fixed Cost for MaineCare Reimbursement in Nursing Facilities. The bill was tabled in anticipation of additional bills coming before the committee dealing with long term care rate reform.
 
Staff contact: awesthoff@mehca.org

Does your team understand your CMS Five Star Quality Rating?

The CMS Care Compare website and Five Star Rating System continues to be a primary source of information for families selecting a care center for their loved ones.  Don’t miss the opportunity to grow your understanding of the five star methodology, how to improve your ratings, the importance of your quality improvement process, and more.
 
MHCA's webinar, CMS Five Star: Methodology & Improvement Strategies, will be hosted on April 12, 2023 from 1-2:00PM (using the Zoom platform). For details, you may click here to visit the event page on our website.

If you have questions, feel free to reach out to me at 207.623.1146 (ext. 216) or use the link below to send me an email. 

Staff Contact:  kmichaud@mehca.org

National Skilled Nursing Care Week

“Cultivating Kindness" announced as the theme for National Skilled Nursing Care Week® (NSNCW) from May 14 - 20, 2023.  Created by AHCA in 1967, the annual observance celebrates the essential role that skilled nursing care centers serve in providing safe and effective 24-hour nursing care to millions of individuals each year. 
 
Skilled nursing care centers around the country are encouraged to host events that celebrate the individuals who reside, work, and volunteers while adhering to infection control requirements and precautions in place for COVID-19.  
 
On February 21, the products and a planning guide will be available. Share your stories and acts of kindness throughout the year on social media with the hashtag #NSNCW. Follow National Skilled Nursing Care Week page on Facebook.

Staff contact: dchicoine@mehca.org

MaineCare Rate Reform Meetings Have Begun

Maine DHHS and partners have begun hosting their MaineCare Rate System Reform meetings. The first meeting for Section 67 Nursing Facility and Section 97 Residential Care Facility (PNMI Appendix C) was on February 1. Click on these links to see the meeting presentation slides and recording. We will be sure to let you know about future meetings as they get scheduled.

Staff contact: bhawkins@mehca.org 

CMS Resources on Strengthening the Direct Care Workforce

The Centers for Medicare & Medicaid Services (CMS) has released an online training course and a series of resources that offer strategies and information on self-direction of home and community-based services, strengthening the direct service workforce (DSW) in rural areas, and emerging strategies for states. Emerging Strategies for States: DSW Learning Collaborative summary of themes, challenges, and strategies from state Medicaid and partner agencies participating in CMS’ 2021 DSW State Medicaid Learning Collaborative.

Check out: ACL's Direct Care Workforce Page

Supporting and strengthening the direct care workforce is a priority for ACL. Living in the community and participating fully in community life often depends on the availability of services and supports provided by this workforce. Visit our direct care workforce webpage to find more federal resources focused on recruiting, training, retention, and self-direction. 

 

MHCA Continues to Work at the State House

MHCA is continuing to make our needs known to lawmakers in Augusta. This past week included appearances before the Health and Human Services Committee and the Appropriations and Financial Affairs Committee. 

One highlight was our testimony in support of LD 251 - Resolve, to Classify Employee Health Insurance as a Fixed Cost for MaineCare Reimbursement in Nursing Facilities and neither for nor against LD 99 - An Act to Clarify the Allowable Temperature Range in Certain Long-term Care Facilities. Wanda Pelkey, Mike Tyler, Mary Jane Richards, and Ben Hawkins spoke before the committee to elucidate the state of long term care in Maine. MHCA sincerely appreciates Wanda, Mike, and Mary Jane for taking the time to share their valuable perspectives with these legislators. 

The appearance resulted in a positive Maine News Center clip. Click here to view and read the segment. 

Staff contact: bhawkins@mehca.org
 

Reminder: Contact CMS about Potential Minimum Staffing Requirements

CMS is working on creating a nationwide rule to implement a minimum staffing ratio at skilled nursing facilities. Despite Maine having its own staffing ratio requirement, this federal change could require us to hire hundreds of more employees. As we all know, finding employees right now is already hard enough. 

If you haven't contacted CMS yet, we recommend doing so by February 28. Below is an overview of how to do so. Additionally, AHCA updated the 2023 Q1 Your Top Line report on LTC Trend Tracker. This report notes your current staffing ratio, which can be used to help illustrate in your letter to CMS how much an increased requirement (which is likely to be 4.1 hours per resident day) would be an added strain on your hiring needs. Click here to learn more about how the trend tracker can enhance your testimony. 

We aim 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:  
Staff contact: bhawkins@mehca.org

 

Register Now for 2023 AHCA/NCAL Quality Summit

The 2023 Quality Summit will provide can’t miss programming designed for quality practitioners at all levels. Sessions will showcase the innovative practices of providers across the country, offer peer-to-peer idea exchanges, new solutions from sponsor partners, and engaging keynote presentations. The Summit will feature a strong slate of sessions this year, with topics including the Baldrige criteria, workforce retention, diversity, equity and inclusion, quality improvement, survey/regulatory, etc.
 
For more information click here.
 
Staff contact: awesthoff@mehca.org

New Long COVID Resource Available

Some people who have been infected with COVID-19 can experience long term effects, known as post-COVID conditions or long COVID. The Centers for Disease Control and Prevention has a website devoted to long COVID, including the science behind long COVID. AHCA/NCAL has developed this resource to better educate providers about the impact of long COVID including prevention, treatment and related research. Reveiw the Long COVID resource here.
 
Staff contact: awesthoff@mehca.org
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