Archive July 2023

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Quality Reporting Program: Non-Compliance Letters Sent via iQIES

On July 20, 2023 CMS provided notifications to facilities that were determined to be out of compliance with Quality Reporting Program (QRP) requirements for CY 2022, which will affect their FY 2024 Annual Payment Update (APU).

Non-compliance notifications have been distributed by the Medicare Administrative Contractors (MACs) and were placed into facilities’ My Reports folders in iQIES for SNFs.

 Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 pm, August 18, 2023.
If you receive a notice of non-compliance and would like to request a reconsideration, see the instructions in your notice of non-compliance and on the appropriate QRP webpage:  
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AHCA's New Podcast Discusses Workforce Development

AHCA published the first episode of its new podcast, Perspectives in Long Term CareEpisode 1 dives into ways to combat workforce challenges with Christopher Schmidt, president and CEO of Schmidt Wallace Healthcare in Alabama. 

Below is a summary of the key points Christopher Schmidt made about how his company is improving its workforce during the nationwide labor shortage. 
  • Recruiting and Hiring
    • They now have a full-time recruiter
      • Job offers have to be instantaneous
      • Following up on applications has to be nearly immediate, and his staff follow up by 1) text, 2) call, and 3) email
    • They have less red tape and fewer supervisors are involved in the interview process, further expediting the job offer process
    • The team meets the job market where they are
      • Food markets and pickup soccer matches are two targets 
      • Working only with community colleges is not enough
    • Special job titles
      • For example "concierge" instead of a "customer service representative"
        • In the past, a job post for the title of CNA received zero to two applicants
        • Now they use titles like “Hospitality Aid,” which receives 100+ applications
          • While this type of title receives applicants who cannot be CNAs, they still try to find value in those other applicants for other positions
  • Perks
    • Wages are important, but that is not all that matters
    • The environment, culture, and how people are treated make a big difference 
      • Respect from supervisors 
      • All of the managers are also CNA credentialed 
    • Weekly retention brainstorming meetings with management and other staff
    • They host a weekly retention event 
      • Always aiming for meaningful and memorable events
        • Theme
        • Music
        • Contest with a prize 
      • Pizza parties are overdone
      • Take the events to the units; the break room is sometimes overly relied upon
  • Training and education
    • Broadening the workforce pipeline
    • Make a clear career path and promotion ladder 
      • Clear pay increases can be earned over time

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Proposed Rule Changes for Immunization Requirements for Health Care Workers

The Maine Department of Health and Human Services, Maine Center for Disease Control and Prevention has announced a public hearing will be held on August 7th at 9:00 am at 109 Capital Street, Augusta, ME. The purpose of the hearing is to hear feedback regarding proposed changes to Immunization Requirements for Healthcare workers. 

The Department is proposing routine technical rule changes to amend Chapter 264, Immunization Requirements for Healthcare Workers, that include removing COVID-19 from the list of vaccine preventable diseases for which Designated Healthcare Facility employees must show proof of immunization or provide appropriate exemption documentation. 

Written comments will be accepted until August 17th.

More information can be found here:

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MHCA now accepting registrations for 2023 Fall Health Care Conference & Expo

Dear Member,
MHCA will be posting information about our annual Fall Health Care Conference & Expo to our website very soon. As a member benefit, we are thrilled to offer you an advanced copy of the Attendee Registration Packet and Conference Brochure.
The theme is Staying Resilient in Challenging Times. This year, we set out to include sessions to celebrate successes, encourage resilience, and provide tools and resources to help you beat the burnout blues, prepare for upcoming changes, build connections, overcome challenges, manage stress, improve communication, provide high quality care, and so much more. 
If you're hoping to reserve a room at the Samoset, we strongly encourage you to review the corresponding section in the attendee registration packet ahead of time so that you have ample time to prepare. The hotel reservation process goes LIVE on August 7, 2023 at 10:00am (not before).  
We're anticipating an excellent conference and we look forward to connecting with you on site at the Samoset.  We hope you'll be able to join us this year!

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Antimicrobial Stewardship Certificate Program Scholarships Available

The Society of Infectious Diseases Pharmacists (SIDP) is offering scholarships to complete our new Antimicrobial Stewardship Certificate Program (a $600 value!) free of charge!

Eligibility: Clinicians (physicians, pharmacists, nurses, nurse practitioners, physician assistants, and microbiologists) without specialized training in infectious diseases who are engaged in antimicrobial stewardship work or who wish to transition to this area of work and who live and work in the United States who identify as underrepresented minorities.

Benefits of Program Participation:
  1. Opportunity to network with other clinicians across the nation
  2. Live panel discussions with experts once per quarter
  3. Review and feedback on submitted project from members of SIDP
  4. Access to premier content delivered by expert clinicians
  5. Certificate of completion (28-32.5 hours of ACPE-accredited CE for pharmacists)
  6. FREE 1-year associate membership to SIDP (upon program completion)
Enrollment: Participants will complete the program as part of a cohort. Start dates will occur on the first business day of each quarter starting August 15th, 2023 and continuing through July 1, 2024. Completion of the program is expected in 1 year from initial enrollment.
Submit an Application
SIDP is solely responsible for the content of the Program and selection of all faculty, authors, and moderators. Scholarship opportunities are supported by an independent medical education grant from Pfizer, Inc.  

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Maine Department of Labor to Start Rulemaking Process in the Fall for Paid Family Medical Leave Program

On July 11, Governor Mills signed an historic budget that includes the creation of a paid family and medical leave program, making Maine the 13th state to establish one. Beginning in 2026, eligible workers in the private and public sector will have 12 weeks of paid time off available to them for family or medical reasons including illness, to care for a relative, or for the birth of a child.

“Paid family and medical leave improves the lives of Maine’s working families and strengthens our workforce and economy,” said Laura Fortman, Commissioner of the Maine Department of Labor. “The Maine Department of Labor will be diligently working with all interested partners to stand up this new program.” 

The new program was negotiated by Governor Mills to ensure it is tailored to meet the needs of Maine families and Maine’s economy.

When the budget goes into effect in October 2023, the Department will begin the rulemaking process. Initial rules necessary for implementation must be adopted by the department by January 1, 2025.

The rulemaking process will include an informal period for collecting information prior to the formal process required by the Maine Administrative Procedures Act (MAPA). MAPA requires the Department post draft rules for public comment for a period of at least thirty days. During this comment period, the Department intends to hold a public hearing in order to gather feedback on the drafted rules as well as collect written comments. Final adoption of the rules requires the Department to provide a response to all public comments.

Contributions to the Paid Family Medical Leave fund will begin January 1, 2025, and benefits are scheduled to begin on May 1, 2026.

As the process evolves, the Department will keep the public, workers, and employers involved and informed. As information becomes available, it will be posted on the Department’s website here:

Time to Review Your Provider Preview Reports

The Skilled Nursing Facility (SNF) Provider Preview Reports have been updated and are now available. These reports contain provider performance scores for quality measures, which will be published on Care Compare and Provider Data Catalog (PDC) during the October 2023 refresh.

The data contained within the Preview Reports are based on quality assessment data submitted by SNFs from Quarter 1, 2022 through Quarter 4, 2022. Additionally, the Centers for Disease Control and Prevention (CDC) COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) measure reflects data from Quarter 4, 2022. The data for the claims-based measures will display data from Quarter 4, 2020 through Quarter 3, 2022 for this refresh, and for the SNF Healthcare-Associated Infections (HAI) measure, from Quarter 4, 2021 through Quarter 3, 2022.

Providers have until August 14, 2023 to review their performance data. Only updates/corrections to the underlying assessment data before the final data submission deadline will be reflected in the publicly reported data on Care Compare. If a provider updates assessment data after the final data submission deadline, the updated data will only be reflected in the Facility-Level Quality Measure (QM) report and Patient-Level QM report. Updates submitted after the final data submission deadline will not be reflected in the Provider Preview Reports or on the Care Compare website. However, providers can request Centers for Medicare & Medicaid Services (CMS) review of their data during the preview period if they believe the quality measure scores that are displayed within their Preview Reports are inaccurate.

SNF Provider Preview Reports can be retrieved by:
  1. Select the CASPER Reporting link on the “Welcome to the CMS QIES Systems for Providers” webpage.
NOTE: You must log into the CMS Network using your CMSNet user ID and password in order to access the “Welcome to the CMS QIES Systems for Providers” webpage.
  1. Enter your QIES user ID and password on the QIES National System Login page.
  2. Select the Login button, review the contents of the U.S. Government-Authorized Use Only Window pop-up message box and select the OK button to proceed to the “CASPER Home” webpage.
  3. Select the Folders button from the menu bar.
  4. Select your provider’s shared folder from the Folders list on the CASPER Folders page. The folder will be named in the following manner: [State Code] LTC or SB [Facility ID] Where:
State Code = your 2-character state code
LTC = Nursing Home Providers
Facility ID = CMS-assigned facility ID used for submitting Minimum Data Set (MDS) records
NOTE: The SNF Provider Preview Reports will not be in your provider’s Validation Report (VR) folder.
  1. Select the desired SNF Provider Preview report link from the list of reports displayed on the right side of the CASPER Folders page and the report will display.
NOTE: The SNF Provider Preview report links are titled “SNF Provider Preview Report”.
For questions related to accessing your facility’s provider preview report, please reach out to the iQIES helpdesk at or call 1-877-201-4721. For questions about SNF Quality Reporting Program (QRP) Public Reporting, please email

Mike McNeil Scholarship Fund – Online Application Open!

The Mike McNeil Scholarship Fund application is live now at Supporting documentation, including sealed references, can be mailed to MHCA, 317 State Street, Augusta, ME 04330. Applications for the 2023/2024 school year will be accepted until August 10, 2023.
Now in its 17th year, this program has awarded $76,000, supporting 125 students in their educational pursuits. We are pleased to support these dedicated long-term care employees, their families and volunteers!
Please feel free to contact or (623-1146) if you have questions or comments.
To support the Mike McNeil Scholarship Fund, please consider making a monetary donation and/or participate/sponsor at the MMSF Golf Tournament Fundraiser being held on Tuesday, October 10, at the Samoset Resort, Rockport, Maine. For more information on the tournament, please contact Dianne Chicoine.
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MaineCare Proposes Rule Changes for Nursing Facilities Principles of Reimbursement

In June, the Maine Department of Health and Human Services, Office of MaineCare Services announced proposed rule changes to 10-144 C.M.R., Chapter 101, Ch. III, Section 67, Principles of Reimbursement for Nursing Facilities. A public hearing was held on July 13th. MHCA President/ CEO Angela Westhoff testified on the rule changes and noted a number of positive changes and several items of concern. She also sought clarification on the minimum occupancy penalty which had been previously waived during the public health emergency. She asked for the State to either consider continuing of the waiver or not reinstating it to its full capacity given that nursing facilities are still grappling with a force crisis of epic proportions and occupancy recovery is still not back to pre-pandemic levels. 
Other noteworthy items include a change from 50% to 100% the percentage of the amount owed that nursing facilities must pay when the Division of Audit determines, from the as-filed cost report, that the nursing facility owes money to the Department; adding health savings accounts and flexible spending accounts to the list of Direct Care Cost Components; adding background checks and software costs and licensing fees to the list of allowable costs for the routine component of the rate (we recommended it be fixed cost); proposed language changes to allowable interest expenses being related to patient care; and proposed changes to the classification of purchased central office services.
A full copy of the proposed rule changes can be found here:
Written comments will be received until 11:59 PM on July 24, 2023. For more information, contact Derrick Grant, MaineCare Policy, 109 Capitol Street, Augusta, ME or email:
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Maine DHHS Proposes Removing COVID-19 Vaccine From Health Care Worker Immunization Requirements

On July 11th, the Maine Department of Health and Human Services (DHHS) announced that it will propose removing the COVID-19 vaccine from the list of required immunizations for workers in health care facilities in response to evolving scientific evidence and trends.  
While COVID-19 vaccination remains an important tool to protect public health, the vaccination requirement for health care workers achieved the intended benefits of saving lives, protecting health care capacity, and limiting the spread of the virus in Maine during the height of the pandemic. Despite having the oldest population in the nation, Maine consistently rated among the top states in the country on vaccination and among the lowest on COVID-19 deaths. Maine currently ranks third on bivalent booster vaccination overall and first for those age 65 and older. Additionally, Maine health care professionals’ strong culture of patient safety has limited risk of severe COVID-19 being spread among staff and patients. 
The Department filed the proposed rule change with the Secretary of State earlier this week.  This follows the U.S. Centers for Medicare and Medicaid Services’ (CMS) withdrawal of its requirement for COVID-19 vaccination of health care workers on June 6, 2023. Maine is among four remaining states with some type of COVID-19 vaccine requirement.  
DHHS expects the rule to be published next Wednesday and to adopt the rule following public comment by the end of 2023. DHHS will exercise enforcement discretion regarding COVID-19 vaccination of health care workers during the rulemaking process. Health care providers remain free to implement COVID-19 vaccination requirements for their employees.   
“MHCA commends the Mills Administration for continuing to respond to the latest data and updating COVID vaccine requirements accordingly,” said Angela Westhoff, President and CEO of MHCA. “The requirement achieved its intended goals and we fully support this change. Infections remain low and Maine has some of the highest vaccination rates for long-term care staff and residents. As the science evolves, we will continue to follow best practices for infection prevention and control and will promote ongoing efforts to educate our community about the many benefits of vaccines.”
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