Blog
Archive December 2023
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MHCA Advocacy on Protecting Rural Seniors Access to Care Act to Halt CMS Min Staffing Rule
- By: Angela Westhoff
- On: 12/07/2023 16:29:58
- In: Legislative/Government Affairs
In addition to Senator Deb Fischer (R- Neb.) and Jon Tester (D-Montana) as original sponsors, the legislation is also cosponsored by U.S. Senators Roger Marshall (R-Kan.), James Lankford (R-Okla.), Kyrsten Sinema (I-Ariz.), Joe Manchin (D-W.Va.), Roger Wicker (R-Miss.), Susan Collins (R-Maine), and Angus King (I-Maine) as noted in this Skilled Nursing News article.
MHCA President/ CEO Angela Westhoff comments, “We are extremely grateful for Senator Collins’ and Senator King’s support for the Protecting Rural Seniors Access to Care Act. Long term care is experiencing a severe staffing crisis and the CMS minimum staffing rule will only further exacerbate the work force shortage. Maine continues to experience a cascade of nursing facility closures that limit access to care for our state’s older adults and individuals with disabilities. Two-thirds of our nursing homes would not be able to comply with this unfunded federal mandate. We appreciate Senators Collins’ and King's steadfast leadership in sustaining access to long term care for Maine’s most vulnerable populations.”
Many of the cosponsors have noted access to long term care as a main reason behind introducing the bill. In Maine, MHCA led the advocacy efforts with our coalition of partners including Maine Hospital Association, Maine Medical Association, Maine Osteopathic Association, Leading Age ME/NH, and the Maine Council on Aging.
Read AHCA/NCAL’s latest coverage here.
Staff contact: awesthoff@mehca.org
Changes to Nursing Home Principles of Reimbursement Finalized
- By: Angela Westhoff
- On: 12/07/2023 16:29:20
- In: Legislative/Government Affairs
Maine Health Care Association provided detailed testimony on the proposed changes. The Department’s response to public comments on the proposed rule changes can be found here.
A few highlighted changes include:
- Principle 13.2 (Cost Reports): The Department made two changes: (1) To comply with the Social Security Act, 42 U.S.C. Section 1320a-7k(d), if a nursing facility determines from the cost report that the nursing facility owes moneys to the Department, it must submit 100% (changed from 50%) of the amount owed to the Department with its filed cost report; and (2) In compliance with P.L. 2023, ch. 121, added a requirement that if it is determined that the Department owes the facility money, the Department must reimburse at least seventy-five percent (75%) of the settlement pursuant to the facility’s cost reports within ninety (90) days of receipt.
- Adds health savings accounts and flexible spending accounts to the list of Direct Care Cost Components.
- Adds background checks and software costs and licensing fees to the list of allowable costs for the routine component of the rate.
- Principle 17.4.2.6 (Purchased Central Office services): Adds “Purchased Central Office Services” to the list of Administration Functions under Routine Cost Components to clarify that Central Office services purchased from another provider are only allowable to the extent they are actual costs, as a service provided by a related party. After comments, the Department added clarifying language to the final rule, clarifying that the nursing facility providing this service to another nursing facility, would not be reimbursed for the cost of providing the service.
- Clarifies the Motor Vehicle Allowance to state that only one vehicle per facility is allowed as a Routine Cost Component.
Staff contact: awesthoff@mehca.org
MHCA launching monthly Nutrition and Food Service webinar series in January!
- By: Karen Michaud
- On: 12/07/2023 16:00:13
- In: Education
For dates, and additional information on the sessions we have planned across the series, you may click here to access the event page on our website. [Scroll down to the bottom of the page for the link to the printable flyer, which includes program descriptions.]
We hope you'll consider registering your team for this series. This is an excellent opportunity for your food service department to discuss key concepts, best practices, and essentials for meeting the nutritional needs of residents, improving dining practices, enhancing residents’ quality of life, and being in compliance with regulatory guidelines.
Staff Contact: kmichaud@mehca.org
Exciting Pilot Project Opportunity- PNMI Telehealth Technology Expansion
- By: Ben Hawkins
- On: 12/07/2023 14:09:46
- In: Announcements/Reminders
In this phase (Year 2), MCD Global Health is able to work with up to 95 PNMI sites across Maine – this will include conducting in-depth technology assessments at each of the selected sites, helping each individual location select a telehealth solution that meets their needs, and finally to purchase and deliver the technology to each of the sites under the MaineCare PNMI project funding.
All PNMI Facility Types are eligible to participate, and all participating sites are allocated a base level of funding around $5,500; This funding will be to purchase at least one device that will be used solely for telehealth encounters. All equipment will be purchased via grant funds, and then owned/maintained by the PNMI’s in perpetuity. If spatial considerations or assistive software and hardware needs are required to best suit the residents and the facility’s needs, both of these open up an additional funding bucket that can be utilized in addition to the base funding.
Additional Information can be found here and here, and if you have further questions, feel free to contact either Reid Plimpton, Program Manager, at rplimpton@mcd.org, or Phonse Allen-Laney, Program Coordinator, at aralaney@mcd.org.
Finally, If you are interested and ready to on-board and participate, as a next step, MCD Global Health is hoping you will take just a few minutes to complete their survey. https://www.surveymonkey.com/r/DW6HMKB
Staff contact: bhawkins@mehca.org
MHCA offering our first ever AAPACN Director of Nursing Services-Certified workshop!
- By: Karen Michaud
- On: 12/07/2023 11:14:13
- In: Education
The DNS-CT® credential from AAPACN shows that individuals have the leadership and management skills and knowledge to excel as a DON. Certification indicates that they have met nationally recognized standards of expertise for directors of nursing services in long-term care, that they are up to date with the rules and regulations, and that they can lead and nurture their team.
For program details, you may click here to access the event page on our website. MHCA is an AAPACN Training Partner so registration will be completed through their website. Please note, an AAPACN membership is not required to participate but purchasing a membership (at the point of registration) is the best value for your investment dollars. For information about AAPACN membership you may click here.
This is an excellent opportunity for both seasoned Directors of Nursing Services as well as nurses interested in exploring this career path.
Staff Contact: kmichaud@mehca.org
Have you completed your CMS Resident Internet Questionnaire?
- By: Maureen Carland
- On: 12/07/2023 09:21:45
- In: Quality/Regulatory
Wireless Internet Access
CMS believes that all nursing home residents should have access to the internet, just as they would in a common household. If your facility does not have facility-wide wireless internet access for residents, please fill out and submit the Wi-Fi questionnaire by 12/22/23 for CMS to explore the reasons and possible solutions. The questionnaire can be found in the downloads section below.
Access the Questionnaire Here
For more information see QSO 23-23-NHs
Staff Contact: mcarland@mehca.org
HHS Issues Cyber Security Alert
- By: Maureen Carland
- On: 12/06/2023 14:13:08
- In: Quality/Regulatory
This advisory highlights a pressing concern related to a security vulnerability known as "Citrix Bleed," which poses a significant risk to the confidentiality of healthcare data. Citrix Bleed has been active since August 2023 and potentially enables malicious actors to gain unauthorized access to sensitive healthcare information by circumventing password and multifactor authentication protocols.
The systems at risk of Citrix Bleed compromise include NetScaler ADC (formerly Citrix ADC) and NetScaler Gateway (formerly Citrix Gateway). The affected versions are as follows:
- NetScaler ADC and NetScaler Gateway 14.1 versions before 14.1-8.50
- NetScaler ADC and NetScaler Gateway 13.1 versions before 13.1-49.15
- NetScaler ADC and NetScaler Gateway 13.0 versions before 13.0-92.19
- NetScaler ADC and NetScaler Gateway version 12.1 (End of Life)
- NetScaler ADC 13.1FIPS versions before 13.1-37.163
- NetScaler ADC 12.1-FIPS versions before 12.1-55.300
- NetScaler ADC 12.1-NDcPP versions before 12.1-55.300
- kill aaa session -all
- kill icaconnection -all
- kill rdp connection -all
- kill pcoipConnection -all
- clear lb persistentSessions
As a reminder, it is imperative for everyone to remain vigilant, especially during the holiday season, and refrain from clicking on suspicious emails.
Staff contact: mcarland@mehca.org
MDS Errata
- By: Maureen Carland
- On: 12/06/2023 13:13:39
- In: Quality/Regulatory
Please note that these revisions are scheduled to take effect in production on December 12, 2023. Importantly, they will have a retroactive impact, meaning that any assessments submitted between October 1, 2023, and December 12, 2023, will also be subject to the edit and mapping changes outlined in these issues during assessment validation.
To download, go to the CMS MDS Technical Information webpage and scroll to the Download section.
Staff contact: mcarland@mehca.org
Holiday Decorating and Life Safety
- By: Maureen Carland
- On: 12/06/2023 13:11:01
- In: Quality/Regulatory
1. Choose Artificial Greenery
When adorning your facility with greenery, use only artificial greenery rather than natural evergreens. Artificial greenery is not only durable but also safer when it comes to fire hazards. Make sure the artificial greenery you use is labeled as fire-resistant or flame-retardant and is UL listed. This label indicates that the product meets recognized safety standards.
2. Use LED Lights
Lights are an integral part of holiday decorations, adding warmth and sparkle to your facility. When selecting lights, choose LED lights, which are more energy-efficient and produce less heat compared to traditional incandescent bulbs. Be sure to check the label to confirm that the lights are intended for indoor use and bear the Underwriter's Laboratories (UL) or Factory Mutual (FM) marks, signifying their safety compliance.
3. Use Electrical Power Safely
An outlet is the best way to power your holiday lights and decorations, you can use a single power strip if necessary. However, it's crucial to ensure that the power strip is UL 1363 listed and surge-protected. This added protection can prevent electrical overloads and reduce the risk of fires caused by faulty equipment. Can't reach an outlet? Move closer. Don't use extension cords or "piggyback" with multiple power strips plugged in to one another.
4. Inspect Electrical Decorations
Before putting up your electric lights, inspect them carefully. Look for labels indicating that they are designed for indoor use and bear the Underwriters' Laboratories (UL) or Factory Mutual (FM) marks. Damaged or frayed wires, as well as loose sockets, can pose fire risks and should be replaced promptly.
5. Use Safe Hanging Methods
When hanging decorations, opt for electrical tape or cup-type hooks rather than staples, tacks, nails, or paper tape. These alternatives reduce the risk of damaging wires and causing electrical issues.
6. Maintain Clearance
Make sure that your holiday decorations do not come into contact with items such as paper, packages, or cloth. Keeping a safe distance between decorations and flammable materials is essential to prevent fires.
7. Avoid Blocking Exits and Safety Equipment
For the safety of your colleagues, residents, and visitors, keep decorations out of corridors, aisles, stairways as well as and off windows and doors. Ensure that decorations do not obstruct exit doors, exit signs, fire and smoke doors, sprinklers, smoke detectors, fire extinguishers, pull stations, emergency lights, or any other life safety equipment. This unobstructed access can be critical in the event of an emergency.
8. Respect Fire Safety Measures
It's vital to avoid hanging decorations on fire doors or doors in fire corridors. These doors play a crucial role in containing fires and maintaining safe evacuation routes.
By following these life safety guidelines while decorating for the holidays, you can create a festive and secure environment for residents, staff, and visitors alike. Enjoy the holiday season and may your center shine with the spirit of the season while prioritizing safety.
Staff contact: mcarland@mehca.org
Special Announcement from Carrie Rice at Maine CDC Regarding New C-Diff Collaborative
- By: Maureen Carland
- On: 12/06/2023 13:09:01
- In: Quality/Regulatory
We are happy to announce the Phase 1 launch of that workgroup today. First, we partnered with the U.S. CDC to administer a survey to assess current practices surrounding C. diff infections. This survey is based off of one they use in hospitals and is unique for Maine LTCFs. The survey can be completed non-identifiable and will demonstrate overall combined state status.
The overall intention of the collaboration would be to identify best practices and share information for learning and improvement. Participation at the facility level does not need to be limited to Infection Prevention and we encourage the IP to partner with other persons at their facility to fill out the survey. For this phase, please fill out only one survey per facility.
As announced at the MHCA fall conference, a Clostridioides difficile (C. diff) collaborative workgroup is launching.
We are happy to announce the Phase 1 launch of that workgroup today. First, we partnered with the U.S. CDC to administer a survey to assess current practices surrounding C. diff infections. This survey is based off of one they use in hospitals and is unique for Maine LTCFs. The survey can be completed non-identifiable and will demonstrate overall combined state status.
The overall intention of the collaboration would be to identify best practices and share information for learning and improvement. Participation at the facility level does not need to be limited to Infection Prevention and we encourage the IP to partner with other persons at their facility to fill out the survey. For this phase, please fill out only one survey per facility.
Survey Instructions for Use:
Click on the Link: https://www.surveymonkey.com/r/CDI-Maine.
The infection preventionist should partner with others (e.g., frontline staff representation, champion representation, quality personnel) to fill out the survey.
- Please answer to current practices occurring and not just best practice policies to help identify any opportunities for improvement.
- The tool may be filled out anonymously by leaving the optional questions blank.
- The hard copy can be used to pre-record and work with key partners prior to entering on the survey link.
- Only one survey per facility needs to be filled out.
- When answering open-text fields consider exceptions to the rule, variations by role, frequency, and challenges.
If you have issues with the link above, please reach out to MECDC.HAI@maine.gov and we can work with you to get your information entered.
~~Please complete survey by December 27th, 2023~~
After survey next steps:
- U.S. CDC will provide a state-wide complied report to share with all LTCFs to highlight best practices, gaps, and opportunities.
- We will schedule a webinar to discuss the report, and schedule Phase 2 of the workgroup.
- For Phase 2, participants would select at least one identified opportunity-for-improvement (OFI) at their facility to work on. (A more in-depth review and report into each facility led by the US CDC will be an option for participants).
- Participants will engage with each other through scheduled virtual meetings to exchange challenges, wins, and outcomes.
Please reach out to Carrie for any questions at MECDC.HAI@maine.gov
Staff Contact: mcarland@mehca.org