Archive March 2024

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CMS updates QSO 24-12-NH Federal Monitoring Surveys

CMS has released an update to Quality, Safety, and Oversight Memo (QSO) 24-12-NH (QSO) 24-12-NH, which focuses on Federal Monitoring Surveys (FMS) in Nursing Homes. These surveys are conducted to verify adherence to federal regulations and standards concerning the quality of care and safety within nursing home facilities. The revised QSO communicates the FY2024 mandates and FY2025 estimates for the statutorily required number of Long-Term Care FMS related to Health and Life Safety Code (LSC) and Emergency Preparedness.

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FREE Infection Control Consultation Ending Soon

Maine CDC has collaborated with APIC Consulting to offer complimentary services to Maine Nursing Homes, aimed at enhancing their readiness to prevent the transmission of emerging multi-drug resistant organisms. As this funding is limited, seize the opportunity now to prepare for the future. This consultation will offer valuable insights into areas for improvement, assistance in crafting action plans, and access to resources and educational support.
Top areas of improvement centers have experienced include:
  • MDRO Precautions
  • Early detection and management of residents at risk of MDRO
  • Written Policy, procedure, or protocol regarding CRE or CPO
  • Environmental Cleaning/disinfection
  • Objective quality monitoring/auditing for hand hygiene, environmental cleaning
  • Inter-facility communication/transfers
  • Antimicrobial stewardship plan, including surveillance data collection.
  • Program oversight.
  • IP Education and Training
To learn more about why this is such an import topic, click and watch this brief video.  
Then follow this link to learn more or to sign up for this free resource:  ME CDC - Facility Information — APIC Consulting Services, Inc. 

Feel free to reach out with questions to

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Upcoming Educational Offerings

MHCA has several excellent programs planned in the coming weeks that will be beneficial for you and your staff. Here's a list of what’s on our calendar so far:    For details on any one of these programs, you may click on the titles above to access the corresponding event page on our website. As always, for the latest information on MHCA’s education calendar, we encourage you to visit the Event Calendar on our website.

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Over Two Dozen Hospitals Join Who Will Care? Campaign, Urges Legislators to Save Maine’s Long Term Care Facilities from Further Closures

On Thursday morning, Who Will Care? Campaign hosted a press conference at the State House urging legislators to increase MaineCare reimbursement rates to meet the rising costs of providing long term care. 
Representatives of MaineHealth, Northern Light Blue Hill and Maine Coast Hospitals, Maine Hospital Association, Long Term Care Ombudsman, and Maine Health Care Association, all shared perspectives on the challenges of providing adequate care in a health care system with a rapidly diminishing number of long term care facilities and the urgent need for increased funding from the Legislature. 
“Older adult patients hospitalized in Ellsworth and Blue Hill often need post-acute rehabilitation or skilled nursing home care to successfully recover and before returning home.  With the recent closure of several local nursing home facilities, patients are having to travel far from home for care,” shares Vice President Nursing and Patient Care Services Kristin Cyr, MSN, MBA, CHC, CHPC, Northern Light Blue Hill and Maine Coast Hospitals. “The lack of available beds leads to longer hospital stays as well as added travel burden placed on aging family members wishing to visit.”
“The time for action by Maine’s lawmakers to support a long-term solution is overdue. Too many patients are languishing in hospitals throughout Maine, waiting for a bed in a long term care facility – and waiting for hospital beds that should otherwise be accessible. Care is delayed and outcomes can be impacted,” said Dr. Daniel Meyer, MD, practicing hospitalist and Director of Hospital Medicine at Maine Medical Center. “A wise person once stated, ‘a society can be judged based on the way it treats its most vulnerable people.’ With that as a standard, Maine is failing. We must do better. I ask the Legislature to support additional funding for Maine’s nursing homes to improve access for our vulnerable older Mainers.”
“The latest count is that there are 200 patients in hospitals waiting for a long term care placement. This compromises our ability to care for other patients’ medical needs,” Jeff Austin of the Maine Hospital Association, which represents 36 hospitals statewide, shared. “Furthermore, hospitals are not the right setting for our older adults to be living in when their needs would be best met in a long term care center.”
“Residents deserve to have friends and family just a close drive away, fostering a sense of community and connection that is integral to their well-being. However, the reality is that many rural regions of Maine have only one or two nursing homes within an hour's drive, making the closure of these facilities all the more unfortunate,” said Nicole Marchesi, project manager in the Maine Long-Term Care Ombudsman’s office. “As Maine loses nursing home beds across the state, especially in rural areas, it has become increasingly more difficult to find a new home, especially one that is close enough for loved ones to regularly visit.”
“We are only three months into the year, and three nursing homes have already announced their closure,” said Ben Hawkins, Director of Public Affairs for the Maine Health Care Association. “Since 2020, our state has lost 11 skilled nursing facilities. As today’s speakers made clear, each of these losses ripples across the community, hinders our entire healthcare system, and disrupts residents' sense of security in their homes.”
Since 2014, there have been approximately 50 nursing home and residential care facility closures or conversions to lower levels of care in Maine. Of those closures and conversions, 25 have been nursing home closures, 11 of which occurred since 2020. This escalating rate of closures is happening because of low reimbursement rates coupled with record inflation levels and exploding labor costs due to too qualified direct care workers. The only solution to this problem is to increase MaineCare reimbursement rates to meet today’s price of providing care to Maine people. 
Who Will Care? campaign coalition members include the Alzheimer’s Association, Northern Light Health, Maine Hospital Association, Maine Health Care Association, Leading Age Maine, Maine Medical Association, the Maine Council on Aging, MaineHealth, Maine Osteopathic Association, the Maine Long-Term Care Ombudsman Program, and Maine Public Health Association. The coalition was formed with the intent of advocating for public awareness on the issue of long term care closures and increased funding for long term facilities from the State of Maine. 

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Requesting Survey Responses from Direct Care Worker on Proposed Education Benefit Bill

Lawmakers are considering whether to create a new higher education tuition benefit specifically for direct care workers and their family members. Please fill out this short survey to tell us about whether this would be helpful to you and your family, and what are the most important things you need to stay in your profession.

More information on the proposal: if lawmakers in Augusta pass and fund LD 1718, full-time direct care workers (averaging at least 30 hours per week) would receive an annual $4,000 grant to help pay for college, for up to four years. This benefit could be used by the worker, their immediate family, or their grandchildren to help cover the costs of enrollment at the University of Maine, community colleges, or Maine Maritime Academy.

Direct care workers (such as CNAs) are asked to fill out this survey on how useful the benefit might be for you and your family. 

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Nursing Home Rate Reform Draft Methodology Public Review & Comment Period Open until March 25th

On March 7 and 8, MaineCare held a two-part virtual public meeting to present recommended draft rate methodologies specific to Nursing Facilities, along with rationale. Different components of the methodology were presented at each meeting for interested stakeholders. The presentations and video recordings are now posted online. 
Draft Rate Methodology Public Review and Comment for Section 67, Nursing Facilities Part I, Presentation and Recording - 3/7/2024
Draft Rate Methodology Public Review & Comment for Section 67 Nursing Facilities Part II, Presentation and Recording - 3-8-2024
Guidehouse, the Department’s rate reform vendor, is accepting written comments until Monday, March 25, 2024. The Department will then respond in writing to comments with an explanation of whether and how the feedback was incorporated into the final rate determination. ?
As providers your feedback is very important! MHCA has created this template to help members draft their response to the proposed rate model. Please note that feedback via this on-line survey process is specific to the vendor’s presentations on March 7 and 8 and there are two separate feedback collection links. 
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MHCA Fall Health Care Conference Request for Presentations!

Do you have an innovative idea that has had promising results in your workplace? Do you have clinical expertise that could help improve the health and well-being of the residents we serve? Have you implemented a program that has contributed in a positive way to resident quality of life??
Now is the time to make your mark on the long term care industry in Maine!
MHCA is accepting proposals for breakout sessions at our annual Fall Health Care Conference & Expo, which will be held at the Samoset Resort in Rockport, Maine on October 16 & 17, 2024.
This event targets individuals who serve in long term care communities and provide high quality care and supportive services to residents at all levels of the continuum of care.
Here's a list of topics that members highlighted as educational priorities in a recent survey:
  • Reimbursement Strategies
  • Leadership Skills
  • Quality Assurance & Performance Improvement (QAPI)
  • Behavioral Health / Behavior Management Techniques
  • Culture Change Initiatives ~ Creating a Resident-Centered Culture
  • Care Practices (Dementia, Wound, Alzheimer, Fall Prevention)
  • Ethical Decision Making
  • Coaching ~ Mentoring Staff
  • Communication Strategies
  • Recruitment & Retention Strategies
  • Transitions of Care
  • Regulatory Compliance ~ infection control, fire and life safety, resident rights, state inspections, etc...
To be considered, your proposal must include the following:
  1. Program Title, Description & Learning Objectives
  2. Speaker Biography
  3. Speaker Resume or Curriculum Vitae
Once you have all of the required information, please visit our website to complete the Online Presentation Proposal Form. If you have questions, please contact Cindy Richards by email or phone. Thank you.
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Change Healthcare Update: CMS Posts Accelerated Payments FAQs

Clarifications Address Provider Eligibility Questions

The Centers for Medicare and Medicaid Services (CMS) has posted  a fact sheet with additional guidance for providers and Medicare Administrative Contractors impacted by the Change Healthcare security incident. The fact sheet specifically focuses on frequently asked questions about implementing the Change Healthcare/Optum Payment Disruption (CHOPD) Accelerated Payments program.

This information comes following AHCA/NCAL’s participation in a roundtable discussion with the White House, the U.S. Department of Health and Human Services (HHS), the Department of Labor, and other health care community leaders to discuss ways to mitigate patient and provider harms caused by the cyberattack. Additionally, AHCA/NCAL submitted written questions and proposed solutions to HHS and CMS to help clarify the recently issued Accelerated Payment guidance. 

In the CMS Fact Sheet, there are two Application Criteria FAQs that may be especially helpful for providers: 
  • Question 6: Clarifies that a skilled nursing facility receiving a Periodic Interim Payments (PIP) for bad debts but does not receive Medicare Part A PPS payments via PIPs is eligible to receive an Accelerated Payment if all other requirements are met. 
  • Question 10: Clarifies that a provider is eligible to receive an Accelerated Payment if they are experiencing a delay in claims submission and processing, which has resulted in a disruption of some Medicare claims payments related to this cyber incident. All other requirements must also be met. CMS does not require providers to quantify the level or percentage of impact to their Medicare claims. 
AHCA/NCAL will continue to advocate on behalf of impacted members and provide updates. Please reach out to Grant Beebe or Dan Ciolek with any questions. 
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CMS issues QSO implementing Enhanced Barrier Precautions

The Centers for Medicare and Medicaid Services released memorandum QSO-24-08-NH concerning the incorporation of enhanced barrier precautions (EBPs) in nursing homes to combat the transmission of multi-drug resistant organisms. Despite the introduction of EBPs by the Centers for Disease Control and Prevention in 2019, they had not been integrated into guidance for State Survey Agencies (SSAs). This memorandum now provides formal directives under F880 Infection Prevention and Control to both SSAs and long-term care facilities regarding the adoption of EBPs, in accordance with established national standards effective April 1st.
For further information about EBP, including links to CDC education, click here to access AHCA NCAL Resources.
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Upcoming Change to NHSN Up to Date Definition for LTC COVID-19 Vaccine Reporting

The National Healthcare Safety Network (NHSN) is changing the definition of "up to date" for COVID-19 vaccine reporting in long term care (LTC) beginning Quarter 2 of 2024 (week of April 1, 2024).?This change, which reflects the latest guidance from the Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control and Prevention (CDC), aims to ensure the most effective vaccine protection for individuals, especially those aged 65 years and older.
Key Points 
The ACIP and CDC provided new recommendations of COVID-19 vaccines for individuals aged 65 years and older. 
Those 65 and older are now considered up to date when they have received 2 doses of the updated 2023-2024 COVID-19 vaccine, or 1 dose of the updated vaccine in the past 4 months. 
For individuals under 65 years, there is no change; they are up to date with 1 dose of the updated 2023-2024 COVID-19 vaccine since its approval in September 2023. 
The updated definition applies to both the NHSN Weekly HCP and Resident Vaccination Forms. 
These changes will be implemented at the beginning of Quarter 2 of 2024 (week of April 1, 2024). 
Data Reporting in Quarter 2 of 2024
Residents and health care personnel aged 65 and older should ONLY be counted as up to date after receiving a second dose of the 2023-2024 updated COVID-19 vaccine or if they have received 1 dose in the past 4 months. 
Avoid over-reporting: Residents aged 65 and older who have received only 1 dose of the 2023-2024 COVID-19 vaccine more than 4 months ago should NOT be counted as up to date. 
Continue to count residents and health care personnel under 65 as up to date with 1 dose of the updated 2023-2024 COVID-19 vaccine.
Click Here to Read More
Upcoming Training Webinars Hosted by NHSN
The NHSN Vaccination team will host two webinars to detail these changes to the surveillance definition of being up to date with COVID-19 vaccines. Both webinars cover the same information. After registering, you will receive a confirmation e-mail containing information about joining the webinar. 
Wednesday, March 27, 2024 at 2:00 p.m. ET
Register in advance for this webinar.
Tuesday, April 2, 2024 at 2:00 p.m. ET
Register in advance for this webinar.
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