HFAM Update
In times of change, there is power in association.
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Friends:
Please don’t ever get tired of genuine appreciation for all you and your teams do to provide quality care to Marylanders in need, and in creating quality jobs for caregivers with trained hands and caring hearts.
The state COVID positivity rate in Maryland remains above eight percent. However, the positivity rate in our sector is trending down. The post-vaccination world is different than it was before. That said, recent surges have proven the value and clinical necessity of vaccines and boosters. Together, it is imperative that we are all ambassadors of vaccination that we can execute operational goals around vaccination and boosting.
As we advised HFAM members a few weeks back:
- The Maryland Department of Health will, in the remaining months of this year, move toward skilled nursing and rehabilitation centers and assisted campuses being more self-sufficient on COVID vaccination and boosters (as we were with the seasonal flu before this pandemic).
- We must all be cautious and concerned about late summer and fall surges of COVID, as well as the fall/winter flu season.
Let’s remember the new normal with vaccination means we can all enjoy being out and we can choose to wear a mask based on current facts and health status. The new normal in our sector will continue to mean vaccination, boosters, masking, and testing. All of this is the action we take to stand for quality care.
AHCA/NCAL Congressional Briefing
HFAM leaders are just back from the AHCA/NCAL Congressional Briefing in Washington, DC. This year’s event was a powerful standing-room-only conference of over 500 leaders from across the county. For more information, please see below the Congressional Briefing update from Hope Morris, who led HFAM’s efforts. This week’s AHCA/NCAL event reminded me:
- In times of change, there is power in association.
- In advocacy and public affairs, it is not enough to oppose ill-conceived government policy. Right or wrong, if an organization or a leader is not part of the solution, they are part of the problem.
- In government relations, if you are not part of a focused and united group at the table, then it is likely you will be the main course on the table!
- That the keys to success in policy are valuing quality and understanding the data.
I want to thank Beth DeLucenay, Charles E. Smith Life Communities, Gabrielle Charnowitz, CommuniCare, Liz Gilbert and Michael Smith, Marquis, Deborah Rowe, Genesis, and Mike Jacobs, Fundamental for being part of the team in leading productive meetings on Capitol Hill. Together, our HFAM leaders and heroes took our messages of quality, workforce, and rates to members and staff of the Maryland Congressional Delegation.
Here was our message:
- Adequate Medicare and Medicaid funding are now more important than ever to maintain care capacity, support wage increases, pay inflated agency costs, and cover increased operational expenses. Unlike other businesses, skilled nursing and rehabilitation centers are reliant on the state and federal government to raise prices to compensate for the extraordinary new costs associated with the pandemic.
- We know that the American Health Care Association, LeadingAge, and other organizations are advocating and working with federal leaders on the proposed parity adjustment. Maryland’s federal Medicare rates would have reflected a 3.9% increase based on the market basket. However, CMS chose to also apply a (4.6%) parity adjustment for an overall reduction in the rate of .7%. This does not take into account Maryland’s unique and historic challenges with the wage index.
- Together we are committed to finding solutions to keeping the 270,000 Emergency Temporary Nursing Assistants in the workforce beyond October 2022, while ensuring continued quality care.
Update on Temporary Nursing Assistants
As we have shared, the federal CMS waiver allowing TNAs to work ended Monday, June 6, 2022. TNAs have 120 days (4 months) to become certified so October 6, 2022 is the last date TNAs will be allowed to work in nursing facilities. HFAM has recently confirmed this in a call with Karen Evans, Executive Director of the Maryland Board of Nursing.
As a general reminder, under Maryland COMAR on GNAs, “persons hired as geriatric nursing assistants shall complete an approved geriatric nursing assistant training program within 120 days of employment.” This has always been the case, even before the pandemic. The CMS waiver allowed for TNAs to work longer than 120 days without license. Since the federal waiver has ended, nursing assistants may not work for longer than 120 days without licensure.
Here in Maryland, as you know, nursing assistants need the GNA certification to work in a nursing home. Those working as nursing assistants in nursing homes will still need to have GNA certification.
This past legislative session, this bill was passed in to law. This allows an individual who has been practicing as a TNA without certification apply on-the-job experience as a TNA toward the total number of training hours required for certification. We have been working the Maryland Board of Nursing on a certification pathway that would take into consideration the experience of a TNA and allow them to sit for the state certification exam after attestation that their experience during the pandemic has been sufficient training. This will provide for quicker certification of GNAs and help keep them on the job.
Proposed emergency rules regarding the attestation process will be published within the next 10 days. Upon the passage of regulations, TNAs will have a pathway to become certified.
We continue to share concerns regarding enough testing capacity for GNAs and are working on all fronts for solutions. Please stay tuned for additional updates regarding the attestation process for TNAs to take the GNA exam.
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As Always
- Focus on what is in your control and not what is out of your control.
- Let’s get those boosters and the flu vaccine in the arms of people.
- Overcommunicate – with residents, patients, families, staff, and government partners.
- Adapt and innovate.
- Rely on your partnerships.
- Speak up when you need help.
- Double efforts on infectious disease protocols, training, and operations.
- Take and document your action; keep a timeline.
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Joe DeMattos
President and CEO
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2022 Congressional Briefing Recap
On June 6 and 7, HFAM and member representatives joined with healthcare leaders from across the nation in Washington, DC to attend the annual American Health Care Association/National Center for Assisted Living (AHCA/NCAL) Congressional Briefing.
A huge thank you to those HFAM members who were in attendance to represent Maryland and meet with Congressional leaders.
The AHCA/NCAL Congressional Briefing was an invaluable opportunity to get the latest federal updates impacting the long-term care sector, make plans and catch up with colleagues from across the nation, and meet with the Maryland Congressional Delegation on Capitol Hill.
Together, we met with leaders on the Hill to discuss issues and propose solutions to challenges we face in the long-term and post-acute care industry. Topics covered included workforce and staffing shortages, COVID-19 recovery efforts, and the Centers for Medicare and Medicaid Services (CMS) FY 2023 Skilled Nursing Facility (SNF) Prospective Payment System Rate Update and Quality Reporting.
We had the exclusive opportunity to build and establish relationships at the federal level – ever important as our sector continues to face economic pressure and potential regulations effecting long-term and post-acute care.
Going forward, we will continue to work closely with AHCA/NCAL, our colleagues across the nation, and Maryland leadership in DC on issues that impact the quality care that you and your teams provide each and every day.
Between Medicare funding and delivery at the federal level, the importance of Medicaid funding, the regulatory environment, critical workforce issues, and our continued battle against COVID, there is more value than ever in our partnership with AHCA/NCAL.
The success and impact of the recent Congressional Briefing proves that our sector is strongest when united, data-driven, and proactive with viable policy solutions. We look forward to advancing this work and hope to seeing you at next year’s briefing.
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The Do's and Don'ts of Survey Appeals
Webinar Presented by Baker Donelson
Wednesday, June 15
10:00 – 11:00 a.m. Central
11:00 a.m. – 12:00 p.m. Eastern
Do you know what to do and consider if your facility or community receives a poor survey from the state or federal agency overseeing the facility? Join us as we discuss the various survey appeal options available including IDR, IIDR and DAB Appeal.
Key takeaways include:
- What each option entails
- The pros and cons of each option
- Lessons learned in navigating the survey appeals process
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Cognito Training - The Office of Medicaid Provider Services
The Office of Medicaid Provider Services invites you to attend a very important training session on Cognito - the web-based intake form that the Long Term Care Provider Resolution Unit (LTCPRU) will use to accept all span inquiries in the near future. This tool will replace email and fax submissions.
The training will be held on June 22, 2022 from 11:00 am to 12:30 pm.
Those who should attend are:
- Nursing facility directors and managers
- Nursing facility staff who may send span inquiries to LTCPRU
- Anyone on your team who works with LTCPRU regarding span inquiries
The official launch date for adopting Cognito full-time is TBD, but likely in July 2022.
Please register for LTCPRU on Jun 22, 2022 11:00 AM EDT at:
After registering, you will receive a confirmation email containing information about joining the webinar.
For those unable to attend, we will record this training and make it available on our website.
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AHCA/NCAL National Quality Award Program
The 2023 Program Year Is Now Open!
Preparing successful applications takes time. Download application packets and begin reviewing and gathering relevant data today.
The AHCA/NCAL National Quality Award Program helps you to evaluate your organization’s strengths and opportunities, identify critical areas for improvement, and implement a plan to be stronger, more resilient, and successful than ever before. The three-level program evaluates long term care organizations capabilities against nationally recognized standards for excellence, making it one of the most comprehensive and cost-effective performance assessments available to providers. Each progressive award levels— Bronze – Commitment to Quality, Silver - Achievement in Quality, and Gold – Excellence in Quality, requires a more detailed demonstration of superior performance. Learn more about the value of the program.
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AHCA/NCAL Convention: Two Unique Keynotes Set Convention Tone
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This year, two transformational speakers take the stage as AHCA/NCAL's General Session keynotes.
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Jade Simmons delivers a stunning, main-stage presentation with the potent combination of music, virtuoso performance, and riveting storytelling.
Simmons is a top-notch “experiential” speaker who uses music to powerfully drive her points home.
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Brandon Stanton shares his journey of personal growth and discovery while revealing the stories behind the stories featured in his photoblog and book "Humans of New York (HONY)."
Come hear the man named to Time's "30 Under 30 People Changing the World" list, as he powerfully illustrates the value of sharing your experiences.
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Want to see previous HFAM updates?
Visit our website to view all previous HFAM alerts, as well as guidance
from our federal and state partners.
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