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DSS Releases Report on the April 1 Nursing Home Rebalancing & Efficiency Plans
Notes from Meeting with DPH regarding Nursing Home Surveys
LeadingAge Connecticut recently met with DPH FLIS representatives for our standing quarterly meeting regarding the survey and certification process. During that meeting, DPH asked that we communicate the following helpful information to our nursing home members:
- Following a survey, please remember that you are required to file a plan of correction for any state violations, in addition to the 2567 plan of correction for federal deficiencies.
- If requesting an IDR, please submit the request on a separate attachment to your plan of correction rather than on the 2567 so that DPH is sure to see the request upon submission. DPH is also requesting that nursing homes submit any information they plan to present at the IDR ahead of the scheduled IDR so that DPH is able to review it in preparation.
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If you are concerned about an individual surveyor’s behavior during the survey or a potential conflict, DPH asks that you address it immediately with either the team leader or with Cheryl Davis or Kim Hriceniak at DPH.
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DPH would like to remind nursing homes of their governance obligations contained in the Public Health Code. DPH looks at governance particularly when issues arise regarding staffing or quality improvement. Surveyors may be asking for the minutes of the required governance and administrative meetings, particularly meetings between the administrator and the DNS where surveyors are looking for documentation of discussion about the acuity tool used for staffing purposes.
COVID Was the Third Leading Cause of Death in the US in 2021
A study conducted by researchers at the National Cancer Institute and published today in JAMA Internal Medicine found that COVID accounted for 1 in every 8 deaths between March 2020 and October 2021. Interestingly, in 2020, COVID was the second leading cause of death in 2020, but fell to third in 2021; the researchers opined that targeted vaccinations in this age group caused the change. The researchers also found that the pandemic indirectly caused increased deaths during the study period from other causes such as heart disease, accidents, stroke, Alzheimer’s disease and diabetes, possibly because people were reluctant or unable to seek medical care. The NCI researchers also suggest that cancer deaths may increase in the future as a result of individuals skipping preventive screenings during the pandemic.
Connecticut Department of Labor’s New Unemployment System, ReEmployCT
The Connecticut Department of Labor (CTDOL) has successfully launched the State of Connecticut’s new unemployment benefits and tax system, ReEmployCT. Replacing a 40-year-old unemployment system, ReEmployCT serves approximately 115,000 businesses in Connecticut who pay into the Unemployment Trust Fund, as well as unemployed workers who are eligible for benefits. Currently, Connecticut has approximately 20,000 weekly unemployment filers. Unlike the prior system, ReEmployCT is accessible 24 hours a day, 7 days a week. Additional information about ReEmployCT is available at www.reemployct.com.
OSHA Extends National Emphasis Program
The Department of Labor, Occupational Safety and Health Administration (OSHA) announced this week that it is extending its “Revised National Emphasis Program for COVID-19” until further notice. The program, launched in March 2021, focuses enforcement efforts on companies that “put the largest number of workers at serious risk of contracting the coronavirus, and on employers who engage against workers who complain about unsafe or unhealthful conditions or exercise other rights under the Occupational Safety and Health Act.” As has been the case from the start of this program, hospitals, nursing homes, assisted living communities and home health agencies are among the industries considered to have higher potential for coronavirus exposures. OSHA is also temporarily increasing the coronavirus inspection goal from 5% of inspections to 10%. More details in this OSHA press release and in the text of the Revised National Emphasis Program for COVID-19 (click on the PDF in this link).
Medicaid Provider Bulletins
Everyday Assistive Technology Series
AARP CT and the New England Assistive Technology Center at Oak Hill are hosting a series of events on the topic of “Everyday Assistive Technology.” This six-part series will provide attendees an opportunity to learn more about how widely available devices and new technologies can help older adults and people with disabilities live safely and independently at home. All events will take place at Oak Hill, 33 Coventry Street in Hartford, and will include a tour of the Smart Home on Wheels, a mobile demonstration center where individuals and groups can learn more about how technology can support independent living. Events are free, but registration is required. More information can be found here.
Emergency Illnesses and Health Conditions, and the List of Reportable Laboratory Findings Updated
Effective July 1, 2022, DPH amended the List of Reportable Diseases, Emergency Illnesses and Health Conditions and the List of Reportable Laboratory Findings by adding monkeypox disease and orthopoxvirus and non-variola orthopoxvirus laboratory findings to such lists. This action was taken to leverage surveillance data collection to describe the extent of the problem and use case reporting to facilitate control and response actions to reduce the spread of monkeypox. More information can be found here.
Nursing Home Acuity Rates Reminder
The nursing home Medicaid acuity rate system went into effect on July 1, 2022. Up to date information on the rate system can be found on the designated DSS webpage.
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The July 1 rates included a scheduled 4.5% rate increase that will need to be passed through to wage and salary increases. Nursing homes should follow the same guidance as the July 1, 2021 4.5% rate increase.
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For those nursing homes that applied for enhanced health benefit and pension funding, the final file has been posted to the DSS webpage.
Temporary Nursing Home Rate Increase Expired on June 30
The 10% temporary rate increase for nursing homes is expected to expired on June 30, and the request for a continuation of the relief has been denied by the Department. Additionally, as you may recall, the 10% temporary rate increase for the month of June is to be paid utilizing federal ARPA funds. As a result, nursing homes will need to sign an attestation that they will abide by the conditions of the ARPA funding before they will be paid the lump sum amount for June. The attestation forms are not yet available, but will be posted soon and we will notify our membership when they become available.
CMS Releases Nursing Home RoPs 3 and Other Guidance
As reported last week, on June 29, CMS released the long-awaited surveyor guidance on phase 3 of the Requirements of Participation (RoPs) with an implementation deadline of October 24, 2022. Access the CMS memo QSO-22-19-NH on this release and associated attachments here. In addition, here is a link to the related CMS Fact Sheet. LeadingAge will release more detailed information, tools, and resources for compliance on each of the revised sections in coming days.
Temporary Nurse Aide Status
We are anticipating additional guidance from CT DPH on the use of Temporary Nurse Aides (TNA) after the expiration of the state’s TNA program. As you know, in April the state of Connecticut had extended the state’s TNA program to June 30, 2022, with CMS then terminating the permissive waiver for the program on June 6, 2022 and allowing TNAs to transition to full CNAs up to October 6, 2022. DPH is expected to now clarify how the Connecticut and CMS rules and deadlines will be applied and we will notify the membership as soon as we receive the clarification. However, DPH has already clarified that a TNA who has completed their CNA training and is just awaiting their examination date may practice as a CNA within the nursing home or assisted living community for up to 120 days while awaiting the exam.
Testing Nursing Home Employees Over 50 Who Are Not Double Boosted
What does it mean to be “up to date” and how does that impact nursing homes?
There has been a great deal of confusion about what it means to be up to date with COVID-19 vaccination, particularly when it comes to employees over 50 who are not second boosted. The following LeadingAge article describes how the confusion came about and what it means for nursing homes. LeadingAge article.
Reminder of DPH Offer of Free Fit Testing for Connecticut Nursing Homes
DPH recently sent out Blast Fax 22-25 to Connecticut nursing homes outlining an opportunity for free fit testing.
County Rates of Transmission Are High or Substantial
The state's eight counties remain classified as having either a high transmission rate or substantial transmission rate by the CDC. The appropriate CMS and CDC guidance should be followed for these conditions
Election Guidance for Non-Profits
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CMS, CDC and State Covid-19 Links and Resources |
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The NFP HR Compliance Corner
LeadingAge Connecticut's Diamond Partner, NFP, is pleased to provide our members with access to their Human Resource Compliance Corner
Executive and Commissioner Orders-Blast Faxes
A complete listing of Executive and Commissioner Orders can be found
here. A listing of DPH Blast Faxes can be found here. Practitioner and Facility Guidance documents can be found here.
LTC-MAP July Duty Officers
Dave Bouchard (July 1 - 15)
860-207-9270
CT LTC-MAP Duty Officer: Vinnie DeSanti (July 16 - 31)
860-207-9270
Back-Up Duty Officer: Andy McGuire
(On vacation July 24 - July 31)
Cell - 203-648-7116
Office - 860-390-1949
Back-Up Duty Officer: Jim Garrow
(Covering July 24 - July 31)
Cell - 860-944-2803
Office - 860-793-8600
Value First GPO: A Resource for Affordable Products and Supplies
Value First is the LeadingAge owned GPO and a trusted resource for your purchasing department. Our contact for Value First is Den Miciletto, Value First Sales Liaison. Mobile 917.370.6518, Office 518.867.8383 ex.160, Fax 518.867.8384
Schedule for Member Calls
Nursing Home Tuesdays and Thursdays at 2 p.m.
CCRC/Assisted Living Community Every other Thursday at noon
Nursing Director Tuesdays at Noon
Affordable Housing Third Wednesday of the month at 9 a.m.
Human Resource Second Thursday of the month at 10 a.m.
Social Work Second Wednesday of the month 11:30 a.m.
Building Engineering Last Wednesday of the month at 9 a.m.
Recreation Second Tuesday of the month at noon
CFO Roundtable TBA
Mission Roundtable TBA
LeadingAge national Monday and Wednesday at 3:30 p.m.
The Benefits of Your LeadingAge Connecticut Membership
Please Keep Us Up to Date on Your Major Staffing Changes
In an effort to keep our contact information current with our members and their staff, we request that you notify our office manager, Nurka Carrero, as soon as possible when you have significant staffing changes. Thank you!
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LeadingAge Coronavirus Update Calls on Monday and Wednesday
If you have not registered for LeadingAge Monday and Wednesday 3:30 pm Update Calls, you can do so here. You can also find previous call recordings here. Note that to access recordings of the calls you need a LeadingAge password. Any staff member of any LeadingAge member organization can set up a password to access previous calls and other “members only” content.
National Coronavirus News, Tools and Resources
Larry Minnix National Leadership Academy Applications Open
Developing your own leadership style and approach requires self-reflection and uncovering your unique leadership attributes. Embark on this journey alongside your aging services peers through the 2023 LeadingAge Leadership Academy. Applications are due August 1 and the program begins in February 2023. Learn more and start your application.
Annual Meeting Registration
Update Your My.LeadingAge Username/Password
2022 LeadingAge Annual Meeting + EXPO registration will open next week! To register, you’ll need your My.LeadingAge login information. Reset or recover your password here. We’re excited to see you in Denver on October 16-19!
Global Ageing Network Announces 2023 Call for Presentations
The Global Ageing Network is partnering with Scottish Care and the National Care Forum to co-host the 2023 Global Ageing Conference in Glasgow, Scotland September 7-8, 2023. The theme—Care About Our Future: Global Symposium for Sustainable Care and Support—will offer an opportunity to explore and debate the urgency of sustainability in every aspect of aged care and support. Learn more about the conference and how to submit your presentation.
CMS Releases Hospice Care Index Technical Report
The Hospice Care Index (HCI) Technical Report was released July 1, 2022. This report provides descriptive analyses and detailed contextual information about the new HCI quality measure. The national average HCI score is 8.8, with 37.9 percent of hospices receiving a score of 10. HCI scores were higher on average among larger hospices, older hospices, non-profit hospices, and facility-based hospices.
Member Resources on Home Health Proposed Rule
LeadingAge is here to help members navigate CMS’s Home Health Prospective Payment System Rate Update (read our initial summary). They have already spoken out to HHS and in the press, and are working with members to best represent your interests. Find their latest materials below on leadingage.org, and join us for the next Home Health Member Network Meeting on July 19 at 2:00 p.m. Resources and additional information:
Quarterly Home Health CAHPS Newsletter Released
The HHCAHPS Team has posted the next issue of the HHCAHPS Coordination Team Quarterly Review (CTQR) to provide information about HHCAHPS to home health agencies and survey vendors. In this addition of the newsletter, the team walks providers and vendors through how to review historical trends in CAHPS through archived reports. The team also includes reminders on the next data submission period of July 21, 2022 and how to submit Discrepancy Notification Reports (DNRs).
LeadingAge Signs on to CMS Letter Regarding NP’s Certifying Home Health
LeadingAge signed onto a letter reiterate support for the authority of nurse practitioners (NPs) and clinical nurse specialists (CNSs) to order and certify home health services for Medicare beneficiaries. The letter aims to ensure that any future agency guidance reflects the legislative intent of the CARES Act to improve access to home health care services for Medicare beneficiaries. Earlier this year, when CMS updated the guidance for the Notice of Admissions (NOA) implementation they added additional information in an MLN article and the Medicare Benefits Policy Manual that elaborated on the responsibility of NPs and CNSs to have a “collaborative agreement” with a physician which is not required in all states. After advocacy efforts from LeadingAge in collaboration with the home health and advanced practice nurse community, the information has been revised. CMS issued an update June 6th that took out that language completely.
Life Plan Community June Member Network Meeting Materials
Didn’t have a chance to see the entire LPC June Member Network Meeting on the evolution of hospitality culture in LPCs? It was a dynamic discussion that is definitely worth a replay. You can see the recording here and the slides here. Mark your calendars: our next meeting is Thursday, July 28 at 2:00 p.m. ET on the workforce crisis and policy work being done by LeadingAge. You can sign up by emailing Dee at [email protected] if you’re not already a regular attendee. All are welcome.
Backgrounder: Using HUD Project-Based Vouchers to Pay for the Housing Component in Assisted Living
This new three-page LeadingAge backgrounder reviews the use of HUD Project-Based Vouchers in assisted living communities. Public housing authorities can enter into contracts with assisted living owners and agree to provide rental subsidy through project-based vouchers to a certain number of units for a set amount of time. When someone moves from a project-based voucher apartment, the project-based voucher stays with the apartment. Project-based vouchers can be “stuck” to units in assisted living communities to cover shelter costs, offering affordability to residents and steady rental income to owners. Read the new backgrounder for more information.
LeadingAge Participates in SHRM’s “Generation Cares” Workforce Solution Coalition Planning Session
The Society for Human Resource Management (SHRM) invited LeadingAge and other stakeholder organizations to join a soon-to-be-announced coalition – Generation Cares – to build solutions to our country’s child and dependent care crisis. An initial planning meeting was held on June 30, 2022. The coalition will bring together advocates, providers and the employer community in order to advance policies to strengthen the availability and quality of child and dependent care across the United States. The coalition will engage with the public, federal agencies, Congress, and the White House on targeted measures to generate support for workforce solutions, and kick-off in late summer.
Provider Relief Fund Page on LeadingAge Website
LeadingAge has co-located all articles, tools, letters and resources on Provider Relief Funds on a single web page to make it easier for members to find the key dates and information they need. Members can find a link to the page on the Coronavirus Resources page under Provider Resources in the left-hand column.
LeadingAge Member Resources
Get Connected with LeadingAge
LeadingAge offers a variety of ways for members to engage with one another and get involved from listservs and networks to advisory groups, committees and board service. We encourage you to take advantage of your membership and connect with your peers to learn, share and grow. Get connected!
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Defending Your Decisions: Managing Post-Pay Audits
Wednesday, July 13, 9:00 - 11:00am
Presented by Maureen McCarthy, RN, BS, RAC-MT, QCP-MT, DNS-MT, RAC-MTA, President/CEO, Celtic Consulting
Leading With Confidence Virtual Webinar Series
A 7 Week Virtual Management Skills Course
Beginning Thursday, July 14, 2022
Two Session Times Available! 9am to 11 am or 1pm to 3pm
Featuring Del Gilbert, Accelerating Excellence
Best RAI/MDS Practices and Insights
Wednesday, July 27 from 2:00 – 3:30 p.m.
The LeadingAge Learning Hub is offering a webinar, “PDPM, OBRA, and Case-Mix: Considerations for Using the MDS” on Wednesday, July 27 from 2:00 – 3:30 PM. Experts Alicia Cantinieri and Melanie Tribe-Scott both of Zimmet Healthcare Services Group, will discuss the admission and information gathering process for accurate assessment and a quality plan of care; consider best practices for interdisciplinary team collaboration; identify reimbursement drivers and care planning triggers; and suggest how to organize RAI processes and options to ensure compliance with CMS guidelines.
The Dynamic DON Webinar Series
Eight Consecutive Wednesdays beginning August 3
12:30 PM - 1:30 PM
This 8-week webinar series runs August-September 2022 and focuses on skill
building for serving effectively as the Director of Nursing with emphasis on
effective leadership and staff engagement, nursing operations and systems
of care for common conditions treated in the LTC setting.
Annual Dementia Symposium with Teepa Snow
Focus: Fall Prevention and Communication Strategies
Presented by National Dementia Expert: Teepa Snow, MS, OTR/L, FAOTA
Thursday, August 4
9:00am – 3:30pm
Program will be at the Aqua Turf Club
Now Available: June LeadingAge Webinar Recordings
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Staffing Measure Rating Changes with the July 2022 Refresh
In January 2022, CMS began posting new weekend staffing and staff turnover measures on Care Compare (CMS memorandum QSO 22-08-NH). These measures will be included in Nursing Home Five Star Quality Rating System methodology starting with the July 2022 Care Compare refresh. In addition to existing measures of registered nurse (RN) and total nurse hours per resident per day, the new staffing rating methodology will include the following measures:
- Total nurse staffing hours per resident per day weekends;
- Total nurse staff turnover within a given year;
- Registered nurse (RN) turnover with a given year; and
- Number of administrators who have left the nursing home within a given year.
CMS Release OASIS-E Data Submission Specification for EHR
After numerous changes to the proposed OASIS-E item set, CMS has finally issued specifications for electronic health record vendors to update products for home health agencies. There are only six months until implementation of OASIS-E in January 2023 for developers to make modification to systems and allow home health agencies time to educate clinicians on the new systems. The new OASIS Data Submission Specifications were posted in the Downloads section of the Data Specifications webpage. The OASIS-E Guidance manual outlines additional information, as well as the Item Change and Edit Change reports within the data specifications. Members should reach out to their EHR vendors in the coming months regarding updates to systems.
CMS Website Resources
National Government Services News
National Government Services shares important Part A information on their website. Click on www.NGSMedicare.com, determine your Medicare contract. On the Provider Specific Portal Home Page, under Latest Part A News Articles click on the View All News Articles link. Note: you may have to accept the CPT Point and Click Agreement in order to access this information.
NGS Medicare Educational Sessions and Training Events Calendar
Visit the National Government Services Web site for details at NGS Medicare.
Medicare University Computer-Based Training Course Listings
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New Crisis Hotline to Launch in Connecticut. Here’s How It Works.
CT Insider, July 1
In the U.S., 911 is synonymous with “emergency” but police, firefighters and ambulances aren’t always equipped to handle the wide range of mental health crises that callers may be facing. The national 988 hotline is designed to be a solution to that problem, and starting July 16, Connecticut residents can dial those three numbers for mental health emergencies.
Long COVID Persists, but Doctors Are Working on Treatments
CT Mirror, July 5
With a growing number of people getting long COVID, treatment programs have launched in CT and elsewhere to help people manage the symptoms.
CT Created a $34M COVID Relief Fund for Essential Workers. It Remains Largely Unspent.
CT Mirror, July 7
The state has awarded just 1.1% of the $34 million budget for the Essential Workers COVID-19 Assistance Program since it launched.
McKnight’s, July 7
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