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Guidance for activities, visitation, and large group gatherings has not changed significantly. However, as the summer is winding down, long-term care settings that host gatherings are seeking a guidance refresher for these events.

A recent survey of nursing homes conducted by the Long-Term Care Imperative found that several settings throughout the state are closing beds, considering a sale, or considering closing their doors. Due to lost capacity in the system overall, Minnesota seniors are losings access to care in the communities they call home.

LeadingAge Minnesota members, in partnership with the Minnesota Department of Health (MDH), are helping expand nursing assistant testing opportunities throughout Minnesota by piloting in-facility testing in their settings.

If your assisted living setting satisfies the 24-hour staffing rule by utilizing staff from another licensed setting, you must request a variance from the Minnesota Department of Health (MDH) to remain in compliance with assisted living requirements.

Assisted living providers must issue a new version of the Assisted Living Bill of Rights (144G.91) to all residents and obtain a written acknowledgment of its receipt. The update is necessary because the Minnesota Legislature adopted several changes to the Assisted Living Bill of Rights earlier this year.

Over the next few weeks, the Minnesota Department of Health's (MDH) Collaborative Safety steering team members will begin inviting providers with closed Tuberculous and Individual Abuse Prevention Plan correction orders to collaborate, review and map these issues with the goal of learning and improving these systems.

The Centers for Medicare and Medicaid Services (CMS) reported that, due to the significant response to the Request for Information on establishing a minimum staffing standard, it will conclude the staffing study in December. Initially, we expected the study to be part of the recently-issued final 2023 Skilled Nursing Facility Prospective Payment System rule.

Opening Doors to Aging Services is a national LeadingAge initiative to introduce the aging services sector to millions of Americans and positively shift perceptions of our field.

The information available from the Centers for Medicare and Medicaid Services (CMS) Quality, Certification and Oversight Reports (QCOR) database shows that the Minnesota Department of Health (MDH) has completed 127 nursing facility recertification surveys during the federal fiscal year-to-date. There is some lag time in survey data entry, so the actual current total of surveys conducted is somewhat higher. Here's a sampling of the data:

The Health Regulation Division (HRD) at the Minnesota Department of Health (MDH) recently released two brief videos to help assisted living providers understand regulatory expectations and prepare for their next survey.

A new national report found that the national average hourly rate for CNAs and RNs increased by over 10% from 2021 to 2022, with virtually all titles showing significant salary jumps credited to the pandemic and ongoing staffing shortages.

DHS recently released the application form for the Elderly Waiver Customized Living (EWCL) Disproportionate Share Program for 2023. 2022 is the second year of the program, which provides a floor rate of $119 per resident day for their EWCL clients in 2023. The Legislature made some changes to the program that start this year, including:

As reported in last week’s Advantage, the Assisted Living Facility HFID must be on new assisted living contracts entered into on or after Aug. 1, 2022. Also, effective for contracts entered into on or after Aug. 1, 2022, the following changes were made to the required assisted living contract content in item (5) in 144G.50, subdivision 2, the (struck-out language deleted, new language in bold):

Late last week, the Centers for Medicare and Medicaid Services (CMS) published the annual final rule that updates the Prospective Payment System (PPS) rates for care centers.

Saint Therese, a LeadingAge Minnesota member organization, has finalized the purchase of nearly 13 acres of rolling terrain from the city of Corcoran for its senior living community, Saint Therese of Corcoran. The closing of the land purchase is the culmination of efforts spread across three years with the city and becomes both Saint Therese and Corcoran's kickoff to a new senior community and the city's progressive Town Center development, respectively.

Our last Self Care for Safe Care topic is Mindfulness and Self Care. Mindfulness is a practice and a way of being present in the moment. Being present in the moment can help you to gather the inner resources you need to take better care of yourself and be more efficient.

People facing a mental health crisis can now dial 988 to connect to support. The change is part of a nationwide effort to transition the National Suicide Prevention Lifeline to a phone number people can more easily remember and access in times of crisis. The shift also includes an online chat feature and a new texting option.

Though the Minnesota Legislature adjourned this year with unfinished business, including a failure to provide funding for wage increases for aging services caregivers, a small number of bills were signed into law.

The Centers for Disease Control and Prevention (CDC) released updated guidance on enhanced barrier precautions designed to reduce the transmission of multi-drug resistant organisms (MDRO). MDRO are pathogens that cause infections and are resistant to antibiotics commonly used to treat infections.

Providers will be required to make a few minor changes to the assisted living contract in the coming weeks. LeadingAge Minnesota is in the process of providing feedback to the Minnesota Department of Health (MDH) on a draft frequently asked questions document regarding assisted living contract language.

On July 25, the US Department of Health and Human Services, Office of Civil Rights (OCR), issued a Notice of Proposed Rulemaking to revise regulations relating to Section 1557 of the Affordable Care Act (Section 1557), which prohibits discrimination on the basis of race, color, national origin, age, disability, or sex (including pregnancy, sexual orientation, gender identity, and sex characteristics), in covered health programs or activities.

Current assisted living licenses expire on July 31. Beginning Monday, Aug. 1, assisted living facilities operating without a license will be fined $250 per day.

LeadingAge Minnesota has received new and welcome guidance from the Minnesota Department of Health (MDH) concerning changes to assisted living contracts.

The July 2022 Care Compare refresh includes the addition of nursing home staff turnover rates and weekend nurse staffing levels to the Five-Star Quality Ratings. The refresh also consists of a change to how staffing scores can impact a nursing home's Overall Five-Star Quality Rating.

Providers across the state must utilize data per regulatory requirements to help determine specific COVID-19 protocols, yet many data sources from different regulators can confuse the process.

In February, the Centers for Medicare and Medicaid Services (CMS) issued expanded guidance for the COVID-19 In-Person Visitation Aid Grants available to nursing homes.

Earlier this week, the Minnesota Department of Human Services (DHS) released a survey to get input on their Waiver Reimagine effort. Waiver Reimagine is designed to combine the current four disability waivers into two. Under Waiver Reimagine, the current waivers, based on the type of disability, would be replaced with waivers based on the type of service received (living independently vs. residential).

Cuyuna Regional Medical Center: Shift-to-Shift Team Safety and Dignity Rounds

Today, we highlight a successful Safe Care practice from Cuyuna Regional Medical Center (CRMC) in Crosby – Change of Shift Nursing Team Rounds. Jenny Pederson, RN, Quality Care Coordinator for the Care Center, is leading this new practice. It takes approximately five minutes during shift change and prioritizes residents' safety and dignity.

Assisted living providers, effective Aug. 1, need to add specific language to any notice that is issued to a resident or their legal or designated representative due to a requirement in the Minnesota Statute 144G or the Assisted Living Rule 4659 that is required to include information regarding the Office of Ombudsman for Long-Term Care and the Office of Ombudsman for Mental Health and Developmental Disabilities.

Medicare and Medicaid Services (CMS) requires nursing homes to report facility resident and staff COVID-19 case numbers to the Center for Disease Prevention and Control’s (CDC) National Health Safety Network (NHSN) weekly.