April 6, 2023
Featured News
Stark Differences in Human Services Omnibus Bills as Minnesota Legislators Begin Week-Long Break
On April 6, 2023 by LeadingAge
On Monday, the Senate Human Services Committee passed its omnibus finance bill with key differences from the House’s version.
A snapshot of items related to aging services include:
- $37 million per year in SFY24-25 for nursing home increases; funding is dedicated to wages and benefits. By contrast, both the House and the Governor propose only $4 million for critical access nursing homes.
- $140 million for Elderly Waiver of $140 million, raising phase-in to 27.8%. This is a lower funding amount than the House position, which reflects close to 100% of the phase-in. However:
- The bill expands eligibility for EW CL disproportionate share
- Provides additional phase-in rate increase for customized living under CADI/BI CL providers from 10% to 21.6%
- Includes $1 million in Assisted Living Closure Grants (also a Governor’s proposal)
- PACE rate study (also carried in House, not in Governor’s budget)
- $4 million for Critical Access Nursing Home grants (In House and Governor’s budget)
- A new concept to dedicate unspent revenue from this budget into a special revenue account called a LTC Access Fund.
- Does not include:
- Fix for 21-month delay for nursing homes
What happens next?
The Minnesota Legislature will be in recess until April 11, with legislators returning to their districts and communities.
The pace of this session has been unprecedented: as far back as 1983, no chamber has exceeded 3,000 bill introductions in one session year. Yet both the House and Senate crossed that threshold last month. Pre-session statements by the DFL majorities about the desire to pass more individual bills rather than loading up large omnibus bills did not produce much of a change in behavior – legislators have put together large omnibus bills chock full of finance and policy provisions, just as their predecessors in both parties have done.
All omnibus finance bills have now passed to House Ways and Means or Senate Finance Committees, where they will be processed and passed to their respective floors for action in the coming weeks. Though most omnibus bills will require conference committee work, the process will look a bit different this year as the House, Senate, and Walz Administration already agreed to joint targets. Given that leaders left surplus funds on the bottom line, there may be adjustments to certain targets as the session progresses toward a final resolution of the budget bills.
Following the break, the House and Senate Tax committees will put together their omnibus bills, which are expected to look very different despite their joint budget target. All omnibus bills must be finalized and passed before the May 22 constitutionally required adjournment date.
LeadingAge Minnesota and its Imperative partner will continue to pursue improvements to the Legislature’s Human Services Omnibus Bills to ensure that seniors and their caregivers are part of One Minnesota.
Without Addressing Staffing Mandate, CMS Updates SNF Rates in Proposed PPS Rule
On April 6, 2023 by Jeff Bostic
Earlier this week, the Centers for Medicare and Medicaid Services (CMS) published the annual proposed rule that updates the Prospective Payment System (PPS) rates for care centers. The rule calls for an update in the rates starting Oct. 1, which averages 3.7%.
That includes an inflation update of 6.1%, reflecting the large increases in inflation in the last year, reduced by the second year of the “parity” adjustment of 2.3%, which corrects for unexpected increases since the implementation of the Patient-Driven Payment Model (PDPM) in 2019.
This is the final year of the two years of reductions related to correcting for PDPM impacts. The impact on individual care center rates depends on changes to the wage index for their region, plus any changes to this proposal that CMS makes in the final rule this summer. Given the financial stress experienced by care centers, the inflation adjustment this year is much needed.
Updates to value-based purchasing
The proposed rule also makes updates to the Value-Based Purchasing (VBP) program, which will take effect in future years if they remain as part of the final rule. Those changes include revising the one measure that’s been in use for years on readmissions, to focus on preventable readmissions.
The rule also proposes adding four new measures over time, including staff turnover, discharge function score, hospitalization rate, and rate of falls with injury. How those measures will be factored into the VBP formula will be determined in future rules.
Staffing requirement not addressed
Despite expectations that new staffing requirements would be addressed in the proposed PPS rule, the rule does not address that issue and CMS indicates that it will be addressed later this spring in separate rulemaking. National and state provider associations remain very concerned about the impact of a staffing mandate on the ability of providers to be able to continue operating given significant workforce shortages, and we will be reviewing the details of that rule very closely when it is available.
State News
Media Round-Up: Spreading Our Stories
On April 6, 2023 by Libbie Chapuran
LeadingAge Minnesota continues to use earned media to garner support for our legislative agenda and keep pressure on lawmakers. In addition, we’ve recently launched a paid media campaign in strategically targeted areas.
Alongside our partner in the Long-Term Care Imperative, Kari Thurlow, President and CEO, is conducting a series of editorial board interviews to share opinion pages throughout the state.
Additionally, you may have heard recent coverage on MPR, KAAL-TV in Rochester, and papers throughout the state. You can see all the coverage in our press room and on social media.
Paid media and ads
At this critical time in the legislative session, we are also adding paid media to the mix. We’re using paid digital, print, and social to garner additional supporters and keep pressure on lawmakers. We are using bolder, more pointed messaging that helps build urgency.
You can find the ads in the following publications:
- Star Tribune desktop homepage ad
- MinnPost sitewide digital ad
- Sahan Journal sitewide banner ad
- Mankato Free Press Daily
- Fargo Forum
- Champlin Dayton Press/News
- Sun Post
- Sun Current
- Duluth News Tribune
If you don’t see an ad buy in your local paper on this list, we are happy to provide you with the ad so you can place it in your community.
Paid media on social
In addition to paid newspaper ads, we’re about to launch a series of paid social ads on Facebook, Instagram, and LinkedIn. We are excited to share more in next week’s edition of Advantage. Stay tuned!
Listen: WCCO Radio Airs Fluence Forum on Senior Services Issues
On April 6, 2023 by Libbie Chapuran
WCCO political analyst Blois Olson hosted a new Fluence Forum, a conversation about the caregiving crisis in Minnesota.
More Minnesotans are aging, and fewer Minnesotans are working. The state sets the rates, and the legislature funds the programs that determine caregiver wages. The shortage is leaving beds empty when Minnesotans need care, and nursing homes closing across the state.
Where to listen
You can listen online on WCCO Radio’s website. Please consider sharing with your community to spread the word about these important topics.
Who you’ll hear from
In the forum, here’s what and who you will hear:
- Segment 1- Megan Dayton, Senior State Demographer
- Segment 2- How dire is the caregiving work shortage? Amanda Gruber, Caregiver at Three Links in Northfield; Tracy Franklin, Nurse manager at Catholic Eldercare in Minneapolis; Kari Thurlow, President and CEO of LeadingAge Minnesota
- Segment 3- The future of caring for our seniors, and this legislative session - Kari Thurlow, President and CEO of LeadingAge; Minnesota Adam Suomala, Minnesota Leadership Council on Aging; Anna Mowry, Workforce Director at LeadingAge Minnesota Foundation; Angela Brown, Chief HR Officer, Cassia
Thanks go to all the members who participated, shared their stories, and lead the change we need in our sector.
Federal News
QSO Updates Enforcement for Infection Control Citations
On April 6, 2023 by Kari Everson
On March 30, the Centers for Medicare and Medicaid Services (CMS) released QSO-23-10-NH, which rescinds QSO-20-31-NH and provides updated guidance on enforcement for infection control non-compliance. As a result, enforcement actions are more severe than before when cited under F880 and/or F887.
Enhanced remedies based upon scope and severity
The scope and severity of an F880 or F887 deficiency determine enforcement remedies. Directed plans of correction, discretionary denial of payment, and civil money penalties are imposed depending upon scope and severity.
Deficiencies at D, E, F
- Directed plan of correction (DPOC), including Root Cause Analysis (RCA) and working with a Quality Improvement Organization (QIO) or another qualified consultant
- Discretionary denial of payment for new admissions with a 30-day notice period to achieve substantial compliance.
- Additional remedies may apply if F887 is cited at a higher-level severity.
Deficiencies at G, H, I
- DPOC, including RCA and working with a QIO or hiring an Infection control consultant to develop and implement a plan of correction.
- Discretionary denial of payment for new admissions with a 15-day notice period to achieve substantial compliance.
- Civil Money Penalty (CMP) imposed according to the CMP Analytic Tool with a 10% increase adjustment.
Deficiencies at J, K, L
- DPOC with RCA and working with QIO or other Infection control consultant
- Discretionary denial of payment for new admissions with a 15-day notice period to achieve substantial compliance.
- Civil Money Penalty (CMP) imposed according to the CMP Analytic Tool with a 20% increase adjustment.
QIO available for support
Superior Health Alliance is the QIO for Minnesota and has quality improvement advisors available to assist. In addition, they have infection preventionist support, QAPI program and RCA assistance, an education library, and more. You can visit their website or contact their program director for more information.
If you have additional questions, please contact Kari Everson.
Notable News
LeadingAge Minnesota Foundation Awarded Mental Health Grant to Support Members
On April 6, 2023 by Terri Foley
The LeadingAge Minnesota Foundation team will be using more than $72,000 to continue offering free Mental Health First Aid training to members, through the Minnesota Department of Health’s Mental Health Care Professionals Grant program.
The goal is to build peer-to-peer safety nets for mental health in member sites. Since 2021, LAMF has helped more than 270 LeadingAge Minnesota members attend the MHFA training at no charge. With this new funding, we will be able to support an additional 240 members to attend this training.
What is Mental Health First Aid (MHFA)?
Training as a Mental Health First Aider prepares any staff person to have a peer-to-peer conversation about how stress is affecting a co-worker’s mental health. Many people are afraid to seek professional care for a mental health problem but may be open to having a first conversation with a co-worker trained to respond without judgment.
The program offers a nationally proven strategy to improve staff well-being and to reduce the stigma of talking about mental health concerns.
One member who is implementing MHFA across the organization has found that employee assistance program usage has increased after introducing the program. First Aiders can be frontline staff, supervisors, and leaders.
More Free Training Coming Soon
Look for more information this summer about new training sessions. You can also contact Terri Foley, LAMF Program Officer, at with questions.
This project is supported by the LeadingAge Minnesota Foundation, a partner of LeadingAge Minnesota, using grant dollars and tax-deductible contributions to support initiatives that transform and enhance the experience of aging. Learn more about our work.
Workforce Technology Solutions Playbook – Scheduling Software
On April 6, 2023 by Julie Apold
The Scheduling Software Playbook is the first in a series of workforce technology solution playbooks designed to assist you in identifying technology solutions to help address the workforce crisis.
Lack of time to research technology solutions and vendors was one of the primary barriers to technology implementation that members identified in a project survey.
The playbooks are designed to address this barrier by providing key product information, including:
- Vendor Matrix with key feature comparisons
- General cost information
- Infrastructure/space requirements
- Product capabilities/limitations
- Implementation strategies
Background
The LeadingAge Minnesota Foundation provided funding to research available workforce technology solutions. Input was gathered through surveys and focus groups involving LeadingAge Minnesota members, business partners, and LeadingAge Center for Aging Services (CAST) to identify priority areas that may benefit from technology. Feedback was also gathered on product information that should be included in each playbook. In-depth discussions were held with individual providers and vendors locally and nationally to research and gather information on specific technology solutions.
Upcoming Workforce Technology Playbooks
Two additional workforce technology playbooks are scheduled to be released in the coming weeks:
- Robotic dining solutions
- Resident vitals/monitoring technology
For questions or more information, please contact Julie Apold at 651-659-1407 or japold@leadingagemn.org.
Member News
Providers Join Lawmakers to Call for Nursing Home Funding
On March 30, 2023 by Libbie Chapuran
On Thursday afternoon, several nursing home providers from across the state visited the Capitol to support funding for nursing homes in the House Human Services bill.
Unfortunately, the House Human Services Finance Omnibus Bill makes no additional investment for Minnesota’s nursing homes beyond a $4 million grant program for critical access nursing homes. With a $17.6 billion surplus, the House and Governor propose to spend less than 0.02% to help nursing homes pay their caregivers a livable wage and preserve access to care across the state.
Providers met in front of the House chamber to express their disappointment, then joined several lawmakers for a press conference in support of additional funding for nursing home providers. If you missed the press conference, we invite you to watch it on-demand.
After the press conference, members of the minority party used a procedural vote to try to bring HF 733 to the floor, which was rejected on a partisan basis.
For more information about what is included in the House Human Services bill, read our recent summary in Advantage.