Department of Health will not impose this fee during 2007.

We are happy to report that the Minnesota Department of Health (MDH) will not impose the “assisted living surcharge” that we expected to begin July 1, 2007.

As a reminder to members, the 2006 assisted living law included a provision that directed MDH to assess a surcharge on the annual registration fee of each assisted living provider, to cover costs related to bringing actions for injunctive relief to enforce the new provisions.  [The surcharge applies only to “assisted living”.]

The Long-Term Care Imperative had urged the Department not to impose the surcharge until it had some actual enforcement experience with the law.  We were concerned that MDH would over-estimate the number of enforcement actions it would have to bring and then impose a larger fee than necessary.

Fortunately, the Department agreed to wait.  According to an email from Darcy Miner, Director, Division of Compliance Monitoring at MDH, “MDH does not intend to impose a surcharge at this time, as we have no experience with costs and volume of these activities.  To date we have not had to use injunctive relief as a method to obtain compliance with state regulations.”

Based on our communication with the Department, we believe MDH will bring a recommendation to the 2008 Legislature, for a surcharge to begin July 1, 2008.  In any event, the Department has pledged to inform us and other affected stakeholders before it takes any action to impose the surcharge.

As required by the Legislature, MDH issued a brief report about enforcement of the new law, which we have posted to our website.  The report further explains the Department’s position on the surcharge:

“Since the Injunctive Relief requirements were not effective until January 1, 2007, MDH has not had the opportunity to pursue an injunctive relief action.  The timeframes for completing the analysis were prior to the effective date of the legislation.  Therefore, MDH has not had an opportunity to gather information as to the scope, number and cost of injunctive relief actions that may be conducted.”

“As authorized by Minnesota Statute 144D.03, subdivision 1A, a surcharge will be established with a sliding scale based on client capacity.  However, MDH needs to gain experience in this area prior to establishment of the surcharge.  To date there are no complaints nor known violations.  As MDH gains experience with injunctive relief actions and develops the surcharge, the stakeholders will be kept informed.”

Jonathan Lips
952.851.2480
jlips@careproviders.org

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Third Committee “Visit” Happened on April 16

With the “interesting” committee structure in the House this session, the House health and human services (HHS) omnibus appropriations bill has had quite a journey these past few weeks.  As reported in last week’s newsletter, the House HHS omnibus appropriations bill, originally H.F. 297 (Huntley, DFL-Duluth), passed out of the finance division prior to the start of the Spring break on April 2.  Upon their return from “vacation”, the House got busy with their bill processing:

First, they substituted the bill number of the Senate Health and Human Services Omnibus Appropriations bill, S.F. 2171 (Berglin, DFL-Mpls) for the house HHS bill number.  This means that both the House and Senate will be working off of the same bill number, S.F. 2171, but the content within these bill numbers will be remarkably different—the “insides” are the amended version of the House HHS and Senate HHS bills.  Then, the bill was amended and passed out of the House Finance Committee on April 12 and referred to the Committee on Taxes.  The bill was heard in the House Tax Committee on April 13, with only a small author’s amendment adopted, and re-referred to the Committee on Ways and Means.  On April 16, the bill was passed out of the Ways and Means Committee with, again, a technical author’s amendment only and sent to the House floor.

Several other amendments were attempted in these committees, but ultimately defeated along a party line vote—many of the arguments that were made concerned the percentage of cost of living adjustments that would be provided to nursing homes under the bill.  Many committee members believed that 3% was not enough, that rebasing needed to happen sooner, and/or that lower rate facilities should receive “bump ups” for equity before rebasing happens.  One of the best speeches was given by Rep. Bob Gunther (R-Fairmont) in the House Ways and Means Committee as the bill was ready for the final vote:  “Thank you Rep. Huntley for finding funds for the 3% increase, and for including rebasing for nursing homes in the bill but I am concerned the increases aren’t enough and rebasing may be too late.  Nursing homes in my district are hurting—seven facilities are operating in the red now and five of these facilities are the biggest employers in their communities.  I urgently request that you continue to work on this issue and try to find a way to both increase the percentage increase to 5% and move up rebasing.”

It should be noted that some of the same committee members expressing interest in increasing nursing home spending were very concerned about the growth of the health and human services budget area.  The House HHS bill spends over $300 million more than the Governor’s proposed biennial budget in this area; the percentage increase from this biennium to the next in HHS spending proposed in the House bill is 19.7% vs. the 16% increase in the Governor’s budget.

It is expected that the House floor debate on the HHS omnibus appropriations bill will take most of one day and they are looking at April 20, 21 or 23 for this day of amendments.  This means that the earliest date for any conference committee meetings to begin will be April 25.  The conferees for the House are appointed by the Speaker of the House. Conferees in the Senate are appointed by the Subcommittee on Committees.

Patti Cullen
952.851.2487
pcullen@careproviders.org

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Summary on Rebasing Benefits Delineated Below

As the House and Senate health and human services omnibus appropriations bills moved through committees, during every stop the issue of rebasing nursing facility rates was brought up and discussed.  There are significant differences between the House and Senate rebasing proposals as they stand right now:  differences in when it starts, how long the phase-in period is, median increases estimated, and indexing of costs.  Our current position is that we prefer the language of the House bill, but prefer the start date included in the Senate bill, which is October 1, 2008.  We put together a list of talking points for the House author (Rep. Tom Huntley, DFL-Duluth) that we have listed below for your reference as you discuss this issue with your elected officials.

Key Points on Nursing Facility Rebasing

• It aligns operating rates more closely to the actual cost of providing care to nursing facility residents for the first time since 1993, the last time costs were recognized without spending limits;

• Rebasing of operating rates begins to cover a growing gap between Medicaid rates and the actual cost of care which was shown to be almost $20 per resident day in a national study by BDO Seidman;

• Rebasing rates helps address the issue of differing rates for each facility, because the rebased rates will actually be tied to the cost of care in each facility.  For lower rate facilities that have held down their costs, the proposal indexes costs to match future rates—as long as rebasing occurs on a regular basis, as indicated in the bill, lower rate facilities will have the ability to catch up to higher rates;

• Unlike legislation that brings all facilities up to the median metro rate, rebasing does not result in a significant number of facilities that would receive less than $100 or a handful of facilities that would receive increased revenue of more that $1 million.  Only six facilities would not see some measure of increase;

• After the phase-in is complete, operating rates would continue to be rebased every other year—preventing the gap between Medicaid rates and costs from developing again.

• Our proposal was developed by a national consultant who has developed rebasing  mechanisms for several other states.  He conducted a financial analysis of the proposal that shows it to be both reasonable and equitable across peer groups.  Peer groups were established using labor statistics from the department of economic security, then tested using a financial model which included a cost coverage analysis.  After several modeling tests, we came up with the peer groups in the proposal, and each of the groups will end up with the recommended cost coverage at the end of the phase-in.

• We developed a three-year phase in so the state budget would not have to absorb the entire cost at one time; and incorporated several layers of limits to ensure that the system is affordable in the long term.

Patti Cullen
952.851.2487
pcullen@careproviders.org

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Governor Pawlenty Poised to Veto

By a vote of 40-23 the state Senate passed a bill on Wednesday, April 18 that would increase the state minimum wage, even knowing that Governor Tim Pawlenty intends to veto the proposal.

Under Senate File 875 (Anderson, E., DFL-St. Paul), the minimum wage for large employers would rise to $6.75 per hour on August 1, 2007 and to $7.75 per hour on August 1, 2008.  (Under current law a “large employer” is defined as any enterprise whose annual gross volume of sales made or business done is not less than $625,000, and the bill does not change that threshold.)  The minimum wage rate for small employers would increase to $5.75 per hour on August 1, 2007, and to $6.75 per hour on August 1, 2008.  The minimum wage would be indexed to the Consumer Price Index for all urban consumers (CPI-U) as of November 1 of each year and increased the following January 1 based on the percentage change in the CPI.  The bill also eliminates current law that allows the "training wage," which is a lower minimum wage rate for a beginning employee under the age of 20.

Supporters of the bill argued that the minimum wage is not keeping up with inflation and not keeping low-wage workers out of poverty, despite the increase that took effect in August 2005, while opponents countered that another increase will harm businesses and result in job losses.

The House of Representatives has not yet acted on the companion file (HF 456 / Rukavina, DFL-Virginia), but we do expect the House to pass that bill within the next few weeks, which will set up a showdown with the Governor.

In an April 17 letter to legislative leaders, Governor Tim Pawlenty stated that he will veto the bill in its current form.  (We have posted the letter to our legislative web page at Find It Here / Legislative / 2007 Legislative Session.)  Among other things, the Governor objects to the fact that proposed increase is greater than what the U.S. Congress is now considering.  Observers do expect legislation to pass soon that would raise the federal minimum wage to $7.25 over a two year phase-in period.

If today’s vote in the Senate is an indication, the Senate would not have the votes needed (45 would be required) to override a Pawlenty veto.  Stay tuned.

Jonathan Lips
952.851.2480
jlips@careproviders.org

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Visit our Legislative webpage for this week's bill introductions!

Each week during the 2007 legislative session, we will post a list of Bill Introductions on the “Find It Here / Legislative / 2007 Session Bill Tracking” section of the Association’s website.

Please contact Jon Lips or Patti Cullen any time if you have questions about proposed legislation or just want to know the general "buzz" at the Capitol.

Jonathan Lips
952.851.2480
jlips@careproviders.org

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OHFC & Survey Quality Improvement

The Minnesota Department of Health recently released the following two reports linked below:

1. Annual Quality Improvement Report on the Nursing Home Survey Process for the Federal Fiscal Year 2006

2. Complaint Investigations of Minnesota Health Care Facilities

These reports are required on an annual basis under Minnesota statute.  Both reports outline deficiencies issued, statistical information, and 2007 quality improvement goals.  Providers are encouraged to review both reports to better understand what is happening within these departments and what areas they are focusing on for improvement.

Doug Beardsley
952.851.2489
dbeardsl@careproviders.org

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Focus of Meeting Was New Survey Criteria and Quality of Life Thresholds

The April 13 meeting of the Nursing Facility Policy and Rates Advisory Committee was spent on two agenda items:  selection of a new method for determining rankings for the state inspection measure of the Nursing Home Report Card; and finalization of the quality of life risk adjusted thresholds for the quality measure tied to the customer satisfaction surveys.

First, the change in the state inspection measure:  over the past year, staff from both the Department of Health and the Department of Human Services have been meeting to figure out a new way to “judge” nursing facilities under the state inspection measure.  Association staff had provided input to their discussions at several points along the way, and continued to provide suggested changes at the April 13 meeting.  The need for change in this measure is derived from several criticisms of the current state inspection scoring methodology:  the current scoring doesn’t cover all of the state agency inspection activities the public is interested in; there is no context of history; there is no meaningful scoring criterion with 90% of providers currently obtaining the highest score; and the current scoring is potentially misleading to the public by ignoring relevant situations where serious harm or substandard care is occurring.

After some discussion, the option being “tweaked” a bit after our suggestions is one that evaluates each provider on five survey-like criteria, with a met/not met determination.  Report card stars will be awarded based on combinations of met and un-met criteria.  Those are:

1.  most recent survey will be “met” if the provider has no G level or above and no finding of substandard quality of care on its most recent survey.  There is a single G exception that can be applied to improve the number of stars ultimately awarded;
2.  complaints will be “met” if there are no complaint investigation findings which result in substandard quality of care or immediate jeopardy;
3.  prior survey will be “met” if there was no substandard quality of care or immediate jeopardy deficiency citation on its prior health survey;
4.  special focus will be “met” when the facility is not one of the few facilities (currently four) in the state listed as a special focus facility; and
5.  total deficiencies will be “met” if the total number of deficiency citations is less than a certain number—the number yet to be determined.  We argued at the meeting that this criteria needs some reworking because of survey team inconsistency, so they are considering changing the method of calculations for this criteria.

Under this new method, it is estimated that nearly 2/3 of the nursing facilities would receive the full five stars, with another 67 facilities receiving four stars.  There is still a bit of work left to do before this new method is finalized; however, the general outline noted above will be the outline for this new method.

The second agenda item, quality of life thresholds, took far less discussion time.  The advisory committee agreed to an 80th percentile for the high quality threshold; and the 10th percentile for the low quality threshold.  The committee reviewed the shape of the domain distributions for these categories of questions for both 2005 and 2006, and noted the consistency between the two years.

Patti Cullen
952.851.2487
pcullen@careproviders.org

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Spring…a Time of Change!

The Minnesota Department of Health has notified Care Providers of Minnesota of two staff changes that will be occurring this spring:

Pam Kerssen will be returning to MDH on April 30, 2006.  Pam will be an Assistant Program manager for the Licensing and Certification program; she will work in this statewide position from her office in the Bemidji District Office.  Pam will be filling in the void left by the June 5, 2006 retirement of Bob Gunkle (Bob will remain ½ time for one year).

Linda Tallaksen will begin in the position of HFE Supervisor II with the Licensing and Certification program in the weeks ahead.  Linda will be replacing Carol Hirschfeld, who will be retiring in May.  Linda will oversee the Licensing and Certification program assurance, enforcement, and nursing assistant registry activities.

Doug Beardsley
952.851.2489
dbeardsl@careproviders.org

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Level of Activity Is Low

Flu activity remains low this week, following its peak in early February.  One confirmed outbreak of influenza was reported in a Steele County nursing home this week.  No outbreaks of influenza-like illness were reported in schools.

Click here:  http://www.health.state.mn.us/divs/idepc/diseases/flu/stats/index.html to see how we are doing so far this year in comparison to the previous two flu seasons.

Doug Beardsley
952.851.2489
dbeardsl@careproviders.org

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U.S. Congress is considering co-pay "equity act"

This week the National Center for Assisted Living (NCAL) and the American Health Care Association (AHCA) praised Senator Gordon Smith (R-OR) and his co-sponsors for their introduction of the Home and Community Services Copayment Equity Act of 2007.  This legislation would provide dual eligibles—those eligible for Medicare and Medicaid—living in our nation’s assisted living residences and other home- and community-based settings (HCBS) the same copay coverage under Medicare Part D as those residing in nursing facilities.

To read a four page letter on this topic, submitted by NCAL to the U.S. Senate Special Aging Committee Hearing in January, click here.

The following is from the press release issued this week by AHCA/NCAL:

“We applaud Sen. Smith’s leadership and steadfast support on an issue that is critically important to assisted living’s low-income and frail elderly beneficiaries,” said David Kyllo, Executive Director of NCAL.  “Our residents require the same number of medications as nursing facility residents, yet, this group of low-income assisted living residents is unable to afford their co-payments and therefore is denied access to their life-saving medicines.”

AHCA/NCAL also praised the bill’s bi-partisan cosponsors, which include Senators Jeff Bingaman (D-NM), Barbara Boxer (D-CA), Hillary Clinton (D-NY), Susan Collins (R-ME), Blanche Lincoln (D-AR), and Bill Nelson (D-FL).  According to research, dual eligible assisted living residents take eight to 10 medications, and with Part D drug copays ranging from $1 to $5 dollars, their expenditures can quickly add up and exceed the resident’s monthly personal allowance under Medicaid.

“Remedying this gap in prescription coverage is based upon simple common sense, and is supported by a coalition of more than 35 national organizations representing consumers, geriatric care professionals, health care and long-term care providers, pharmacists, and state officials,” said Kyllo.  NCAL led the coalition to garner support on behalf of assisted living residents.

As more states opt to use Medicaid to cover assisted living services, this population of beneficiaries is expected to increase.  Analysis prepared for AHCA/NCAL by the Lewin Group revealed that by 2008, the HCBS dual eligible population will be larger than the number of dual eligible beneficiaries living in nursing facilities and other institutions.

“Assisted living providers are concerned about the quality of life of their dual eligible residents,” Kyllo said.  “The passage of the Home and Community Services Copayment Equity Act of 2007 would ensure that residents receive their needed medications.”

Jonathan Lips
952.851.2480
jlips@careproviders.org

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Suppliers Must Be Accredited by August 31

In order to participate in the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program, suppliers must meet quality standards and be accredited by a CMS-approved Deemed Accreditation Organization.  Suppliers that are interested in bidding under the new program must be aware of two key deadlines:

1. Suppliers must be accredited or be pending accreditation to submit a bid.  CMS cannot accept a bid from any supplier that is not accredited or that has not applied for accreditation.

2.  Suppliers will need to be accredited to be awarded a contract.  The accreditation deadline for the first round of competitive bidding is August 31, 2007.  Suppliers must be accredited before this date to be awarded a contract.  Suppliers should apply for accreditation immediately to allow adequate time to process their applications.

Bidding is expected to open in late April 2007.  For a list of the CMS-approved Deemed Accreditation Organizations and information about the Medicare DMEPOS Competitive Bidding program, visit:  http://www.cms.hhs.gov/CompetitiveAcqforDMEPOS/.

To view a Special Edition MLN Matters article on this topic, visit:  http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0713.pdf.

Patti Cullen
952.851.2487
pcullen@careproviders.org

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CMS Website is a great source of information

Have you obtained your National Provider Identifier (NPI)?  May 23, 2007 is the NPI compliance date.  The implementation of the NPI is a complex process that will impact all business functions of your practice, office or institution including:  billing, reporting and payment.  This is why providers are urged to get, share, and use their NPI NOW to avoid a disruption in cash flow.

To learn more, information and education on the NPI can be found at the CMS NPI page:  www.cms.hhs.gov/NationalProvIdentStand on the CMS website.  Providers can apply for an NPI online at:  https://nppes.cms.hhs.gov or can call the NPI enumerator to request a paper application at 1-800-465-3203.

Todd Bergstrom
952.851.2486
tbergstrom@careproviders.org

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Next Quarterly Meeting to Be Held on June 20

Over 25 providers gathered to discuss housing and community-based services issues at a three-hour meeting on Tuesday, April 17th.  While there was only one DHS Bulletin pertaining to housing and community-based services to discuss since we met on January 18th, we are anticipating the publication of a DHS Bulletin on Elderly Waiver and Customized Living.  This could come as early as Monday, April 23 in conjunction with the DHS Video Session on Elderly Waiver and Customized Living, which will be held on that date in various locations around the state.

By the end of our meeting, members were aware of at least four developments that will impact housing with services providers:

1)  Implementation of Hennepin County's "Free Market Method,"
2)  Uniform Consumer Information Guide for Assisted Living providers,
3)  Rate Setting methodologies being discussed at a DHS work group, and
4)  Regulatory practices at the state and federal level.

A healthy and spirited discussion ensued about options for providers as recently approved policies are implemented and potential changes for the future are anticipated.  As one provider shared, "I didn't realize these three or four trains were arriving so quickly."

Jon Lips provided a legislative update as well.  The group is looking forward to meeting again on Wednesday June 20th and invites other members to consider joining them.

Phil Manz
952.851.2484
pmanz@careproviders.org

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Final step is a focus group with consumers next week.

The Uniform Consumer Information Guide for Assisted Living is just a few weeks away from completion.

A group of seven providers—including four from Care Providers of Minnesota—filled out the beta test version of the Guide and submitted them to the Department of Health (MDH) a couple of weeks ago.  The members who turned it in reported no difficulty with filling it out, except that one wished there was more room to include explanatory comments.

Next Tuesday, April 24, the Department will conduct a focus group with actual consumers of assisted living services, plus family members and potential consumers.  The MDH staff who worked on developing the guide will deliberately exclude themselves from the process.

Once the Department receives feedback from the consumer focus group, it will finalize the Guide and issue notice of its formal adoption.  Once that occurs, assisted living providers must begin using it within six months.

Jonathan Lips
952.851.2480
jlips@careproviders.org

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Does Your Medical Director Know about F329 Changes?

Dr. Edward Ratner, President of the Minnesota Medical Directors Association (MMDA), recently sent out an excellent letter to all MMDA members summarizing the new changes to unnecessary medications (F329) regulations as they relate to prescribing physicians.  Click here to view the letter.  Your facility’s Medical Director may want to consider writing a similar letter to the primary physicians of your residents.

Facilities are encouraged to have their Medical Directors be a member of the MMDA; dues are only $125.00 per year.  MMDA membership information can be found on their website:  http://www.mmaonline.net/SpecialtySocieties/mmda.cfm.  Make sure your Medical Director is aware of MMDA’s Fall Conference, scheduled for October 25-26 in Bloomington.

Finally, does you Medical Director receive a weekly emailed Action Newsletter?  To sign your Medical Director up for our electronic Action Newsletter, send the following information to Lisa Olson:  Facility name, Medical Director’s name, and Medical Director’s email address.

Doug Beardsley
952.851.2489
dbeardsl@careproviders.org

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Nominations Due by May 25

Don’t get caught off guard.  This year’s award nominations have an earlier due date—May 25th!

We’ve accelerated the timeline for nominations this year, so if you haven’t already, it’s time to start thinking of who you can nominate!  The list of categories includes Employee of the Year, Leadership Award, Teen Volunteer of the Year, and Quality Improvement Team Award.  There are also two new categories:  Innovation of the Year and Technology Advancement Award.  (For a complete list of award categories, visit our website at Find It Here / Awards / Listing of All Association Awards.)

One other award category is the Public Official Recognition Award.  This award honors an elected official (local officials are eligible, too) and people who have gone beyond the call of duty in advocating for the long-term care community.  If you need any help putting together a nomination for this category, please contact Jon or Patti at the Association.

All nominations are due by Friday, May 25th.  Awards will be presented at the annual convention in November.

Lisa Olson
952-851-2483
lolson@careproviders.org

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Have we heard from you?

National Nursing Home week is just weeks away.  The celebration begins Sunday, May 13 and continues through the 19th.

This special week is an opportunity to honor all those in your community—residents and their family members, staff, and volunteers.

Based on the theme—Treasure Our Elders—AHCA has created a 14-page publication filled with great ideas that can help you celebrate the week.  (AHCA's planning guide can be accessed at:  http://www.nnhw.org/2007/NNHW2007planning_guide.pdf.)

And if you use one of their ideas or one of your own, we want to know about it.  Actually, we want to more than know about it, we want to be a part of it!  We are compiling a list of events for that week, and as staff time allows, we would love to be a part of your celebration.  So if you have something planned for that week, please contact Lisa Olson as soon as possible.

This is the last year that Rick E. Carter will be able to join the celebrations...so get your requests in early!  Staff cannot attend all events, but priority will be given to those that get their requests in first!

Send the following details to Lisa Olson at lolson@careproviders.org or by phone at 952-851-2483:

• name of event
• your facility
• date and time of event
• a brief description
• contact person, phone and email

Let us know of your celebrations as soon as possible so we can get them on our calendar.  We will be following up on all invitations the week of May 7th.

We look forward to seeing you next month!

Lisa Olson
952-851-2483
lolson@careproviders.org

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Magnetic Door Locks

The Minnesota Department of Health and the State Fire Marshal Division have been informed by CMS regarding a significant change regarding how surveyors must inspect magnetic locking devices on doors in the means of egress.

The Minnesota Department of Health has provided the following instructions to State Fire Marshals, based on CMS instructions:

“Effective immediately, if your staff observes the installation of magnetic locks on doors in the means of egress, they must cite a K038 deficiency IF the locking devices are on any door EXCEPT those doors that define or are within a specialized care unit.  In other words, magnetic locking devices are permissible on doors in the means of egress associated with a memory care unit (commonly referred to as an Alzheimer unit, dementia unit, memory loss unit, etc).  All other use of this type of locking device requires a K038 deficiency, with the following exception:

A transponder activated magnetic locking system (such as Code Alert or WanderGuard) is acceptable on all doors in the means of egress because this system only restricts those wearing the transponder.  These are precisely the residents referred to in LSC 19.2.2.2.4, exception #1.

If the facility desires to continue using this type of locking device to protect remote exit doors, stairwells, etc. in areas other than within or to define the limits of specialized care units, they must request an annual waiver from CMS.  A K084 page is required.”

Facilities should review their use of each magnetic lock to determine:

1.  Does the magnetically locked door define, or is it within, a specialized care unit?  (This should be OK)
2.  Does the magnetically locked door only lock for those residents wearing a transponder (ie:  Code Alert, WanderGuard, etc.)?  (This should be OK)
3.  Does the magnetically locked door not define the area of a specialized care unit and not lock only when tripped by a responder?  (NOT OK—may require an annual waiver after K038 is issued)

This new interpretation only applies to nursing homes, not assisted living or housing situations.

Doug Beardsley
952.851.2489
dbeardsl@careproviders.org

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Liquid Oxygen

The Minnesota Department of Health has advised the State Fire Marshal Division staff to NOT issue K-76 deficiencies in situations when liquid oxygen is left unused in a room for more than 30 minutes under an appropriate resident specific prn oxygen order.  The prn oxygen source (liquid or gas) should be removed from a resident room and stored properly if it is left unused for “an extended period of time, such as several days.”  This decision was based on new information from CMS which determined that S&C-07-10 pertained to both gaseous and liquid oxygen, something that Care Providers of Minnesota and AHCA had believed ever since S&C-07-10 was issued.  Providers should be pleased that staff from both the Minnesota Department of Health and the State Fire Marshal Division advocated strongly on behalf of providers and residents in pushing for this change in interpretation.

Doug Beardsley
952.851.2489
dbeardsl@careproviders.org

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