Nursing Facilities

The Medical Facilities Unit oversees the licensing of all long-term care nursing facilities in the State of Maine as well as federal certification jurisdiction as determined by the Centers for Medicare & Medicaid Services (CMS). A nursing facility is an institution which is primarily engaged in providing skilled nursing care and related services for residents who require:

  • medical or nursing care
  • rehabilitation services for the rehabilitation of injured, disabled, or sick persons
  • health-related care and services to individuals who because of their mental or physical condition require care and services

Federal Regulations:

State Rules

The Certification Process

The functions that the Division of Licensing & Certification (DLC) perform for the Centers for Medicare & Medicaid Services (CMS) under the agreements in Section 1864 of the Social Security Act (the Act) are referred to collectively as the certification process.

The State Licensure Process

The functions that DLC perform under the authority of MRSA 22 §1811 and §1814 are collectively referred to as the State Licensure Process.

How to Become Federally Certified

To become federally certified, you must do the following:

  1. submit an enrollment application
  2. DLC will provide additional, CMS-required, forms. Complete these and return to DLC

How to Apply for Licensure

To apply to for an initial licensure, you must do the following:

  • visit the Healthcare Oversight page of our DLC website and review the instructions under the Certificate of Need program
  • Fill out and submit by mail as one package the Nursing Facility application as well as other required documentation and fees
  • Submit a written statement signed by an authorized representative of the Department of Public Safety
  • Provide DLC with provider policies that has been approved by a professional group of advisors

To apply for a renewal of a license, you must do the following:

Fill out and submit by mail as one package the Nursing Facility application as well as other required documentation and fees

Changes to a Nursing Facility After Initial Licensure/Certification

The provider must report the following changes to DLC:

  • Change of ownership
  • Change of administrator
  • Change in number of beds
  • Change in services
  • Relocation
  • Change of mailing address
  • Change of phone/fax number or email address

These changes require a change in licensure and must be reported to DLC with the applicable fee as outlined in MRSA 22 §1723.

Any applicable CMS-required forms must be completed, as required by CMS, and submitted to the fiscal intermediary.

For the addition of services, please follow the guidelines outline in the Certificate of Need section of the Healthcare Oversight page.

Construction/Renovations

In the event of construction or renovations to a nursing facility, the provider must do the following:

  • visit the Healthcare Oversight page of our DLC website and review the instructions under the Certificate of Need program
  • Submit architectural plans electronically to the State Fire Marshal’s Office and to DLC
  • An architect’s certification must be submitted to DLC as indicated in the state rules.

 

Civil Money Penalty (CMP) Reinvestments

A CMP is a monetary penalty the Centers for Medicare & Medicaid Services (CMS) may impose against nursing homes for either the number of days or for each instance a nursing home is not in substantial compliance with one or more Medicare and Medicaid participation requirements for long-term care facilities. A portion of CMPs collected from nursing homes are returned to the states in which CMPs are imposed. State CMP funds may be reinvested to support activities that benefit nursing home residents and that protect or improve their quality of care or quality of life.

 

CMP funds may be used for (but not limited to) the following:

  • Assistance to support and protect residents of a facility that closes or is decertified
  • Time-limited expenses incurred in the process of relocating residents to home and community-based settings or another facility when a facility is closed or downsized pursuant to an agreement with the state Medicaid agency
  • Projects that support resident and family councils and other consumer involvement in assuring quality care in facilities
  • Facility improvement initiatives, such as joint training of facility staff and surveyors, or technical assistance for facilities implementing quality assurance and performance improvement programs.

As part of its continued commitment to the nation’s most vulnerable populations, the Centers for Medicare & Medicaid Services (CMS) has launched the Civil Money Penalty Reinvestment Program (CMPRP) to improve quality of life by equipping nursing home staff, administrators and stakeholders with technical tools and assistance to enhance resident care. CMPRP is one of several initiatives CMS has underway to strengthen safety and health outcomes for nursing home residents

 

Proposals for CMPRP  

Proposals for use of CMP funds should normally be received by October 1st, in order to be included in the State's CMP Plan for the upcoming year. Two projects have been received for CY 2020, one related to bereavement education for nursing home residents, their families and staff and the second is training and distribution of a toolkit to assist nursing homes in dementia care and decreasing use of anti-psychotic medications, these projects will be extended into CY2021 to be completed.

More Information

More information about prior years CMP projects approved by the State of Maine can be found at the CMP website hosted by CMS.

Emergency Projects during Covid-19

CMS has approved for the States to approve projects related to nursing homes for communication equipment and physical barriers for visitation. Regarding Communication equipment, the Maine Health Care Association organized a project for all 93 nursing homes for a total of $153,746. to provide for communications equipment. Recently,  another project was approved to provide funds for physical barriers for nursing homes to facilitate visits with residents. This project has limited funds and facilities are advised to apply as this money will be provided for a total not to exceed $3,000 per facility on a first come first served basis. Please contact Larry.Carbonneau@maine.gov.