April 20 is a day recognized globally for celebrating cannabis culture, but it’s also like the cannabis industry’s Black Friday. 

Dispensaries offer deals designed to inspire people to flood their stores to stock up. 

However on Saturday, dispensaries across the state using an inventory platform called Dutchie were hamstrung for hours by technical challenges, which caused many of their registers to go down or move at snail pace. 

It was the second year in a row that a 4/20 sales surge caused the system to crash.

“Imagine running a restaurant where you have one burner working and you normally have 20 stoves operating,” said Nick Rinella, CEO of Hippos Cannabis dispensaries. “We had one burner going.” 

Each Hippos location went from selling around 500 items per hour to less than 100 because of the issues the outages were causing, he said.

Dutchie is similar to the platforms major stores, such as Home Depot and Walmart, use to scan items at check out. However, Dutchie also has the special function of communicating with the state’s seed-to-sale tracking system called Metrc. 

It keeps the stores compliant with the state’s stringent tracking requirements of marijuana products. 

With recreational marijuana now legal, 4/20 looked much different in Missouri

Rinella said all three Hippos dispensaries in Springfield, Chesterfield and Columbia faced delays all day — causing them to lose an estimated $200,000. 

Mark Hendren, president of Flora Farms, also said his six stores across the state faced delays up to five hours. He’s not sure what kind of loss Flora Farms experienced, he said, because the company extended their deals through Monday to make it up to their customers.

“It seems to be working,” he said.

John Mueller, CEO of Greenlight cannabis company, said his 15 stores were not impacted, nor were any of the company’s 32 stores across the country. Greenlight stores experienced some outages last year, he said, so they were expecting the same this year. 

“We prepared and trained for the outage that never came,” Mueller said. “But I’ve heard from a number of my peers that they had outages and somehow we did not.”

Dispensaries that are on certain servers faced more difficulties, Rinella said, but it’s the luck of the draw which servers companies are put on. Companies can’t pay more to get on the “good server,” he said.

Missouri was not alone. Dispensaries across the country experienced delays on Dutchie.

“This year’s 4/20 was a record setting day for the majority of Dutchie powered dispensaries,” Chris Ostrowski, chief technology officer of Dutchie, said in a statement emailed to The Independent. 

Ostowski said the systems powered more than two million transactions, representing $165 Million dollars in retail commerce — which was a 50% increase from last year’s 4/20. 

“While Dutchie and our partners prepared extensively for this year’s 4/20, a group of customers local to a specific instance of our POS system experienced serious issues that impacted their ability to transact,” Ostrowski said. 

The difficulties impacted less than 20% of Dutchie customers, he said.

Rinella said Dutchie’s statement just made the incident sting even more. 

“Hearing that is just painful to me,” Rinella said. “So they had a 50% increase. That means I probably would have had a 50% increase had they not jacked my entire system for the day.”

It’s unclear if Missouri’s cannabis industry had record-breaking sales this past weekend. April’s sales numbers won’t be available on the state’s website until early May.

However, Rinella said the sales were likely record-breaking, which is why the bandwidth on Dutchie’s server couldn’t handle the volume that was coming through. 

Lisa Cox, spokeswoman for the Division of Cannabis Regulation, said the Dutchie malfunctions did not interfere with the division’s tracking operations. 

“While licensees are permitted to use these [point of sale] systems, it is their responsibility to ensure each day’s transactions and inventory are recorded accurately in the statewide track and trace system,” Cox said, “no matter what happens with the POS system.”  

Rinella said the staff and customers were very understanding, and hopes any new customers that came to the stores on 4/20 aren’t discouraged to come back. 

“We kind of want to do more of an apology,” he said. “Obviously, this wasn’t something that we could control, but we do want to be able to make sure that customers get the greatest experience they can possibly get when coming to a dispensary.”

The Biden administration finalized nursing home staffing rules Monday that will require thousands of them to hire more nurses and aides — while giving them years to do so.

The new rules from the Centers for Medicare & Medicaid Services are the most substantial changes to federal oversight of the nation’s roughly 15,000 nursing homes in more than three decades. But they are less stringent than what patient advocates said was needed to provide high-quality care.

Spurred by disproportionate deaths from COVID-19 in long-term care facilities, the rules aim to address perennially sparse staffing that can be a root cause of missed diagnoses, severe bedsores, and frequent falls.

“For residents, this will mean more staff, which means fewer ER visits potentially, more independence,” Vice President Kamala Harris said while meeting with nursing home workers in La Crosse, Wisconsin. “For families, it’s going to mean peace of mind in terms of your loved one being taken care of.”

When the regulations are fully enacted, 4 in 5 homes will need to augment their payrolls, CMS estimated. That includes roughly two-thirds in Missouri.

But the new standards are likely to require slight if any improvements for many of the 1.2 million residents in facilities that are already quite close to or meet the minimum levels.

“Historically, this is a big deal, and we’re glad we have now established a floor,” Blanca Castro, California’s long-term care ombudsman, said in an interview. “From here we can go upward, recognizing there will be a lot of complaints about where we are going to get more people to fill these positions.”

The rules primarily address staffing levels for three types of nursing home workers. Registered nurses, or RNs, are the most skilled and responsible for guiding overall care and setting treatment plans. Licensed practical nurses, sometimes called licensed vocational nurses, work under the direction of RNs and perform routine medical care such as taking vital signs. Certified nursing assistants are supposed to be the most plentiful and help residents with daily activities like going to the bathroom, getting dressed, and eating.

While the industry has increased wages by 27% since February 2020, homes say they are still struggling to compete against better-paying work for nurses at hospitals and at retail shops and restaurants for aides. On average, nursing home RNs earn $40 an hour, licensed practical nurses make $31 an hour, and nursing assistants are paid $19 an hour, according to the most recent data from the Bureau of Labor Statistics.

CMS estimated the rules will ultimately cost $6 billion annually, but the plan omits any more payments from Medicare or Medicaid, the public insurers that cover most residents’ stays — meaning additional wages would have to come out of owners’ pockets or existing facility budgets.

The American Health Care Association, which represents the nursing home industry, called the regulation “an unreasonable standard” that “creates an impossible task for providers” amid a persistent worker shortage nationwide.

“This unfunded mandate doesn’t magically solve the nursing crisis,” the association’s CEO, Mark Parkinson, said in a statement. Parkinson said the industry will keep pressing Congress to overturn the regulation.

Richard Mollot, executive director of the Long Term Care Community Coalition, a New York City-based advocacy nonprofit, said “it is hard to call this a win for nursing home residents and families” given that the minimum levels were below what studies have found to be ideal.

The plan was welcomed by labor unions that represent nurses — and whom President Joe Biden is counting on for support in his reelection campaign. Service Employees International Union President Mary Kay Henry called it a “long-overdue sea change.” This political bond was underscored by the administration’s decision to have Harris announce the rule with SEIU members in Wisconsin, a swing state.

The new rules supplant the vague federal mandate that has been in place since the 1980s requiring nursing homes to have “sufficient” staffing to meet residents’ needs. In practice, inspectors rarely categorized inadequate staffing as a serious infraction resulting in possible penalties, federal records show.

Starting in two years, most homes must provide an average of at least 3.48 hours of daily care per resident. About 6 in 10 nursing homes are already operating at that level, a KFF analysis found.

The rules give homes breathing room before they must comply with more specific requirements. Within three years, most nursing homes will need to provide daily RN care of at least 0.55 hours per resident and 2.45 hours from aides.

CMS also mandated that within two years an RN must be on duty at all times in case of a patient crisis on weekends or overnight. Currently, CMS requires at least eight consecutive hours of RN presence each day and a licensed nurse of any level on duty around the clock. An inspector general report found that nearly a thousand nursing homes didn’t meet those basic requirements.

Nursing homes in rural areas will have longer to staff up. Within three years, they must meet the overall staffing numbers and the round-the-clock RN requirement. CMS’ rule said rural homes have four years to achieve the RN and nurse aide thresholds, although there was some confusion within CMS, as its press materials said rural homes would have five years.

Under the new rules, the average nursing home, which has around 100 residents, would need to have at least two RNs working each day, and at least 10 or 11 nurse aides, the administration said. Homes could meet the overall requirements through two more workers, who could be RNs, vocational nurses, or aides.

Homes can get a hardship exemption from the minimums if they are in regions with low populations of nurses or aides and demonstrate good-faith efforts to recruit.

Democrats praised the rules, though some said the administration did not go nearly far enough. Rep. Lloyd Doggett (D-Texas), the ranking member of the House Ways and Means Health Subcommittee, said the changes were “modest improvements” but that “much more is needed to ensure sufficient care and resident safety.” A Republican senator from Nebraska, Deb Fischer, said the rule would “devastate nursing homes across the country and worsen the staffing shortages we are already facing.”

Advocates for nursing home residents have been pressing CMS for years to adopt a higher standard than what it ultimately settled on. A CMS-commissioned study in 2001 found that the quality of care improved with increases of staff up to a level of 4.1 hours per resident per day — nearly a fifth higher than what CMS will require. The consultants CMS hired in preparing its new rules did not incorporate the earlier findings in their evaluation of options.

CMS said the levels it endorsed were more financially feasible for homes, but that assertion didn’t quiet the ongoing battle about how many people are willing to work in homes at current wages and how financially strained homes owners actually are.

“If states do not increase Medicaid payments to nursing homes, facilities are going to close,” said John Bowblis, an economics professor and research fellow with the Scripps Gerontology Center at Miami University. “There aren’t enough workers and there are shortages everywhere. When you have a 3% to 4% unemployment rate, where are you going to get people to work in nursing homes?”

Researchers, however, have been skeptical that all nursing homes are as broke as the industry claims or as their books show. A study published in March by the National Bureau of Economic Research estimated that 63% of profits were secretly siphoned to owners through inflated rents and other fees paid to other companies owned by the nursing homes’ investors.

Charlene Harrington, a professor emeritus at the nursing school of the University of California-San Francisco, said: “In their unchecked quest for profits, the nursing home industry has created its own problems by not paying adequate wages and benefits and setting heavy nursing workloads that cause neglect and harm to residents and create an unsatisfactory and stressful work environment.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

HOLTS SUMMIT — Retold Tales Used Bookstore in Holts Summit hosted its inaugural “trash bash” trash cleanup Monday as part of its Earth Day celebration, allowing residents to make a positive impact on the environment. 

The trash bash began at Retold Tales and included a 1.5-mile circuit for volunteers to walk along while collecting trash. The loop headed up South Summit Drive to Holts Summit Park, and then down Greenway Drive and back to the bookstore.

The community cleanup was sponsored by both Retold Tales bookstore and True Value of Holts Summit. The sponsors provided water and supplies, like gloves and bags, to volunteers.

Katherine Boyce, an employee at Retold Tales, helped organize and execute the cleanup effort. She said events like this one help increase awareness of the amount of waste put into the environment. 

“It’s really easy to get caught up in like trying to get from point a to point b, and you get in like autopilot mode, and you don’t see all the litter building up,” Boyce said. “But you notice the people standing there picking it up, and it makes you a bit more conscious of what you’re doing to help and how much waste you’re putting out into the environment.” 

The trash bash offered the opportunity for community members to come together and show their commitment to environmental stewardship, but Boyce said you don’t have to be cleaning in groups to make a difference.

“You can go out in your backyard and clean that up or walk out into your front yard, or just walk down your street,” Boyce said. 

According to Boyce, the community in Holts Summit shows a true care for the environment. 

“In Holts Summit, there’s gardens everywhere and those attract all the bees and the butterflies, and that’s a huge impact,” she said. 

Boyce said initiatives like this one on Earth Day are an important reminder of the responsibility humans have to help the planet. 

“I live on the Earth, and the Earth needs to be taken care of,” Boyce said. “I think because we all live here, we kind of all share the same responsibility to take care of it.”

This Earth Day’s trash bash served as a beacon of hope to a greener, cleaner future, Boyce said.