The Lead August 21 2025 - LeadingAge Illinois

Nursing and Rehabilitation
Upcoming COE-NF Free Training
CMS Releases Final MDS 3.0 Item Sets for October 1
Missing Your LeadingAge Five-Star Report?
CMS Pauses Care Compare Updates
Regulatory Review – Notice of Certain Balances & Conveyance

Housing
LeadingAge RAD for PRAC Webinar Series: Preserving Your Aging HUD Property

HCBS
Updated Home Health Advocacy Resources

Other
Ask the Expert

Help Set the 2026 LeadingAge Illinois Legislative Priorities

The last three legislative sessions have been the most successful in association history. We have held off burdensome legislation while also passing important measures from our member-driven legislative agenda.

It is now time to plan for the 2026 session of the Illinois General Assembly, which begins in January. Help us set our 2026 agenda by taking part in one or more of the below forums. Come with any ideas or feedback on challenges you are facing. Our goal is developing solutions to those challenges.

We are making it simple. To register, simply email Jason Speaks at jspeaks@leadingageil.org with the RSVP for the forum date you would like to attend. You will then receive a calendar invitation for the virtual meeting. (Example: Subject: RSVP September 9 Assisted Living Forum).

Legislative Priorities Member Forums:

Assisted Living
September 9
10:00 – 11:30 am

Life Plan Communities/ CCRCs
September 16
10:00 – 11:30 am

Nursing Homes
September 23
10:00 – 11:30 am

Housing
October 7
10:00 – 11:30 am

Home and Community Based Services
October 21
10:00 – 11:30 am

LeadingAge Illinois PAC Represented at Recent Events

The LeadingAge Illinois PAC was represented at a number of recent events. Yesterday, Jason Speaks represented the PAC at a small, private lunch with House Speaker Emanuel Chris Welch in Elmwood.

Jason also connected with the Speaker at an event held in Springfield last week. That event was one of a number of others Jason attended surrounding the Illinois State Fair, a prime week for legislative events in Springfield.

LeadingAge Illinois Bi-Weekly Member Call

We are excited to invite you to our biweekly member meeting, open to all members! This is a great opportunity to stay informed on the latest legislative developments and education updates, as well as engage with our featured guest speakers.

Mark your calendars!
Every other Friday from 9:00 – 10:00 AM
Next Zoom is August 29

Meeting Highlights:

Legislative Updates: Learn about the most recent legislative changes that may impact our community from our Public Policy Team.
Education Updates: Stay up-to-date with the latest education offerings.
Featured Guests: Special guests will join us to share their expertise and insights on key topics.

This event is free and open to all members—we encourage you to join, participate, and connect with fellow members and LeadingAge Illinois staff.

RSVP Here.

We look forward to seeing you on Zoom!

Upcoming IDPH Webinars

The Illinois Department of Public Health announced the following upcoming webinars. Registration is required and attendance is limited. If you’re unable to attend, email Michael.moore@illinois.gov as the webinar will be recorded and can be distributed following the event.

Contractor Toolkit on August 22 from 1 – 2 p.m.
Multidrug- Resistant Organism (MDRO) and Denial of Admission on September 17 from 1-2 p.m.

Send us your MCO Issues

LeadingAge Illinois is working with the Illinois Department of Healthcare and Family Services (HFS) and the MCOs to resolve MCO billing issues. If you have a pattern of claims issues (not single claims) that you have not been able to resolve using the normal channels, such as working with your provider relations representative or through the use of the complaint portal, we can help by raising attention to these issues.

If you have issues, please contact Jason Speaks.

Learn More About Age-Friendly Health Systems

The Institute for Healthcare Improvement (IHI) is offering an opportunity for LeadingAge members and other aging services providers to join the Age-Friendly Health Systems movement. The Age-Friendly Health Systems Online Course with Coaching is an in-depth program that teaches the elements of the 4-Ms Framework and develops an organization’s ability to provide age-friendly care in various settings, including hospitals, ambulatory clinics, nursing homes, and home health agencies. The program will help teams of attendees get started with age-friendly care and learn to act as age-friendly champions within their health system. The price per person is $549 and is approved to provide 10 continuing education credits for physician’s, nurses, pharmacists, social workers, and Certified Professional in Patient Safety (CPPS) recertification. IHI is pleased to offer a limited number of scholarships to assist with program registration costs. Scholarship applications are due September 3, 2025. All scholarship applications are reviewed on an individual basis using the same scoring criteria. Click here to apply for one of the scholarships and here to learn more or register for the course. If you have any questions, please reach out to the LeadingAge Program Manager Lauren Cameron afhsocc@ihi.org.

CMS Launches Effort to Remove Ineligible, Non-Citizen Medicaid Enrollees

On August 19, the Centers for Medicare and Medicaid Services (CMS) issued a press release about an effort to ensure Medicaid enrollees are U.S. Citizens, U.S. Nationals, or have satisfactory immigration status. This will be accomplished with monthly enrollment reports sent to states detailing individuals whose citizenship or immigration status could not be confirmed through federal databases, including the Department of Homeland Security’s Systematic Alien Verification for Entitlements (SAVE) program. CMS expects states to take quick action and will monitor state progress monthly. Specifically, states are responsible for reviewing cases sent to them on August 19 and subsequent reports, verifying citizenship or immigration status of individuals, requesting additional documentation from individuals, and acting, when necessary to adjust coverage and enforce non-citizen eligibility rules. LeadingAge will be reviewing the process for potential impacts on aging service providers including nursing home or home and community-based services eligibility.

IDPH Issues SIREN on Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease (HFMD) is currently surging across Illinois and nationally without an increase in severity identified. Clinician diagnosis is important due to co-circulating measles which both present symptoms of a rash and fever. Hand, Foot and Mouth Disease is typically a seasonal illness caused by several of the non-polio enteroviruses and commonly presents with a rash on hands and feet, and mucosal sores in the mouth. While HFMD can affect people of all ages, it predominately affects children under five years of age.

If any of your staff and/or if you have a daycare within your community, and present with a rash and fever, they should be referred to their clinician for further directions. Upon being fever free for at least 24 hours without use of fever-reducing medication, individuals can return to work or school unless otherwise directed by their clinician.

You can find additional guidance on the Pan American Health Organization and CDC’s Hand, Foot, and Mouth Disease.

Clinical Best Practice – Pressure Ulcer Prevention & Nutritional Considerations

The National Pressure Injury Advisory Panel Quick Reference Guide for Pressure Ulcer Prevention identified that nutrition plays a key role in pressure ulcer prevention along with good practice statements and recommendations for individuals at risk for pressure ulcer development. Once you’ve completed a pressure ulcer risk assessment and the resident is identified as being at risk for development, the care plan must identify interventions that will be implemented in the resident’s ongoing care. Here are some ideas for best practices related to a nutritional aspect of the prevention.

Conduct a comprehensive nutrition assessment to screen residents for possible malnutrition and aid in developing a person-centered care plan. A comprehensive nutrition assessment should be conducted routinely regardless of the resident’s risk for pressure ulcer development, but identifying additional needs related to this risk is necessary for these individuals to ensure a multidisciplinary approach.
At a minimum, residents at risk of pressure injury should be encouraged to consume a well-balanced diet which includes nutrient-dense foods as well as ensuring adequate hydration. You may consider implementing a hydration program to aid in prevention (along with the numerous other benefits that adequate hydration provides).
Residents who are at risk of pressure injury and are also identified as being malnourished should be considered for additional general nutritional and protein supplementation. This may be done in the form of a shake or by requesting vitamin supplementation from the resident’s physician.
The Pressure Injury Advisory Panel only recommends carbohydrate-based energy and micronutrient supplementation when there is a known micronutrient deficiency in addition to the interventions identified above.
Tube feeding protocols are generally not recommended solely for pressure ulcer prevention methods and should be preceded by a comprehensive multidisciplinary assessment and used in conjunction with other clinical needs.

While it is not required, you may consider implementing a practice that reviews other preventative measures first upon identified risk of pressure injury development (such as repositioning and hydration) and then consider nutrition supplementation when the risk is very high or the resident has a pressure ulcer. Interventions such as additional protein at meals (which could be provided by adding more meat, eggs, or nuts to their diet). Are non-pharmacological methods to supplement nutrition and avoid administering more medication to the resident. Regardless of your practice, ensure that your nurses are well educated on the standards to ensure that when they’ve identified either a risk or actual injury, they are implementing the measures according to your policy.

CMS Issues Memo on State Performance Measures

On August 6, the Centers for Medicare & Medicaid Services (CMS) issued a Quality, Safety, & Oversight Group administrative memo 25-04-ALL on the Fiscal Year 2024 (FY24) State Performance Standards System (SPSS) Findings. The memo outlines several measures for both accredited and non-accredited levels of care and based on national and state performance. How does Illinois measure up?

Under the Survey and Intake Process there are seven non-accredited measures and six accredited measures included. Illinois met five of seven measures including surveys of nursing home special focus facilities, off-hour surveys for nursing homes, timeliness of upload of recertification surveys, use of the immediate jeopardy template, and intakes are prioritized as immediate jeopardy and started within the required time period for nursing homes.

The measure that assesses the immediate jeopardy intakes are overdue for nursing homes and accredited providers wasn’t applicable for Illinois.

Illinois also met the following measures for accredited providers timeliness of upload of recertification surveys, use of the immediate jeopardy template, and intakes prioritized as immediate jeopardy are started within the required period for deemed providers.

The survey agency did not meet measure goals for accredited providers related to EMTALA prioritized as IJ and non-IJ high are conducted within the required time period, as well as the same measure for non-deemed, accredited providers.

Finally, Illinois partially met the frequency of nursing home recertification surveys.

The memo also included three measures under the survey and intake quality including the assessment of survey practice is in accordance with federal standards using focused concern surveys, nursing home tags downgraded/removed by informal dispute resolution or unresolved informal dispute resolution, and data submission were all met by the survey agency. Finally, the survey agency met the noncompliance resolution measures including an assessment of the timeliness of revisits completed for both nursing home and accredited providers.

CMS Announces Transition to Electronic CLIA Processes

The Centers for Medicare & Medicaid Services (CMS) Clinical Laboratory Improvement Amendments (CLIA) program will be transitioning to electronic systems. After March 1, 2026, CLIA will be completely electronic. Providers completing laboratory services including point of care (POC) testing, must switch to email notifications to receive CLIA fee coupons and certificates. To transition to electronic notifications, providers must email their CLIA State Agency Contact (Illinois is DPH.CLIA@illinois.gov). More information is available on the CLIA page of the CMS website and CMS developed a toolkit to assist labs and providers during this transition.

Upcoming COE-NF Free Training

The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) is offering the following free training opportunities in August:

Empathy and Compassion: Foundations for Person-Centered, Staff-Sustaining Care on August 26 from 12:30 – 1:30 p.m. CT
Opioid Stewardship in Skilled Nursing Facilities: Preventing Opioid Use Disorder (OUD) Before it Starts on August 28 from 1-2 p.m. CT
Mental Health First Aid (MHFA) on August 29 from 10 a.m. to 3:30 p.m. CT

CMS Releases Final MDS 3.0 Item Sets for October 1

The final Minimum Data Set (MDS) 3.0 Item Sets version 1.20.1v3 and Item Matrix v1.20.1v3 are now available in the downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS v1.20.1v3 will be effective for nursing home providers on October 1, 2025. The final Item Sets include the following changes from the v.1.19.1:

A0800 – Instead of “Gender”, CMS revised to “Sex”.
A1250 – Transportation was retired and A1255 implemented. The difference includes slight wording changes “In the past 12 months, has lack of reliable transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living?” With coding options of Yes, No, Resident declines to respond, and Resident unable to respond.
Throughout the MDS, updates were made accordingly if specific item sets were changed or removed. For example, under B0100, if you coded 0 = No, you skipped to B0200, Hearing while you will now skip to B1300, Health Literacy.
O0390 was added where providers will now code what therapies were administered for at least 15 minutes a day on one or more days in the last 7 days with options including Speech-Language Pathology and Audiology Services, Occupational Therapy, Physical Therapy, Respiratory Therapy, Psychological Therapy, and None of the above.
Subitems in Section O including O0400A, O0400B, O0400c, O0400D1, O0400E, and O0400F were changed to O0425 and will only be completed if A0310H=1. A couple years ago when therapy services were revised to only Medicare Part A services, there was a lot of concern expressed about case mix index and resident acuity which led to changes shortly after implementation. We will monitor this change as well.
Additionally, as notified by CMS Section R which was included in the initial draft MDS is not included in the final version.

Kellie Van Ree, Director of Clinical Services expressed concern to LeadingAge regarding the revision of the therapy minutes on behalf of nursing home members and will continue to monitor.

Missing Your LeadingAge Five-Star Report?

LeadingAge Illinois staff recently emailed nursing home Five-Star Reports, and we don’t have current contact information for several members. If you did not receive a report and want to check on the status or be placed on the list for your nursing home please email Kellie Van Ree, Director of Clinical Services.

CMS Pauses Care Compare Updates

The Centers for Medicare & Medicaid Services (CMS) issued a Quality & Safety Special Alert Memo (QSSAM) QSSAM-25-03-NH temporarily pausing updates to care compare. According to the memo, the temporary pause was effective on July 30 and will resume in October 2025. The reason behind the temporary pause relates to the transition of the nursing home survey software to iQIES on July 14 and CMS wants to ensure that publicly reported data is accurate before resuming updates to the Care Compare website. All information that will be displayed on Care Compare for skilled nursing providers will remain static as of the latest refresh.

The memo includes a reminder that the Requirements of Participation (RoP) for all nursing home providers includes ensuring that survey reports are publicly accessible.

Regulatory Review – Notice of Certain Balances & Conveyance

The next regulation in the resident’s right section of Appendix PP is F569 which requires that the nursing home notify each Medicaid resident when the amount in their account (if they deposit funds in an account with the nursing home) reaches $200 less than the resource limit for one person and that if they exceed that limit they may lose Medicaid coverage. According to the Illinois Department of Human Services, the resource limit is $17,500.

Additionally, this regulation requires that if a resident discharges or passes away, the nursing home must reimburse the resident the amount of funds deposited within 30 days of discharge along with a final accounting of those funds. If the resident passes away, the nursing home must reimburse the individual or probate jurisdiction administering the resident’s estate the amount of funds deposited into the resident’s account, in accordance with any State law.

This regulation is rarely cited for non-compliance, but during the rare event that it was cited the concern was identified during a complaint and related to the time it took to reimburse the funds that the resident deposited in the nursing home account.

LeadingAge RAD for PRAC Webinar Series: Preserving Your Aging HUD Property

Join LeadingAge for a special mini-series on the Rental Assistance demonstration (RAD), a critical senior housing preservation tool administered by the Department of Housing and Urban Development (HUD). Many affordable senior housing providers are exploring preservation options for aging PRAC properties with limited opportunities to attract recapitalization and rehabilitation investment; the September webinar series, taught by affordable housing expert Gates Kellett, reviews the basics of RAD and then dives into best practices and pitfalls to avoid. Whether you are just beginning to explore RAD or seeking to refine your approach, this insightful two-part webinar will provide valuable knowledge and practical guidance for making informed decisions and ensuring the long-term success of your housing portfolio.

Updated Home Health Advocacy Resources

LeadingAge, along with partners at the National Alliance for Care at Home, have released state by state one pagers on the impacts of the proposed Calendar Year (CY) 2026 Home Health Payment rule. You can find all of the resources including the new one pagers here.

Ask the Expert

Why has IDPH not updated the COVID-19 guidance?

Historically, the guidance has been established by the Centers for Disease Control & Prevention (CDC). Late in 2024, LeadingAge Illinois along with many others submitted comments to the CDC’s HICPAC Committee on the guidance. They issued recommendations to better align all respiratory illnesses to the CDC. However, this was around the time of the change in Administration which included key personnel at CDC. Recently, Congress appointed a new CDC Director, Susan Monarez, and LeadingAge sent a letter to the new director urging an update in the infection control guidelines. You can read more about LeadingAge’s advocacy here.