Lead July 21, 2022 - LeadingAge Illinois

Nursing and Rehabilitation:
HFS Webinar on New Reimbursement Methodology
Fiscal Year 2023 Long Term Care Provider Assessment
HFS Files Emergency Rules on Medicaid Rate Reform
New Nursing Home RoPs Guidance and Updates – 2022 Resources

Home and Community Based Services (HCBS):
New Resources for Home Health Prospective Payment Rule

Other:
ValueFirst Update

Top Stories:

A Day of Action on the Aging Services Workforce
Get Ready for the July 27 Aging Services Workforce Day of Action! On Wednesday, July 27, join fellow LeadingAge members around the country for a virtual Aging Services Workforce Day of Action, part of the Aging Services Workforce Now campaign, to demand Congress take immediate action to address the workforce crisis in aging services.

Get ready for July 27 when we will ask LeadingAge members to:

Contact your members of Congress and tell them to take action on legislation that will strengthen the workforce and support the aging services infrastructure.
Share your workforce story with your members of Congress: what staffing challenges do you have and how are they impacting your ability to meet the needs of older Americans.
Urge others, including residents and staff, to add join us on the July 27 Aging Services Day of Action.

Learn more about LeadingAge’s Aging Services Workforce Now campaign.

Nursing and Rehabilitation:

HFS Webinar on New Reimbursement Methodology
The Illinois Department of Healthcare and Family Services (HFS) has scheduled a Webinar: July 25, 2022, 9:00 – 11:00 am on New Reimbursement Methodology.

Fiscal Year 2023 Long Term Care Provider Assessment
The Illinois Department of Healthcare and Family Services (HFS) released a provider notice on the bed tax.

HFS Files Emergency Rules on Medicaid Rate Reform
The Illinois Department of Healthcare and Family Services (HFS) has officially adopted emergency rules on Medicaid Rate Reform, effective July 1, 2022 for a maximum of 150 days.

Here is another look at the rules:

Institute a new nursing home provider assessment.
Terminate the former licensing fee of $1.50 per licensed nursing bed day and assessment of $6.07 per occupied bed day effective June 30, 2022.
Effective Jul 1, 2022, the assessment amounts will vary (from $10.67 to $22.40 per resident day) based on the number of paid Medicaid resident days, which will include provisional and hospice days, per annum.
For non- profit facilities without Medicaid certified beds, the assessment will be $7 per occupied bed day.
HFS will update assessment amounts annually and publish each facility’s updated rates on its website at least 30 days before they take effect.
The assessments that will be effective on July 1, 2022 , and all updated assessments thereafter, will be calculated based on HFS’ records of Medicaid resident days for each facility for the year ending nine months previously. This assessment will be due and payable monthly.
Notices of a facility’s assessment shall specify how many paid Medicaid days for each facility are
attributable to managed care organization (MCO) payments, fee for service payments, and contracted Medicare-Medicaid Alignment Initiative plans.
The notices shall also specify the dates of service used in the determination of the assessment and the date on which this data was queried.
Facilities may appeal their assessments to HFS in writing. If a successful appeal was filed within 30 days after assessment rate notification, the new rate will be effective from the beginning of the assessment year.
If a successful appeal was filed more than 30 days after the assessment rate notification, the new rate takes effect on the 1st day of the month after the complete appeal was received. If an appeal is successful, HFS shall apply the money it owes the facility as credits toward future assessments.
The rules institute the Patient Driven Payment Model (PDPM) reimbursement system developed by the federal Centers for Medicare and Medicaid Services (CMS) and phases out the current Resource Utilization Groups-IV (RUG-IV) system. Base per diem rates will be increased by $7 effective July 1, 2022.
From July 1, 2022 through September 30, 2023, the nursing component of reimbursement rates will be based on a combination of the RUG-IV and PDPM systems. Beginning October 1, 2023 the nursing component will be entirely based on PDPM, but HFS must continue to provide RUG-IV data through September 30, 2023. Facilities will also receive add-on payments based on their levels of staffing and a Medicaid Access Adjustment based on their percentage of Medicaid residents.
Facilities may also receive incentive payments for hiring, retention and promotion of Certified Nursing Assistants (CNAs) as well as quality incentive payments based on the facility’s CMMS Star Rating.
No later than July 20, 2022, HFS must post on its website and publish in its provider handbook all its data sources, formulas, and collection periods for calculating per diem, add-on, and incentive payments, in sufficient detail for facilities to estimate their appropriate payments.
In advance of each quarter, HFS must notify each facility of its updated nursing component rate and all add-ons and adjustments. These notices must clearly state the amount attributable to each add-on or adjustment.
Notices must also clearly state the percentage of Medicaid bed days used to determine eligibility for the Medicaid Access Adjustment. Reimbursements may be appealed.
The rules require MCOs to pay nursing facilities within seven business days after the MCO receives its payment from HFS, or be subject to financial penalties.

New Nursing Home RoPs Guidance and Updates – 2022 Resources
On July 15 LeadingAge released a new QuickCast on the LeadingAge Learning Hub, New Nursing Home RoPs Guidance 2022: Abuse and Neglect. This 24-minute QuickCast provides an overview of revisions related to nursing home resident health and safety in the Abuse, Neglect, and Exploitation section of the new surveyor guidance. When accessing the QuickCast, members will also have access to implementation checklists to assist with compliance. Check out the QuickCast here. Additional resources on other new/updated guidance are forthcoming, including a live virtual update on August 2 that will provide an overview of all changes. Register for the August 2 virtual update here.

Home and Community Based Services (HCBS):

New Resources for Home Health Prospective Payment Rule
To help members navigate the CMS Home Health Prospective Payment System Rate Update, LeadingAge is taking action. If implemented, these cuts to home health providers would further erode access to care and services needed by older adults and their families. Check out these helpful talking points, a sample op-ed template, and slides from our recent Home Health Member Network meeting.

Other:

ValueFirst Update
Value First is a Group Purchasing Organization (GPO) that goes beyond the ordinary GPO to support LeadingAge members in the operations of their community. With the current labor shortage that is affecting senior living providers, Value First is spotlighting some of the suppliers with labor-saving products and services that can help during these challenging times. Procurement Partners can provide 40% time savings and 95% contract compliance by automating the entire purchasing process end-to-end, from product selection to vendor payment. Learn more by clicking here.