Lead March 12, 2021 - LeadingAge Illinois

Nursing and Rehabilitation:
Nursing Home Medicaid Rate Reform Update
HFS Provider Notices
Pass Through Update

Independent Affordable/Subsidized Housing:
Weigh in on HUD’s Physical Inspection Overhaul

Top Stories:
CMS Updates Visitation Guidance
As we notified you via listserv and member alert this week, CMS has issued new guidance for visitation in nursing homes during the COVID-19 Public Health Emergency (PHE), including the impact of COVID-19 vaccination. Read LeadingAge National’s summary here.

We immediately reached out to the Illinois Department of Public Health (IDPH) and they indicated that they are currently reviewing the guidance and will be updating their guidance soon. Illinois providers must continue with IDPH guidance until further notice. In addition to receiving updates from IDPH in our weekly meetings and conversations, we listen to the IDPH webinars, where information and updates are shared. We also strongly encourage you to register for the other two IDPH webinars this month: Register for March 19 and March 26. There are high numbers of participants on each webinar, so if you have trouble getting in, email Michael Moore at IDPH.

Concurrent with the new guidance from CMS, CDC also updated guidance for infection prevention and control recommendations in healthcare settings. The guidance on visitation is consistent with CMS’s visitation guidance to nursing homes. Additionally, the CDC has updated recommendations for work restrictions and quarantine following exposure for fully-vaccinated individuals.

While the CDC continues to recommend that nursing home residents quarantine for a full 14 days following exposure regardless of vaccination status, healthcare personnel are no longer required to be restricted from work. This is a change from the previous recommendation that healthcare personnel were exempt from work restrictions in cases of staffing shortages only. Additionally, the CDC no longer recommends quarantine for fully vaccinated residents being admitted to nursing homes provided they have had no close contact with anyone with COVID-19 infection in the past 14 days.

LeadingAge Visitation FAQs:

How do I know my resident vaccination rate? Recall that in the updated guidance released yesterday, CMS stated that indoor visitation was restricted for unvaccinated residents if the county positivity rate was greater than 10% and the total resident vaccination rate at the nursing home was less than 70%. At this time, CMS has left this up to the discretion of the nursing home how this will be tracked. One suggested way to do this is by reporting aggregate vaccination rates through NHSN. This reporting tool is optional and is different from the reporting that the pharmacy does when they administer the vaccine. Using this reporting tool does not require SAMS Level 3 access because you are reporting aggregate data, not patient-level data. Learn more here. An added bonus of reporting through this module is that it will help CDC better track vaccination rates, which could translate into more freedoms sooner.
Where does this leave us with activities and communal dining? CMS has not relaxed requirements here yet. Residents must continue to wear masks and social distance in activities and must be social distanced for dining regardless of vaccination status.
If everyone is now permitted visits, do I still need to supervise or enforce any limitations? CMS has not required supervision of visits. CMS does still recommend setting limits around visitation, such as limiting the number of visitors per resident or the total number of visitors in the building at once in order to ensure a safe environment and visitation experience. Visitors must also continue to adhere to core infection control principles such as masking, hand hygiene, and social distancing (though recall that fully vaccinated residents may now choose to engage in physical touch during a visit provided they remain masked and practice hand hygiene before and after contact).

Remember, Illinois providers are to follow the IDPH reopening guidance until further notice.

LeadingAge and AHCA: Joint Nursing Home Policy Recommendations
On Monday, LeadingAge and AHCA will announce a set of policy recommendations aimed at ensuring quality in nursing homes. The proposal pulls together the first, immediate steps needed to address issues that LeadingAge has been talking about for years, including survey reform and staffing. These reforms are predicated on an increase in Medicaid and other funding that is consistent with the cost of delivering quality care. The pandemic exacerbated the long-standing challenges our nursing home members have been grappling with – and created an opening to make real changes in policy and practice. Get a preview of the proposals before it’s available to the public.

IDPH Weekly Meeting Recap
LeadingAge Illinois and the other associations continue our weekly meetings with the Illinois Department of Public Health (IDPH). Here is a recap of yesterday’s meeting:

Two additional pharmacies were added to the program. There are now eight.
IDPH would like to highlight vaccination success stories (high numbers of residents AND staff getting vaccinated at a community). IDPH may highlight them on a webinar. If you would like to share a success story, contact Ruta Prasauskas.
IDPH issued a provider notice stating that the cards you have may have a longer than expected expiration date.
Screening forms must be kept for at least three months.
IDPH is working on the new guidance. The Governor’s Office has asked for the Department to work on it. At this point, providers should continue to follow current IDPH guidance.
CMS Mandated Training. Essential Caregivers (EC) do not need to complete the QSEP Training. They do not work for the facilities.
Staffing Rule. The first date IDPH expects PBJ data to be submitted is June 1, 2021. This will be data for the first quarter, January-March.
IDPH is caught up on complaint surveys. They are caught up on assisted living surveys as well. For annuals, IDPH has done about 97 to date. All regions are doing two to three per week in addition to the complaints, revisits, and focused infection control. If you did not have one last year, it will be done on the new cycle this year.
National Long-Term Care Administrators Week. Catherine Counard said: “I would like to give a shout out to all the long term care administrators and a thanks.”

COVID Relief Package Update
As you may know, President Biden signed the $1.9 trillion American Rescue Plan into law – one of the largest stimulus plans in American history. LeadingAge prepared two articles on the bill (one general and one specifically on HCBS and other provisions). We will be meeting with LeadingAge National and other state affiliates today to debrief on the package. We also have been meeting with the other associations on a joint funding ask to present to the Governor and Illinois General Assembly. The need for relief funding for member settings has been a talking point in our Partners in Quality Virtual Visits and we will continue to stress this need in our ask.

Save the Date: LeadingAge National Lobby Day on April 21
On April 21, LeadingAge is hosting a virtual Lobby Day where members around the country can connect with policymakers to address the critical issues and proposed policies facing the aging services field. Plan to take advantage of this opportunity to tell your story and share your passion for making America a better place to grow old. Registration opens next week!

Become a PAC Partner
As you are well aware, the previous year was one of the most challenging in the history of our industry. We enter 2021 with several of the same lingering challenges since the onset of the pandemic, while also in the midst of the 102nd Illinois General Assembly Spring Session.

The phrase “now more than ever” could not ring more true than right now. We need to ensure, now more than ever, that we are a part of the discussion when legislators are making decisions that impact aging services providers and the residents/clients who depend on them.

It is critically import that we have your support for the 2021 LeadingAge Illinois PAC Campaign. It is imperative that we participate in the political process and ensure LeadingAge Illinois has a seat at the table when upcoming legislative and regulatory decisions that impact you are being negotiated.

The LeadingAge Illinois Political Action Committee (PAC) is a bipartisan, voluntary, not-for-profit organization representing professional men and women in the field of older adult care and services. Affiliated with LeadingAge Illinois, the PAC was created to support LeadingAge Illiinois’ friends in the Illinois Legislature and also to gain access to those legislators who may not be current on issues affecting our profession.

Click here to support the PAC.

If you have any questions or would like more information, contact Jason Speaks.

Nursing and Rehabilitation:

Nursing Home Medicaid Rate Reform Update
We continue to have weekly meetings and discussions with the other associations and the Illinois Department of Healthcare and Family Services (HFS) on Medicaid Nursing Home Rate Reform. We have joined with the Illinois Health Care Association (IHCA) to develop a nursing home rate system to achieve improved outcomes and increased accountability with an emphasis on resident-centered care. In addition to meetings with HFS, we are also discussing this issue with legislators. We will keep you updated on the progress of this initiative, which is one of our 2021 Public Policy Priorities.

HFS Provider Notices
The Illinois Department of Healthcare and Family Services (HFS) issued more provider notices this week. We wanted to make sure you didn’t miss them.

Pass Through Update
LeadingAge Illinois has been meeting with other associations that represent hospices and nursing homes on issues related to the Room and Board Pass Through. The associations have been examining issues with the current process and looking at improvements and streamlining. This week, the associations met with the Illinois Association of Medicaid Health Plans (IAMHP) to discuss improving the process. We will continue to meet with this coalition to improve the process and keep you updated on the progress.

Independent Affordable/Subsidized Housing:

Weigh in on HUD’s Physical Inspection Overhaul
As HUD overhauls physical inspections, join us and LeadingAge National in urging HUD to maintain a robust yet feasible approach to portfolio oversight. Act quickly! The deadline for submitting comments to HUD is Monday, March 15.

In the panel on the right of this alert, you can customize your comments and then click “submit” to send them directly to the Federal Register docket. We recommend simply adding a brief description of your community/ies and any other feedback you may have for HUD. LeadingAge Illinois submitted comments today.

For more information, you can also view LeadingAge’s detailed description of HUD’s proposed rule, as well as an outline of LeadingAge’s comments. You can also view HUD’s full proposed rule, and reach out to Juliana Bilowich at LeadingAge with questions.