LeadingAge Illinois eNews

The Lead April 16, 2021

Top Stories:
From the Desk of Karen Messer, President and CEO
IDPH Weekly Meeting Recap
Partners in Quality Update
Update from the Centers for Disease Control and Prevention
Weekly TANs and Medicaid Pendings Update
LeadingAge Illinois Consultant, Matt Werner of Werner Consulting
COVID Test Positivity by County
IDPH COVID-19 Webinars for Long Term Care and Congregate Settings
Vaccine Education Resources for Staff, Residents, and Families

Life Plan Communities/CCRCs:
Member Spotlight: The Selfhelp Home, Chicago

Supportive Living:
Incident Reporting

Nursing and Rehabilitation:
FY 2022 SNF PPS Proposed Rule
Occupied Bed Tax Update
CDC Johnson and Johnson Information, CDC-CMS Call for Nursing Home Stakeholders, and Clinician Call on CVST

Independent Affordable/Subsidized Housing:
HUD Announces Third Round of CSP Funds
Draft House Bill Allows for $2.5 Billion for New Section 202 Homes
Housing Credit Bills Introduced in Senate, House

Technology:
HRSA Telehealth Webinar

Top Stories:

From the Desk of Karen Messer, President and CEO
This week, the President signed the Medicare sequester bill, which suspends the 2% Medicare reimbursement cut, known as “the sequester”, through the end of 2021. This applies to all Medicare billers, including home health, hospices, PACE organizations, and skilled nursing facilities. Medicare announced a delay in payments for services on/after April 1 in anticipation of this legislation, and you can anticipate that any delayed payments will be reconciled soon. LeadingAge has prepared an article with more details, which you can read here.

With gratitude,

Karen

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IDPH Weekly Meeting Recap
LeadingAge Illinois and the other associations had our weekly meeting with the Illinois Department of Public Health (IDPH) yesterday on COVID-19 issues.  Here is a recap:

Medicaid Bed Usage:
Medicaid certified beds may still be used for non-Medicaid residents during the pandemic as we are still in a Public Health Emergency (PHE).  Providers should document why they are using the beds for non-Medicaid residents (e.g. COVID-related issues). A number of the blanket waivers are expiring and IDPH is looking at CMS guidance to determine next steps. 

PPE:
Providers experiencing PPE shortages during an outbreak can contact their local emergency management agency.

Testing:
The CMS county positivity data is posted late on Mondays. If you notice a change that warrants changes to your testing frequency, you can begin the testing within that seven day period after seeing the Monday posting. 

Vaccines:
Illinois is pausing usage of the Johnson and Johnson vaccine. There have been cases in which those that received this vaccine then got blood clot(s).  About 80% of those with negative reactions are women of childbearing age. 

IDPH Website:
IDPH will be placing more information on their website soon related to COVID and long term care, etc. 

Dr. Catherine Counard, chief medical officer at IDPH, reported that 2.87 mill tests have been completed in long term care since last spring.  “It shows the incredible job everyone is doing.  We have gotten through vaccinations, gotten infection control, we have verified with our data team the 2.8 million tests and I am just really pleased with how everyone has worked together and that is an accomplishment.”

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Partners in Quality Update
Central Baptist Village or Norridge took part in our 31st Partners in Quality Virtual Visit of 2021 this week.  Dawn Mondschein, CEO of Central Baptist Village discussed a number of issues and experiences with

State Representative Bradley Stephens (R-20th District; Chicago), who has been in office since 2019. 

Central Baptist Village has existed for 125 years (the last 65 in Norridge).  They have 230 staff.

Dawn has been CEO for five years.  She discussed the human and financial toll COVID-19 has taken.  She also expressed the concern and need to have seniors and providers included in the Reimagine Illinois Plan. Rep. Stephens said he will speak to Republican colleagues on inclusion of seniors and providers in the plan. The representative shared that, although he has been by the community several times, he has yet to have the opportunity to visit. With that, Dawn invited him to visit when it is safe and appropriate and the representative said he looks forward to it. 

Rep. Stephens agreed older adults should not be left behind in recovery funding.  “I liken seniors to veterans, they are the foundation of our communities and we need to take care of them.”

We continue to hold these visits with the goal of educating legislators on the needs of providers.  If you would like to take part in the campaign, contact Jason Speaks. 

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Update from the Centers for Disease Control and Prevention
On Tuesday, the CDC and FDA recommended a pause in the use of the Johnson & Johnson (Janssen) COVID-19 vaccine pending an investigation into six reported U.S. cases of a rare and severe type of blood clot in individuals who received the vaccine. COVID-19 vaccine safety is a top priority for the federal government, and CDC takes all reports of health problems following COVID-19 vaccination very seriously.

If any residents or staff in your facility develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks of receiving the J&J vaccine, please seek medical care, and report the event to the Vaccine Adverse Event Reporting System.

The CDC has notified all federal pharmacy partners about the recommendation to pause the use of the J&J vaccine and is exploring options to minimize any potential interruption in ongoing access to vaccine for long-term care facility (LTCF) residents and staff. Importantly, CDC is not seeing these events with the Pfizer-BioNTech or Moderna COVID-19 vaccines.

The CDCs realize there may be concern among LTCF staff and residents who have received the J&J vaccine, but it’s important to note these adverse events appear to be extremely rare – with six reported cases out of more than 6.8 million doses of J&J vaccine administered in the U.S.. All of the cases occurred among women between the ages of 18 and 48, with symptom onset six to 13 days after vaccination.

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Weekly TANs and Medicaid Pendings Update
Our consultant, Matt Werner, has provided his weekly update on Transaction Audit Numbers (TANs). Click here to access the TANs report and here for an update on Medicaid pendings. 

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COVID Test Positivity by County
LeadingAge Illinois Consultant, Matt Werner of Werner Consulting, has provided his most recent update on COVID Test Positivity by County. Click here for the most recent report.

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IDPH COVID-19 Webinars for Long Term Care and Congregate Settings
The Illinois Department of Public Health (IDPH) continues to hold weekly webinars on COVID-19 for Long Term Care and Congregate Settings. There are important updates and information shared on each webinar pertinent to LeadingAge Illinois member settings. There is also a Q&A during the sessions. Most webinars go from 1-2 p.m. Slides and recordings of the webinars are sent to participants afterwards and they will also appear in the Lead. 

Register for the upcoming webinars:

April 16

April 23

April 30

There are high numbers of participants on each webinar, so if you have trouble getting in, email Michael Moore at IDPH. 

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Vaccine Education Resources for Staff, Residents, and Families
In order to encourage maximum vaccination participation, we are providing you with education and resources you can use with your staff, residents, and families. We will continue to provide updated resources as we have them.

The COVID -19 vaccine is now available but vaccination, along with following the CDC’s recommendation to protect yourself and others, will offer the best protection from COVID-19 and stopping the pandemic. There are many questions regarding the vaccine and below are resources that you can share with staff, residents and families. The internet has various amounts of information regarding the vaccine; please make sure it is from a credible source.

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Life Plan Communities/CCRCs:

Member Spotlight: The Selfhelp Home, Chicago
The Selfhelp Home in Chicago grew out of the Selfhelp not-for-profit human service agency in New York, which was founded in 1935 to assist refugees fleeing Nazi Germany. The Selfhelp Home for the Aged opened in Chicago’s Hyde Park in 1950 and subsequently ceased to be a branch of the New York Selfhelp. The Home relocated to the Uptown neighborhood in 1963 and continues today as a single-site, independent, not-for-profit Continuing Care Retirement Community.

Selfhelp offers Short-Term Rehabilitation, Long-Term Nursing Care, Independent Living, and Assisted Living. Additionally, respite stays and outpatient physical, occupational and speech therapy services are available. The nursing unit has both Medicare- and Medicaid-certified beds, is rated five stars by CMS and is accredited by The Joint Commission. The community is ranked in U.S. News & World Report’s “Best Nursing Homes.” The community is culturally Jewish, but is open to all faiths.

Liza Steinfeld is healthcare administrator at Selfhelp.  Liza, a member of the LeadingAge Illinois Nursing Facilities Cabinet, recently shared the story of Selfhelp and her time in the industry with us.  Liza is our focus in today’s Member Spotlight.

How long have you been in the industry and what made you select it? 
Liza: I have been in the Aging Services and Healthcare industry for the past seven years. It was not so much as decision to select is as it was a series of next best steps. I was working as a medical social worker in Chicago and was assigned to the Skilled Nursing Unit, where I worked extensively with older adults. It was my desire to make a greater contribution to that demographic that led to my pursing a Nursing Home Administrator license and a management position in the field.  

What are you most proud of in your career?
I am most proud of my decisions to take calculated risks and challenge myself, even when uncomfortable at times. My time living and working in Ecuador and Cambodia taught me to let go of expectations, think on my feet, be resourceful, and make the most of the moments I’m in. My transition to the aging services industry has allowed me to utilize the knowledge and experience from the hospitality industry (a degree in Hotel Administration from Cornell University and work in luxury hotels and resorts) and social work (a master’s degree from New York University).

What is your vision for the future of your community and the field? 
If this past year has taught me anything, it is how resilient our community’s older adults are. The role of psychosocial aspects of care has become increasingly apparent during the period of isolation created by the COVID-19 pandemic. I would like to see an industry where the rhetoric about valuing older adults and providing real, person-centered care is not prohibited by reimbursement.

Liza is a firm believer that if one wants to see change, one should take an active role in initiating that change. “I hope to be able to share successes, and failures, as well as insights with my peers in a collaborative effort to advocate for older adults. I am eager to be working with others on the Nursing Cabinet,” said Liza.

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Supportive Living:

Incident Reporting
The Illinois Department of Healthcare and Family Services (HFS) would like to remind providers of the required Preliminary Incident Report Form and Instructions.  Make sure you are using this 2018 version of form, which includes identifying if a resident is Medicaid or private pay.  Below are some reminders regarding the submission of reports.  If you are unsure if an incident is reportable, please contact Kara Helton.   HFS collects a large amount of data from Preliminary Incident Reports for our quality management reporting to Federal CMS. 

Reporting Requirements:

  • The 89 IL Adm Code Sections 146.295 and 146.305 include information re. incident reporting.
  • Reports are due to HFS within 24 hours of occurrence or within 24 hours of SLP staff being notified.  Ex. a resident does not report an alleged theft that occurred on April 4 until April 10. The report is due to HFS on 4/11.
  • If the incident requires immediate staff attention to ensure the health and safety of residents and the submission of the report will be delayed as a result (ex. building fire), please notify Kara by phone or email.

Preliminary Incident Report Form:

  • Make sure the appropriate boxes are checked in the “Type of Emergency”, “Specific Resident Incident” and “Outside Service” sections.
  • Note the date and time of law enforcement contact, if applicable.
  • If an event impacts all residents in the building, such as a power outage, you do not need to list each resident.
  • If the description of the event to be included in the narrative section of the report form is lengthy, you may include as an attachment.
  • Make sure the person completing the form signs and dates it.
  • If an incident requires follow up, such notifying HFS that power has been restored, you may either send an email to me with an update OR send an update on the Preliminary Incident Report form. 
  • Do NOT email information that contains protected health information, such as resident name, RIN, medications, etc.

Notification of Local Law Enforcement:

  • 146.305(b) states local law enforcement will be notified immediately when there is suspected abuse, neglect or exploitation involving physical injury, sexual abuse, a crime or death occurs to a resident as the result of actions by a staff member, family member or another resident. 
  • If a resident is receiving medication management services from staff and medication is missing from the location where it is stored, police must be notified.  This is especially important if the medication is in a locked area/container that only staff can access.  Please also contact the resident’s MD if there is a possibility the resident will not have enough medication available before the next refill (ex. scheduled narcotic pain medication) and include this in the narrative. 
  • If a resident alleges theft or abuse of any kind by a staff member, the police must be notified by the provider.  The resident may decline to file a report with the police.
  • If an allegation of abuse or crime involves an employee, please include the employee’s name in the narrative section.

Payor Source Information:
The form instructs you to identify if a resident involved in the incident is Medicaid or private pay.  Those who are Medicaid pending are considered private pay.  This information is important for HFS’ performance measure data reporting to federal CMS. 

MCO Notification:
For the purpose of HFS’ Preliminary Incident Report form documentation, MCO case managers need to be notified of:

  • Suspected abuse or neglect.
  • Allegations of medication theft.
  • Injuries that occur during an emergency, such as a power outage.
  • Elopement or missing resident.
  • Damage to an apartment or resident’s belongings as the result of an incident, ex. sprinkler pipe leak.

MCOs may also require you to report other incidents, such as routine falls not required by HFS.

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Nursing and Rehabilitation:

FY 2022 SNF PPS Proposed Rule
The FY 2022 SNF PPS proposed rule is available on the public inspection site of the federal register. Read the LeadingAge overview of main provisions here. CMS proposes a 1.3% rate increase for FY 2022. Other key points include new consolidated billing exclusions, considerations for a PDPM parity adjustment, 2 new QRP measures including a measure on staff COVID-19 vaccination rates, suppression of the SNF VBP measure and future expansion to include additional measures. Comments on the rule are due June 7. LeadingAge will be soliciting member feedback over the coming weeks and will share draft comments.

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Occupied Bed Tax Update
The Illinois Comptroller’s Office has issued warrants for December 2020 long term care services.  The Monthly Occupied Bed Provider Assessment for long term care providers for the March 2021 assessment period/December 2020 reporting period is due April 15, 2021. 

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CDC Johnson and Johnson Information, CDC-CMS Call for Nursing Home Stakeholders, and Clinician Call on CVST
Yesterday, the CDC posted a new landing page, “Recommendation to Pause Use of Johnson & Johnson’s Janssen COVID-19 Vaccine.”  Staff suggest checking back regularly as it will be updated regularly.  Equally important for aging services providers, CDC has assured us that they are working hard on ensuring that the J & J pause does not cause any interruption in the distribution of vaccines to LTC pharmacies. Additional information on that is forthcoming; we will pass it on to you as we receive it.

This issue will be covered in the joint CMS-CDC Coronavirus Nursing Home Stakeholder Call on Wednesday, April 21 at 3 p.m. CST.  You can register for the call here.  Recordings are also posted on the CMS website, so you can listen to the presentation afterwards.  A full listing of topics to be covered:

  • Vaccine Updates & Recommendation to Pause Use of Johnson & Johnson’s Janssen COVID-19 Vaccine
  • Pharmacy Partnership for Long-Term Care (LTC) Program updates
  • Long-term Care Emergency Regulatory Waivers Issued in Response to COVID-19
  • Community Champions

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Independent Affordable/Subsidized Housing:

HUD Announces Third Round of CSP Fund:
HUD has opened the third round of application submissions for affordable housing providers to apply for funds to offset COVID-19 costs. Properties can apply for reimbursements for certain COVID-19 expenses that occurred between December 1, 2020, through March 31, 2021, and the deadline to submit CSP requests to HUD is April 26. This new round of supplemental payments can cover PPE associated with conducting vaccination and testing events and temporary clinics at the property; and vehicle reimbursement for transportation associated with vaccination. More information here.

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Draft House Bill Allows for $2.5 Billion for New Section 202 Homes
The U.S. House Financial Services Committee considered 17 bills as part of its hearing on housing infrastructure legislation on April 14, including a draft bill that would provide $2.5 billion for the Section 202 Supportive Housing for the Elderly program. The hearing, Build Back Better: Investing in Equitable and Affordable Housing Infrastructure, included consideration of both the Housing is Infrastructure Act of 2021 and the Broadband Justice Act of 2021, both of which reflect LeadingAge’s goals in their Blueprint for a Better Aging Infrastructure to greatly expand the supply of affordable senior housing and to secure internet in every affordable senior housing home. Read the LeadingAge article here.

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Housing Credit Bills Introduced in Senate, House
Legislation at the federal level to expand and improve the Low Income Housing Tax Credit (Housing Credit) was introduced this week in the U.S. Senate and House. The bills would increase Housing Credit allocation by 50% over current levels phased in over two years and make a long list of improvements to the Housing Credit. The Affordable Housing Credit Improvement Act (AHCIA) also would allow states and their partners to produce and preserve more bond-financed developments by lowering the bond financing threshold from 50% to 25% and includes basis-boosts for harder-to-reach communities. All told, AHCIA’s major unit financing provisions would provide for over 2 million additional affordable homes over the next ten years. The bill also includes a number of other modifications to make the Housing Credit an even better tool for meeting the needs of rural communities, veterans, older adults, Native Americans, and extremely low income families. More is in this LeadingAge article.

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Technology:

HRSA Telehealth Webinar
The Health Resources and Services Administration (HRSA) will hold a webinar as part of the Telehealth Learning Webinar Series. It is on, April 21 from 12-1 p.m. CST.  Topics to be covered on the webinar include: the Rural Health Care Program; the COVID-19 Telehealth Program / Connected Care Pilot Program; the Emergency Broadband Benefit program; and, the Lifeline Program. Featured Speakers:  William England, Senior Advisor, HRSA Federal Office of Rural Health Policy, Office for the Advancement of Telehealth; Jennifer Contreras, Communications Manager, Rural Health Care Program, Universal Service Administrative Company; and Jaymie Gustafson, Outreach Director, Universal Service Administrative Company. You can access the webinar registration here.

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