The Lead April 3, 2025 - LeadingAge Illinois

From the Desk of Angela Schnepf, President and CEO

Assisted Living:
Senators Call for GAO Investigation of Assisted Living

Nursing and Rehabilitation:
CMP Grants Available
Reminder – Nursing Homes Must Submit Medicare Revalidation by May 1
Upcoming COE-NF Trainings
Regulatory Review Article – Immediate Access to Residents & Visitation Rights

Housing:
HUD to Cut Field Office Staff by May 18
HUD Sets 2025 Income Limits for Housing Assistance

HCBS:
United Healthcare Eliminates Prior Authorization for Some Home Health Services
CMS Releases Updated List of Unacceptable Hospice Principal Diagnosis Codes

Other:
Covenant Living at Windsor Park Hosts Legislative Visit
Ask the Expert

From the Desk of Angela Schnepf, President and CEO

As discussion of cuts to Medicaid ramps up during Budget Reconciliation, LeadingAge explained to Congressional leaders, in an April 1 letter rich with examples, Medicaid’s critical role in the financing and delivery of long term services and supports. We asked that no changes be made to the federal financing component of the Medicaid program. Keep up on the latest developments via the Budget Reconciliation 2025 serial post.

Kindest Regards,

Angela

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 Monday from 10:00 – 11:00 AM
Starting March 31st Next one April 14th

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.

We look forward to seeing you on Zoom!

Judge Temporarily Blocks Administration from Ending TPS for Venezuelans

On March 31, a California federal judge issued an order that blocks, temporarily, a decision by Homeland Security Secretary Kristi Noem to terminate a 2023 designation of Venezuela for Temporary Protected Status (TPS). As explained in this background article, there are two groups of Venezuelans registered under and covered by separate TPS designations (one from 2021 and one from 2023). Individuals covered by the 2023 designation were set to lose their TPS as of April 7, but a group of plaintiffs challenging the Department’s decision have successfully argued that the court should temporarily postpone the effective date of Secretary Noem’s actions while the underlying case and legal arguments proceed. Within the next week, the parties will file a joint status report addressing whether the government intends to appeal the court’s order granting the postponement, and whether the parties challenging the government also intend to file a motion to postpone agency action related to Haiti’s TPS designation – which is now within scope because the plaintiffs have amended their original complaint that focused only on Venezuela. LeadingAge will continue to follow these legal developments.

Senator Recognizes LeadingAge Efforts to Protect Medicaid

As part of a record-breaking commandeering of the Senate floor to protest a range of President Trump’s policies, Senator Cory Booker (D-NJ) quoted LeadingAge President and CEO Katie Smith Sloan on threats to the Medicaid program. “Katie Smith Sloan, the President and CEO of LeadingAge, says states would have to fill in massive budget holes if federal funding to Medicaid programs were cut. Even if a cut, such as the change to the FMAP, does not seem to directly impact aging services, it would, because the cost of the cut would have to somehow be absorbed by states budgets. That type of hole cannot be filled in via more efficiency. Balancing the ten-year program budget cycle on the back of the Medicaid program is not a good trade-off for the American people,” Senator Booker stated on March 31, quoting a letter from LeadingAge to House and Senate leaders on the impacts of Medicaid cuts to older adults and the aging services providers who work to meet their needs.

Senate leaders are hoping to vote on a concurrent budget resolution this week. The measure is expected to mirror the House-passed budget resolution, but with different reconciliation instructions to House and Senate committees. The tactic allows House and Senate leaders to avoid the necessary and politically volatile decisions about how much trillions of dollars of new and extended tax cuts and increased spending for mass deportations and border control to be sought in the reconciliation process will be offset by cuts to Medicaid, the tax exemption of municipal bonds, and other mandatory federal spending. LeadingAge’s advocacy to protect Medicaid and tax exempt bonds are greatly bolstered when offices hear from stakeholders through advocacy alerts on these topics.

IDPH Monthly Meeting

On March 27, LeadingAge Illinois met with (Illinois Department of Public Health) IDPH staff and provided them with questions that members shared. Information that IDPH shared during that meeting are provided below. In addition to call updates, IDPH recently provided us with email addresses to ensure all providers have accurate contact information:

Any Assisted Living issues should be sent to LTCAL@illinois.gov.
If you need immediate assistance with AL licensure or LLCS – Wahl@illinois.gov.
SNF/NF compliance, surveys, care plans – CA@illinois.gov
SNF/NF support staff letters and violations/hearing notices – LTCQA.POCHearing@illinois.gov
Telephone line messages – LTCQASURVEY@illinois.gov

LLCS Portal:
IDPH provided a general status update on the LLCS Portal which included they are working on making the Change of Ownership (CHOW) process more user friendly and that they were up-to-date with responding to questions submitted to the portal email as of March 27. If you submitted a question to them and have not received a response back, please resubmit your question to the portal email address at DPH.LLCS@illinois.gov. You can view some basic information on the portal here.

If you have requested access as a new user in the LLCS portal, they typically take 7-10 business days to complete. If you have not received access following this time, you can reach out to IDPH using the email address above.
Licensure renewals are being sent via the LLCS Portal and should be found in the “Task” section. If you are not seeing items in this section, it could be that you do not have the correct boxes checked. IDPH will be distributing a users manual in the near future that we can share. IDPH has identified a concern with renewal payments that they are working with their software developer to correct. If you did not receive the amount of fees due with your renewal, please reach out to them at the email provided above. Additionally, some providers are experiencing an “error” message when attempting to print their license. If you have this happen, please email IDPH at the portal above and they can look at your specific account. They are also working with their software developer to determine if this is a software malfunction that needs corrected.
IDPH indicated that the portal does not interface with the IMPACT Medicaid system.
Several members asked about additional training with the opportunity to ask questions on the LLCS portal. IDPH indicated the June training from the Department will be on the portal. LeadingAge Illinois will be sure to include registration for this session in the Lead when available.
Providers should be submitting reportable incidents to the LLCS Portal by selecting the report an incident button. This will then redirect you and the incident link is at the top of the page. If you aren’t seeing this option, you should email the portal address for assistance. If you do not yet have a user ID, you should submit incidents to your regional office. If you submit them via email they are redirected to the regional office for your community.
Each facility allows up to five users on the portal. This does not include associated AL settings which are allowed up to five users also. If this is not enough users, IDPH is continuously looking at ways to update the portal and this is something they would consider. Please let us know if you have a need for more than five users.
Survey results for nursing homes are sent through the EPAC system linked to the ASPEN program and not the portal. This is an internal process that allows providers to submit a plan of correction through the same system. If you have not received your survey results in a timely manner (note CMS indicates that you should receive them within 10 business days following the exit of a survey) please reach out to the department. Assisted Living providers receive their results via email. The department asked us to ensure that all providers ensure the department has the correct email address for the program to ensure these results are delivered timely.

Misc:
A member reported that during a recent survey, the surveyors asked for their COVID-19 vaccine spreadsheet for employees and residents. This requirement was discontinued by CMS some time ago and the department confirmed that maintaining this spreadsheet is not necessary. They are going to ensure that surveyors are educated on this, but if you have any concerns with this during your survey, please let us know.

Additionally, IDPH and the Department on Aging requested a separate meeting to discuss the LeadingAge Illinois bill that was introduced this session clarifying reportable incidents in Assisted Living. IDPH explained that reportable incidents in Assisted Living Programs do not include incidents that are an expected outcome of the disease process or condition. During discussion, the department indicated that the program should include expected outcomes in the service/care plan. For example, a resident that has diabetes may experience high or low blood sugars which should be included in the resident’s service/care plan. If a resident experiences low blood sugar, the program does not need to report this as it is an expected outcome. IDPH shared that in March, they have reviewed 419 of 1216 incidents for Assisted Living that did not require reporting as they were considered expected outcomes of the resident’s condition.

Members also expressed that they are unable to receive assistance with the Consumer Choice Website which must be updated annually by providers. IDPH confirmed that the Long-term Care (LTC) Ombudsman is overseeing this process and you can find instructions on the website here.

Physician Impersonation Scam Attempts

The Iowa Department of Inspections, Appeals & Licensing (DIAL) emailed LeadingAge Iowa recently to warn of scam attempts in other states where scammers impersonated a physician while attempting to gain access to electronic health records. An Ohio hospital system reported that the scammer called their Information Technology (IT) help desk in an attempt to get credentials of a physician to login to their E.H.R. system. Through investigation, the Ohio Statewide Analysis and Terrorism Analysis Unit identified similar calls to seven other hospitals.

Similar calls have not been reported in Illinois, however, health care providers should educate anyone with access to add/modify users on safety measures to prevent similar incidents from occurring.

CMS Preclusion List Help Desk Updated Contact Information

The External User Services (EUS) Help Desk, which supports the Centers for Medicare & Medicaid Services (CMS) Preclusion List application is updating their contact information on March 31, 2025. If you need support for the CMS Preclusion List please contact the toll-free phone number at 866-484-8049, via email at EUS_Support@cms.hhs.gov, or on their website https://eus.cms.gov. The hours of operation for the EUS Help Desk are Monday – Friday 6 a.m. – 6 p.m. CT.

Interim Final Rule Exempts U.S. Companies from Reporting BOI to FinCEN

An interim final rule published in the Federal Register on March 26 immediately exempts United States companies from reporting beneficial ownership information (BOI) to the U.S Treasury Department’s Financial Crimes Enforcement Network (FinCEN). Established through the Corporate Transparency Act, the goal of this system was to aid law enforcement in detecting illegal financial activities, such as money laundering and terrorist financing. Under implementing rules previously issued by FinCEN, certain corporations, Limited Liability Companies (LLCs) and other similar entities have been required to report certain identifying information about the reporting companies themselves and the beneficial owners who own or control them.

Note, this requirement is separate from the Centers for Medicare & Medicaid Services ownership disclosure rules which nursing homes must continue to comply with. Additionally, this rule did not apply to federally-tax-exempt companies themselves, but they did apply, for example to limited partnership arrangements in which tax-exempt entities were involved.

Register for LeadingAge’s Medicare Advantage Webinar

Contracting with Medicare Advantage plans can be challenging. They often offer low reimbursement and require additional work from providers. LeadingAge is offering a new webinar exclusively focused on Mastering the Medicare Advantage Contract Lifecycle on Wednesday, April 23 from 1 – 2:30 p.m. CT. In this webinar, Strategic Healthcare’s Grant Swemba will dig deeper into how to initiate these contract discussions, what data providers will need to support better contract terms and how to implement the contract provisions to get the payment deserved.

IDPH Releases Guidance for H5N1 (Bird Flu) in Healthcare Settings

The Illinois Department of Public Health released an abbreviated, quick-reference guidance for health care personnel exposure to suspected or confirmed H5N1 (Bird Flu). IDPH encourages providers to post in clinical workspaces and review for preparedness in clinical settings. Note: the poster indicates that this guidance does not replace guidance in Assisted Living or Nursing Facility settings with acute respiratory illnesses.

HHS Updates

Congress swiftly responded to the Department of Health and Human Services (HHS) factsheet HHS’ Transformation to Make America Healthy Again, which will fundamentally change the structure of the nation’s healthcare agency. Among responses, 38 Democratic members of the Senate sent a letter to HHS Secretary Robert Kennedy Jr. with questions regarding the “unprecedented and baseless assault on the federal workforce and the hundreds of millions of Americans who rely on the Department’s services.” Additionally, 28 representatives signed a letter highlighting concerns that this reduction in force “will ultimately lead to slowdowns in service, approvals, and research and impacts to the public health response capabilities.” Ranking House Democrat Diana DeGette (D-CO) on the Energy and Commerce Subcommittee on Health, which has jurisdiction over HHS, used a routine hearing on the Food and Drug Administration’s user fee program to push back over the mass firings. Most significantly, Senators Bill Cassidy (R-LA) and Bernie Sanders (I-VT), chair and co-chair of the Senate Health, Education, Labor and Pensions Committee, requested Secretary Kennedy to testify before the panel on the mass firings that began across HHS the morning of April 1.

What is Known About HHS Reductions:

Employees of HHS began receiving Reduction-in-Force emails on April 1, notifying them they were placed on administrative leave and would no longer have access to their office building as part of HHS’ reorganization efforts. According to media reports, center directors at the Centers for Medicare & Medicaid Services (CMS) were notified that additional staff would be impacted, leading them to believe the number of firings at CMS would be larger than the originally stated 300 staff. As of April 2, the following offices have been significantly reduced or eliminated entirely:

CMS Office of Minority Health, which offers comprehensive sources of information on optimizing health outcomes and closing gaps in coverage for all people CMS serves.
CMS Office of Equal Opportunity & Civil Rights, which oversees equal employment opportunity, civil rights, reasonable accommodation, and the prevention of workplace harassment was closed.
CMS Office of Program Operations & Local Engagement, which works out of regional offices and focuses on working with providers and health plans that serve Medicare recipients to ensure they’re in compliance with CMS requirements. Additionally, they help manage case work for Medicare Advantage and Affordable Care Act marketplace patients.
CMS Federally Coordinated Care Office which works to improve services for individuals dually eligible for Medicaid and Medicare.
The Administration for Children and Families Low Income Home Energy Assistance Program (LIHEAP), which helps families safe and healthy through initiatives that assist with energy costs.

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.

April 4 from 1-2 p.m. Pet Therapy in Long-Term Care
April 18 from 1-2 p.m. MDROs and XDROs
May 2 from 1-2 p.m. Education is More Than Listening to a Webinar. How to Develop Staff Education

Senators Call for GAO Investigation of Assisted Living

Three senators called on the Government Accountability Office (GAO) to investigate assisted living to determine if federal oversight should be implemented. A report released in 2018 by GAO indicated that state oversight of critical incidents in assisted living was poor.

The GAO found that the Centers for Medicare and Medicaid Services may not be aware of occurrences of evictions, medication errors or other critical incidents because of differences in state definitions. The report recommended that CMS increase oversight and state reporting of deficiencies and critical incidents to better understand the wellbeing of Medicaid Participants residing in assisted living. In a letter dated March 31, from Senators Elizabeth Warren (D-MA), Ron Wyden (D-OR), and Kirsten Gillibrand (D-NY) ask GAO Comptroller General Eugene Dodaro for updates to the 2018 report.

The letter outlines the lack of a federal regulatory framework for assisted living and state variation in regulatory administration. The letter goes on to ask GAO to investigate specifics about critical incidents and determine whether there is need for additional federal oversight of assisted living. Any updates from GAO will take some time; in the meanwhile, the current administration is not expected to take measures for federal oversight of assisted living. However, the calling on GAO to investigate perpetuates some of the negative perceptions our field continues to battle. The senators’ request follows a January 2024 hearing of the Senate Special Committee on Aging Hearing,

“Assisted Living Facilities: Understanding Long-Term Care Options for Older Adults.” “We support state systems that provide complete transparency about complaints, their resolution, and quality ratings so that consumers have all the knowledge they need before they move into a residential setting. We do not believe it would be effective to attempt imposing a federal regulation or reporting structure on a set of services that evolved to respond to state and local consumer interest in supportive care – but not nursing care – and a distaste for nursing homes,” LeadingAge said in testimony submitted to the January 2024 hearing.

CMP Grants Available

The Civil Money Penalty Reinvestment Program (CMPRP) has a new opportunity for CMS certified long term care facilities to apply for grants to train staff in Alzheimer’s or grief counseling. You can see the announcement at the IDPH CMP Notice of Funding Opportunity or on EGrAMS to apply.

Application deadline is April 25, 2025 with funding expected to start after July 1, 2025.
All applicants must be federal CMS certified in good standing and are subject to federal CMS approval.

Reminder – Nursing Homes Must Submit Medicare Revalidation by May 1

A friendly reminder that all nursing homes must submit ownership disclosures on the new SNF Attachment of the CMS-855A form no later than May 1, 2025. Additional information including Guidance and FAQs can be found here.

Upcoming COE-NF Trainings

The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) is offering these upcoming opportunities for you or your staff to receive behavioral and mental health trainings:

Question, Persuade, Refer (QPR) Suicide Prevention Training April 8 1 – 2:30 p.m. CT and April 29 from 1-2:30 p.m. CT
An Introduction to Trauma-Informed Care April 10, from 1 – 1::45 p.m. CT.
Effective Strategies for Managing Psychotropic Medications in Nursing Facilities: Navigating New CMS Requirements of Participation April 15, from 1 – 2 p.m. CT
An Easy Pill to Swallow: Nonpharmacological Interventions for Long-Term Care Residents. April 17, from 1-2 p.m. CT
Building a Better Suicide Risk Assessment: The Nuts and Bolts of the Columbia Protocol C-SSRS April 23, from 1-2 p.m. CT
Mental Health First Aid (MHFA) – Registration is limited so please only register if you can attend. April 25, from 10 a.m. – 3:30 p.m. CT

Regulatory Review Article – Immediate Access to Residents & Visitation Rights

Since the next regulations in the residents’ rights section of Appendix PP are similar in nature, we’ve combined the information for your review. These include F562, F563 and F564 related to allowing access to the resident and the resident’s visitation rights.

F562 requires that the nursing home allow immediate access to residents in your care to the following:

Any representatives of the Secretary or the State (i.e. state and federal surveyors)
Any representatives of the Office of the State long term care ombudsman
The resident’s individual physician
Any representatives of the protection and advocacy systems, as designated by the state and as established under the Developmental Disabilities Assistance and Bill of Rights Act of 2000
Any representative of the agency responsible for the protection and advocacy system for individuals with mental disorders
The resident’s representative

With any of the above individuals, the nursing home must not prohibit or discourage any residents from allowing these individuals to visit with the resident. However, the resident can express that they do not want them to visit. This is why surveyors are expected to ask the residents for permission to visit them and/or watch the staff perform care and services (such as personal hygiene). This would not limit the representatives from the federal or state government from reviewing the person’s record though.

In F563, the residents have the right to receive visitors of their choosing, at the time of their choosing, subject to their right to deny visitation when applicable, and in a manner that does not impose on the rights of other residents. This includes immediate and/or reasonable access to the resident by:

An immediate family member or other relatives, subject to the resident’s right to deny or withdraw consent.
Other visitors with the consent of the resident and subject to reasonable clinical and safety restrictions.
Any individual that provides health, social, legal, or other services to the resident.

Additionally, the nursing home must establish policies and procedures regarding visitation rights including examples of reasonable clinical and safety restrictions. Appendix PP outlines the following:

Restrictions to prevent infection or disease transmission. However, CMS notes that risk factors and health status should be considered such as end-of-life care.
Visitors with signs or symptoms of transmissible infections should defer their visitation.
Keeping the doors locked or secured with alarms for the safety of the resident and staff.
Restricting or denying visits to individuals who are suspected of possibly abusing the resident pending any investigation outcomes.
Individuals who have been found to have committed crimes such as theft.
Individuals who may be disruptive or inebriated.
Individuals who may be bringing illegal substances that places the resident and/or other residents at risk of injury or illness.

If nursing homes place specific limitations or restrictions on visitors, the resident’s record must reflect the identified concern and the limitation or restriction that is placed on visitation. The resident and the visitor must be notified of the limitation or restriction and it should be periodically reevaluated. The nursing home should consider offering limitations vs. restrictions whenever possible – such as offering supervised visitation before denying complete access. Any limitation or restriction should be included in the residents’ care plan. In addition, the nursing home should educate the visitors if the resident (or other residents) has a disease or illness that may place their safety at risk (such as an infectious disease outbreak).

Regarding visitation that may violate other residents’ rights, considerations should be made to alternate options that do not violate the rights of others. For example, if a visitor requests to visit late in the evening and the individual resident is okay with this their roommate may be asleep during this time and the late visit may violate their rights. Alternative options such as allowing the late visit to occur in a family room or common area may be discussed as it would allow the resident to still have the visit while not violating their roommates’ rights.

F564 requires the nursing home to notify the resident of their visitation rights, any policy or procedure in place regarding visitation, and any limitation or restriction placed on visitation. This includes the residents’ right to deny visitation at any time. Additionally, the nursing home must not deny visitation privileges based on discriminatory reasons such as race, color, national origin, religion, sex, or disability and that visitation is consistent with the resident preferences.

HUD to Cut Field Office Staff by May 18

On February 24, Department of Housing and Urban Development (HUD) leadership notified union management of the beginning of the agency’s Reduction in Force, also called a RIF. The notification follows an Executive Order issued by President Trump on February 11, 2025, that requires workforce optimization plans across federal agencies, including abolishing federal positions that are not specifically mandated by statute, as well as additional agency reorganization as defined through guidance provided by the U.S. Office of Personnel Management (OPM). HUD’s February 24 notification, sent by Secretary Scott Turner, announced that the agency will abolish all positions of GS-13 and below for employees in the Office of Field Policy and Management (FPM). This includes FPM staff in both Headquarters and field offices. The notice reads that “GS-13 level and below are being abolished” by May 18, 2025. While the RIF action announced on February 24 will begin to impact field office work within HUD, the agency will likely continue to drastically reduce the workforce among its program staff, including within Multifamily Housing program offices, to achieve the stated goal of a 50% staff cuts to HUD. LeadingAge is deeply concerned with the staff reductions, which could stop the agency from administering programs that affordable housing communities rely on. According to OPM definitions and summaries of RIF actions, an agency must give an employee at least 60 days specific written notice before the employee is released from the competitive level by a RIF action. If faced with an unforeseeable situation (e.g., a natural disaster), the agency may, with OPM approval, give the employee a specific RIF notice of less than 60 days, but at least 30 days, before the effective date of the RIF. An employee who has been separated, downgraded, or furloughed for more than 30 days by RIF has the right to appeal. LeadingAge urgently requests an explanation and revocation of the notice from HUD.

HUD Sets 2025 Income Limits for Housing Assistance

The Department of Housing and Urban Development (HUD) released the official 2025 HUD median family income limits, effective April 1. HUD sets income limits every year that determine eligibility for assisted housing programs, including project-based Section 8 and 202, as well as for Public Housing and Housing Choice Vouchers. The limits are based on Median Family Income estimates and Fair Market Rent area definitions for counties and metropolitan areas. The most important statutory provisions relating to income limits are “extremely low-income family” which is defined as very-low income family whose income does not exceed the higher of the poverty guidelines or 30% of the median family income for the area; “very low-income family”, which is defined as low-income families whose incomes do not exceed 50% of the median family income for the area; and “low-income family”, which is defined as those families whose incomes do not exceed 80% of the median family income for the area. Income limits are also adjusted based on family size. Revised income limits do not impact the eligibility of in-place residents, but certain HUD-assisted properties must use the new limits with new move-ins (and initial certifications) of residents, effective April 1, 2025. HUD also develops Multifamily Tax Subsidy Project income limits that determine eligibility for Low Income Housing Tax Credit – financed properties.

United Healthcare Eliminates Prior Authorization for Some Home Health Services

Effective April 1, 2025, United Healthcare (UHC) will stop requiring prior authorization or concurrent review for home health services managed by Home & Company (formerly naviHealth). This change will impact providers servicing Medicare Advantage and Dual Special Needs Plans across 36 States (including Illinois and Iowa). UHC clarifies that home health providers should continue to submit prior authorization and concurrent review requests for dates of service through March 31. Beginning April 1, agencies are expected to provide services according to the Centers for Medicare & Medicaid Services (CMS) coverage guidelines.

This is part of a wider effort by UHC to reduce their prior authorization volume by 10% after a scathing Senate report on the misuse of these utilization management techniques cited access issues for beneficiaries. LeadingAge advocated for increased scrutiny of Medicare Advantage plans use of prior authorization.

CMS Releases Updated List of Unacceptable Hospice Principal Diagnosis Codes

On March 13, the Centers for Medicare & Medicaid Services (CMS) issued a Change Request (CR 13882) which provides an updated list of unacceptable principal diagnosis codes under the hospice benefit. The Claims Processing Manual is also updated to provide guidance on non-reportable principal diagnosis codes and provides clarification of liability claims denials during a hospice election. Specifically, the CR discusses the responsibility and the liability related to missing GW, GV, or 07 modifiers for Medicare-certified providers. CMS noted “It is the responsibility of all Medicare-certified providers to check the Medicare status of each Medicare beneficiary when rendering and billing for services, a claim missing the GW or GV modifier or condition code 07 would be denied as provider liability.” The effective date of the CR is April 1, 2025 – for claims received on or after April 1, 2025, unless otherwise specified, the effective date is the date of service. Any claims submitted with these codes will be returned to the provider with claims edits for non-reportable hospice diagnosis code. Providers will no longer receive edits with reason code 20727 but instead will receive an IOCE edit.

Covenant Living at Windsor Park Hosts Legislative Visit

Yesterday, Shelly Smith, executive director of Covenant Living at Windsor Park, and residents and staff hosted State Representative Amy Grant for a visit. She addressed a large gathering of residents and took several questions as they enjoyed cookies her office brought in for them. Afterwards, she was provided a tour to learn more about the community.

If you would like to host your legislators, please contact Jason Speaks. He will do all the legwork as well as attend to ensure the visit is a success.

Ask the Expert

A number of member questions come in daily to the association. In this article we will feature unique or recent questions of interest to members.

Q: Can you provide any updates on the Assisted Living Advisory Board?

A: According to IDPH, it is nearing finalization, but they are still seeking candidates for the following vacancies. If you have any recommendations, please email Kellie or Jason at LeadingAge Illinois who can pass along to IDPH.

Candidate recommended by a consumer organization that engages solely in advocacy or legal representation on behalf of senior citizens.
Physician
Expertise in the area of gerontology research or legal research regarding implementation of laws apply to assisted living establishments.

Have a question? Email yours now.