The Lead April 9, 2021 - LeadingAge Illinois

Nursing and Rehabilitation:
CMS Proposes FY 2022 SNF Payment Rule

Independent Affordable/Subsidized Housing:
LeadingAge Quarterly Housing Survey
HUD Posts Updated NSPIRE Standards, Seeks Feedback

Home Health and Hospice:
Vaccinations Update
Proposed Hospice FY 2022 Wage Index Rule Released

Technology:
Registration is Open! Collaborative Care & Health IT Innovations Summit 2021
Using Technology to Increase Resident Safety
FCC Posts Emergency Broadband Benefit Resources

Other:
Advancing Racial Equity in Aging Virtual Summit
2021-2022 Flu Vaccines Discounts for LeadingAge Members

Top Stories:

From the Desk of Karen Messer, President and CEO
Nominations for the 2021 LeadingAge Annual Awards are now open. The LeadingAge Annual Awards honor individuals that embody excellence in nonprofit aging services leadership, are models of quality and innovation, and are making outstanding contributions to our field that merit national recognition. Learn more about the award criteria and nomination process.

With gratitude,

Karen

Partners in Quality Virtual Visit Held with Downstate Senator
We had our second Partners in Quality Virtual Visit of the week on Tuesday afternoon with Senator Steve McClure (R-50^th District; Jacksonville), assistant minority leader. He has been in office since 2019 and is a member of the Senate Appropriations-Health Committee, a key legislative committee.

Senator McClure heard the experiences and story of Lewis Memorial Christian Village and River Birch Living, both Christian Horizons communities located in Springfield. Christian Horizons serves 1,400 older adults. They have home care, hospice, assisted living, supportive living, independent living, skilled nursing, and a pharmacy. They are in the process of developing a PACE program in the St. Louis area.

Karen Larson, vice president of community operations at Christian Horizons, gave the Senator an overview of the organization and the collective challenges her communities faced due to the pandemic.

Grace Ellenberg, executive director at River Birch, talked about the uniqueness of her community. They are an assisted living with memory care that was built in 2009. They are unique in the long term care spectrum in that they have a small house model with three separate small homes. They have private suites that open into a common, dining, and kitchen area. She discussed how COVID challenged their community and how she and staff responded to safeguard residents

Christine Hopson, executive director at Lewis Memorial, has been a licensed nursing home administrator for over 30 years. Before her current position and working at other communities, she started as a CNA at Lewis and now she is back as executive director. The community was built in 1975. They are a CCRC. Christine also walked through the last several months and how her community responded to keep staff and residents. She described the toll isolation has taken on residents and urged the Senator to take even more time to learn the impact COVID has had on older adults.

“I appreciate the perspective and you telling you me what you need,” said Senator McClure, who committed to visiting each community when it is safe and appropriate. We alerted him to our funding ask for COVID recovery and he stated he will look forward to seeing the formal ask when the associations deliver it to the Governor and the legislature.

If you would like to take part in the Partners in Quality campaign and join your fellow members in educating the Illinois General Assembly on the needs of aging services providers, contact Jason Speaks.

LeadingAge Illinois Advocacy Center Update
The Illinois General Assembly is still on Spring Break until April 13, but there have still been legislative hearings and meetings during the “break.” We wanted to give you a few updates to ensure you are updated on activity this week. You can view our policy priorities, legislative tracker, and more on the LeadingAge Illinois website in the Advocacy Center.

SB1659:
This legislation was filed as a vehicle/placeholder for an amendment that associations have been working on that would add assisted living and supportive living to the requirement for insurance companies to cover COVID testing. Legislation that passed during the January Lame Duck Session passed and was signed into law requiring coverage for nursing home employees. An amendment has now been filed that would add language to SB1659, adding assisted living and supportive living employees.

SB2137:
Along with the other associations, we met with AARP-Illinois on their legislation initiative regarding nursing home isolation. We made suggestions (such as striking language that would make compliance with this bill a condition of facility licensure) in our first meeting with AARP that were incorporated in an amendment to the bill that will be introduced soon. We are neutral on this legislation. It passed this week, 5-0, out of the Senate Subcommittee on Long-Term Care & Aging and now heads to the Senate Health Committee for consideration. LeadingAge Illinois also had an additional meeting with AARP to discuss common issues and ways we can collaborate.

SB2432:
The “Grocery Tax” bill is in the Senate Revenue Committee and a hearing has been set for April 14 at 4 pm. The bill is sponsored by a key legislator, Senator Bill Cunningham (D-18th District; Chicago), assistant majority leader and senate president pro tempore. This week, another key legislator joined as a co-sponsor. Senator Sara Feigenholtz (D-6th District; Chicago), a veteran legislator who joined the Senate, from the House, in 2020 is co-sponsoring.

HB1766:
LeadingAge Illinois and the other associations held our second meeting with State Representative Maurice West, II (D-67th District; Rockford) on this legislation (posting nursing home violations on facility website). We continue to oppose this legislation as introduced. In the recent meeting, legislative staff from the Illinois Department of Public Health (IDPH) were included. The representative and IDPH liaisons concluded that they will need to discuss his legislation further before moving it forward.

If you have any questions on the above legislation or any other public policy matter, contact Jason Speaks.

LeadingAge Illinois Presents Medicaid Rate Reform Proposal to Medicaid Work Group
On Wednesday morning, LeadingAge Illinois presented on Medicaid rate reform to legislators on the Medicaid Work Group (MWG). Karen Messer, president and CEO of LeadingAge Illinois, thanked the MWG for allotting time during the meeting to hear from the association and provided a background on LeadingAge Illinois and member settings. State Representative Greg Harris (D-13^th District; Chicago), majority leader, presided over the meeting.

Matt Werner, consultant for LeadingAge Illinois, presented on the rate redesign proposal we have been working with the Illinois Health Care Association (IHCA) on, with member input. LeadingAge National and the American Health Care Association (AHCA) are proposing new funding linked to similar goals at the federal level. Matt stated that rates must be tied to staffing to force improvement and provide accountability. He added that rates must include quality, both rewarding those who are quality providers and incentivizing improvements in quality.

We continue to discuss our proposal with the Illinois Department of Healthcare and Family Services (HFS) in our weekly meetings on rate reform, with members, and legislators. We will keep you updated on the progress of our proposal.

CDC Guidance for Older Adults
The CDC updated their information for older adults. Risk for severe illness with COVID-19 increases with age, with older adults at highest risk. Certain medical conditions can also increase risk for severe illness. People at increased risk, and those who live or visit with them, need to take precautions to protect themselves from getting COVID-19.

Upcoming HBO Show to Focus on Long Term Care
Argentum has learned that a story is expected to air this Sunday, April 11, on HBO’s “Last Week Tonight with John Oliver,” focused on the long-term care industry. While they are not certain what specific topics or providers the piece will cover, indications are that it will focus on COVID’s impact on the assisted living and skilled nursing sectors, as well as staffing, training, and turnover issues. As a result, Argentum is sharing below some possible questions you may receive from media following the program’s airing, as well as some sample talking points:

Possible Questions:

What support or benefits did you provide to staff during COVID-19?
Did you hire new staff during COVID-19, and did they receive proper and timely training?
What training (infection prevention, safety, security, etc.) does your staff regularly receive before and during employment?
What special training did your staff receive as a result of COVID-19?
What additional training do you require of your staff caring for those with memory decline?
At any point during COVID-19, were you forced to operate with fewer staff?
How much staff turnover did [company/community] experience during COVID-19?
How much staff turnover does [company/community] typically experience during a similar timeframe?
How strict are your hiring protocols? Do you perform background checks?
How would you describe your staff compensation model?
Do you feel your staff receive competitive compensation and benefits?

Sample Talking Points:

Our residents and their families trust us with their care—a responsibility we take very seriously.
Families can rest assured that our residents’ health, safety, and security continues to be our highest priority.
Our employees are dedicated to caring for our residents and displayed heroic efforts during the challenges brought on by COVID-19.
During COVID-19, we were pleased to offer added resources, benefits, and support to our staff members to help with the unprecedented challenges they faced at home and at work: [i.e. child care benefits, transportation benefits, hero pay, onsite pantries, COVID leave, flexible schedules, etc.].
We hired and trained additional staff at [company/community] to take on new roles due to COVID-19, such as [food packaging and delivery; temperature checks and monitoring, etc.].
All employees undergo a thorough screening process prior to joining the community, including [insert your procedures].
Our employees engage regularly in training focused on [insert your training programs].
All employees that provide direct care to residents are required to undergo [insert requirements].
All employees who care for our residents with memory decline are required to undergo [insert requirements].
We are pleased to provide competitive compensation and benefits to our staff, including [insert benefits].

Key Questions About Vaccine Mandates
Kaiser released these Key Questions About Vaccine Mandates. Top points are that it is unclear whether the federal government can issue a vaccine mandate, but state’s do have the authority to do so. Some healthcare employers require them as a condition of employment as do some universities for students and employees. LeadingAge will cover this brief and some of the legal questions in the Update Call on Monday.

Long Term Care Pharmacy Partners Update
On Thursday’s weekly meeting with the Illinois Department of Public Health (IDPH), we received an updated listing of long term care pharmacies enrolled in the Illinois Long Term Care Pharmacy Program. Click here to view the updated list.

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.

Nursing and Rehabilitation:

CMS Proposes FY 2022 SNF Payment Rule
The FY 2022 SNF PPS proposed rule was released this week. The proposed increase to the SNF PPS payment rate is 1.3% after a 0.8% forecast error adjustment. The rule proposes certain exclusions to SNF consolidated billing and PDPM adjustments including ICD-10 code mappings and includes a discussion of methodology for recalibrating the PDPM parity adjustment. The rule proposes updates to SNF QRP requirements, including a revision of the number of quarters used for QRP reporting due to the public health emergency.

The rule also proposes 2 new QRP measures: Healthcare-associated infections requiring hospitalization and COVID-19 vaccination coverage among healthcare personnel. CMS proposes that data for the latter measure would be reported through NHSN.

The rule also proposes updates to the SNF VBP program, including suppression of the 30-day all-cause readmission measure for FY 2022 VBP program year and other proposals for scoring and adjusting payments to SNFs. The proposed rule can be found here. Comments are due by June 7.

Independent Affordable/Subsidized Housing:

LeadingAge Quarterly Housing Survey
Calling all housing providers! Our quick pulse-check to gather your insights on vaccines, COVID testing, HUD payments, and more is now available. Please take a moment to complete the survey.

HUD Posts Updated NSPIRE Standards, Seeks Feedback
As HUD moves forward with its NSPIRE overhaul of physical inspections, the agency posted an updated set of draft building standards (V2.1) that will be evaluated during inspections under the new NSPIRE model. LeadingAge has identified several key standards updates in Version 2.1, including related to bathtubs and shower functionality, carbon monoxide detectors, exhaust ventilation, electrical components, and fire extinguishers. HUD is still welcoming informal comments on the draft standards; LeadingAge is compiling feedback on HUD’s specific questions. More info here.

Home Health and Hospice:

Vaccinations Update
The Illinois Department of Public Health (IDPH) now approves home health and hospice providers to become COVID-19 vaccine providers through the Illinois Comprehensive Automated Immunization Registry Exchange (I-CARE). Similar to the pharmacy program for long term care facilities, when I-CARE approves a provider, that provider can begin getting their own allotments of the vaccinations. This is separate from work agencies are already doing to collaborate with local health departments to get vaccinations.

Proposed Hospice FY 2022 Wage Index Rule Released
The FY 2022 Proposed Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, Hospice and Home Health Quality Reporting Program Requirements was released this week. The proposed increase to the hospice payment rate is 2.3% ($530 million dollars in increased payment to hospice providers) and there are proposed changes to the hospice program that include permanency of certain 1135 waivers, changes to the proposed labor shares of the hospice payment rates, clarifications and clarifying regulation text changes related to the hospice election statement addendum, and asks for comments on hospice utilization and spending patterns.

Additionally, the rule proposes to update the Hospice Quality Reporting Program by adding the claims-based Hospice Care Index and the Hospice Visits in the Last Seven Days of Life Measure for public reporting, removal of seven HIS measures because CMS sees them as duplicative of other measures being reported, and contains more information on the development of the Hospice Outcome and Patient Evaluation (HOPE) assessment instrument. The rule also has a proposal related to the home health quality reporting program so that timely comments can be received prior to implementation. The proposed rule can be found here. Comments are due by June 7.

Technology:

Registration is Open! Collaborative Care & Health IT Innovations Summit 2021
June 8-10, explore the latest innovations in managing population health in crises, across the collaborative care ecosystem—including pre-acute, acute care, LTPAC, payers, and solution providers—with a compelling look at tech-enabled care delivery and payment models. Learn more and take advantage of early registration discounts.

Using Technology to Increase Resident Safety
LeadingAge CAST has updated its Safety Technology Selection Tool that showcases hands-on resources that help providers understand, plan for, select, implement, and adopt the appropriate resident safety technology. Additions to the tool include two new case studies that evaluate how artificial intelligence can support fall prevention in aging services settings. Read more.

FCC Posts Emergency Broadband Benefit Resources
The Federal Communications Commission (FCC) posted additional resources for the new Emergency Broadband Benefit (EBB), which provides a monthly discount on internet services for income qualifying households across the country. In addition to recently uploaded FAQs, the FCC has also posted a tool that allows partners and consumers to view by state or territory the providers that will be participating in the Emergency Broadband Benefit program; the list currently includes many of the country’s biggest ISPs, as well as local and regional providers. Separately, the FCC announced an upcoming webinar on the new benefit. See more info here.

Other:

Advancing Racial Equity in Aging Virtual Summit
The Illinois Department on Aging, along with the AARP of Illinois and and RRF Foundation for Aging are offering a virtual summit entitled, Disrupt Disparities: Advancing Racial Equity in Aging. This virtual summit, with national and state expert speakers and panelists, will occur April 26 from 2-5 p.m. and April 27 from 2-4:30 p.m. Join state government leaders, legislators, community leaders, policy experts, and philanthropic leaders as we address racial disparities in aging and identify potential actions towards racial equity. To register for any and all sessions at the Summit, click here. To learn more about the Joint Summit, and the Disrupt Disparities Initiative on racial equity and aging, click here.

2021-2022 Flu Vaccines Discounts for LeadingAge Members
This flu season, LeadingAge National is partnering with Member Solutions partner Seqirus, a leader in the fight against influenza with an innovative portfolio of products. As a LeadingAge member, you are eligible to earn multiple discounts across Seqirus’ portfolio of innovative influenza and vaccine solutions, including prompt pay and early reservation offers. Preorder by April 15, 2021 to receive special discounts and the ability to return unused doses.