The Lead February 20, 2025 - LeadingAge Illinois

From the Desk of Angela Schnepf, President and CEO

Nursing and Rehabilitation:
Nursing Facility Estimated Quality Incentive Payments Listing for April 2025
IDPH Issues Memo on Oversight of Contractors in SNF and LTC Settings
Center of Excellence for Behavioral Health in Nursing Facilities Resources & Training
Regulatory Review Article – Right to Refuse a Transfer to Another Room

Housing:
HUD Postpones HOME Final Rule

HCBS:
CMS Ends Implementation of the Hospice Special Focus Program

Other:
Ask the Expert
Become a 2025 LeadingAge Illinois PAC Partner
Get Connected! Emerging Leaders 2025 Lunch & Learn Schedule

From the Desk of Angela Schnepf, President and CEO

U.S. Congress is developing a multi-trillion dollar package of policies that impact federal spending through the budget reconciliation process. Older adults and nonprofit and mission-driven providers who serve them must reach out to members of Congress to ensure that the needs of older adults and the people who serve them are met. The proposals below are actively being considered by Congress for inclusion in a budget reconciliation package. Click here to Contact Congress on this imperative issue.

Kindest Regards,

Angela

Governor Delivers FY26 Budget Address

On Wednesday afternoon, Governor Pritzker gave his FY26 Illinois State Budget Address. The annual tradition unveils the Governor’s proposed budget. The budget still has to be negotiated and may shake out much different by the time session concludes with a budget in the Spring.

The Governor went into the Address with a reported estimated $3.174 billion deficit. However, the proposal shows a slight surplus. This is because revenues are estimates to improve with a decrease in spending pressures.

There is $318 million in new revenues and the rest is better than expected growth mostly from personal income taxes. The new revenues are:

Delinquent Tax Payment Incentive Program – $198 million
State Casinos – realign casino taxes – $100 million
280E Deduction -“The Governor proposes eliminating the state-level deduction for cannabis industry business expenses. This change is estimated to increase gross individual income tax receipts by $20 million.

Here’s a look at some other key items:

Healthcare and Family Services:

FY26 Proposed Budget: $45.302 billion All Funds, including $9.359 billion General Funds
Includes full annualized costs, an increase of over $300 million from prior year levels, of Medicaid program rate increases and programmatic changes enacted last spring, most of which are effective mid-FY25.

Department of Public Health:

FY26 Proposed Budget: $1.715 billion All Funds, including $292 million General Funds
$6 million increase for the Office of Health Care Regulation for licensing, inspecting, and certifying that healthcare facilities are compliant with state and federal regulations.
$450,000 for the Certified Nursing Assistant (CNA) Intern Program designed to increase hiring and retention at facilities through education, mentoring, and financial assistance.
$250,000 for the Certified Medication Aide program to allow medications to be provided by non- licensed certified nursing assistants.

Department on Aging:

FY26 Proposed Budget: $2.022 billion All Funds, $1.796 billion General Funds
$144.4 million increase for the Community Care Program (CCP) for caseload growth, utilization, and annualization of January 1, 2025, $1.56/hour rate increase for in-home providers, which brings the rate to $29.63/hour.
$8.0 million increase for the Home-Delivered Meals Program, which will provide more than 11 million meals to homebound older adults across the State.
$800,000 to support senior services in rural areas.

We are still reviewing the full budget items and will report back additional information as warranted.

Congressional Review Act Resolutions of Disapproval to Overturn CY2025 Home Health Payment Rule Introduced

On February 12, Representative Andrew Clyde (R-GA) introduced 13 Congressional Review Act (CRA) joint resolutions of disapproval to overturn various Biden-era regulations. The CRA provides Congress an additional review period to introduce joint resolutions of disapproval for rules submitted within the last few months of a President’s outgoing term. The only health related rule included in the list was the Calendar Year (CY) 2025 Home Health Prospective Payment System Rate Update. In addition to setting rates for home health agencies for CY2025, this rule also established a new Condition of Participation for home health agencies as well as making permanent COVID era NHSN reporting requirements for nursing homes.

Seeking Participation in National Science Foundation (NSF) Innovation Project

Allison Chi, an Associate Professor at the University of Iowa is working to improve dementia care and is looking for individuals with experience in pain management for individuals with dementia to participate in a 30-minute, recorded Zoom interview. The interviews will be used in developing an Artificial Intelligence (AI) tool to support family caregivers in managing pain for those with dementia. Specifically, the University of Iowa is looking for:

Healthcare providers who work with individuals with dementia and their family caregivers on pain management.
Prior or current adult family caregivers responsible for managing pain and pain treatments for a family member or care recipient with dementia.
Healthcare administrators, caregiver advocacy groups, policymakers, and technology reviewers who could potentially endorse or utilize the future digital tool.

For participating in the interview, you will receive a $20 check upon completion of the project. If you are interested, please contact Nanle Gusen (nanle-gusen@uiowa.edu), to schedule a time.

Upcoming IDPH Education

The Healthcare Associated Infection team is hosting upcoming webinar events for long-term and congregational care settings:

February 21 from 1 – 2 p.m. Topic – Sepsis. Registration link: https://illinois.webex.com/weblink/register/rdc6a98099e652a0a34f1386f9a824b2b
March 7 from 1 – 2 p.m. XDRO Registry. Registration link: https://illinois.webex.com/weblink/register/rd9bbce65807e50d763dde74f92472fe3

If you cannot register or get into the webinar, please email Michael.moore@illinois.gov. These webinars will be recorded with links of the recordings distributed.

IDPH Office of Health Care Regulation Monthly Educational Webinars

The Illinois Department of Public Health (IDPH) Office of Health Care Regulation (OHCR) will be hosting monthly educational webinars providing general information and topics of interest for long term care facilities. Updates will also be provided on new federal and state regulatory requirements and IDPH will also allow opportunities for questions and answers from the audience. Webinars will be announced several months in advance and registration will be required.

February 26 from 1 – 2 p.m. Fall Risk Planning
March 19 from 1 – 2 p.m. Identifying and Reporting Abuse

LeadingAge Develops Resources on Immigration Enforcement Preparedness

As immigration enforcement policies shift under the new administration, LeadingAge members have requested information about how to prepare for potential encounters with U.S. Immigration and Customs Enforcement Officials, including audits or visits relating to employment verification documentation and enforcement visits. LeadingAge developed an initial list of resources and will add additional items and information in the weeks ahead.

Send us your MCO Issues

LeadingAge Illinois is working with the Illinois Department of Healthcare and Family Services (HFS) and the MCOs to resolve MCO billing issues. If you have a pattern of claims issues (not single claims) that you have not been able to resolve using the normal channels, such as working with your provider relations representative or through the use of the complaint portal, we can help by raising attention to these issues.

If you have issues, please contact Jason Speaks.

Nursing Facility Estimated Quality Incentive Payments Listing for April 2025

Click here for listing.

IDPH Issues Memo on Oversight of Contractors in SNF and LTC Settings

The Illinois Department of Public Health (IDPH) issued a memo and released over the SIREN system on February 10 related to Oversight of Contractors in Skilled Nursing and Long-Term Care Facilities. Throughout the memo, IDPH discusses the nursing home’s requirements under infection control rules and regulations for completing an annual risk assessment and establishing standards for the infection prevention and control program in the nursing home, ensuring that contracted service providers are meeting the requirements outlined by the program. The memo outlines the infection prevention and control committee:

Review contractor procedures on dress code (including fingernail length, laundering of scrubs and lab coats), hand hygiene, audits for infection control tasks, seasonal acute respiratory illness policies, vaccination and illness policies, cleaning and disinfection of reusable equipment.
Review the risk assessment and update annually, including review of contractor policies and changes.
Policies for newly instated contract services should be added on an ad hoc basis before introducing the new services.

You can view more information on incorporating review of contract services and infection control in the memo released by IDPH.

Center of Excellence for Behavioral Health in Nursing Facilities Resources & Training

The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) has several upcoming opportunities for nursing homes to enhance behavioral health, mental health and substance use training. The first, is Improving Resident Care: New Behavioral Health In-Service Toolkits for Nursing Facility Staff provides guidance on how to utilize the established toolkits to train nursing home staff and enhance behavioral health knowledge. This session is planned for February 25 from 1-2 p.m. CT. Available toolkits include:

In addition, the COE-NF will begin the Behavioral Health Action Network spring series in March. These three one-hour virtual sessions are free for nursing home staff and provide the opportunity to learn industry best practices from other nursing homes and behavioral health subject matter experts. You can learn more about this series and register for a cohort here.

The COE-NF also has resources aid in compliance with the revised interpretative guidance including training and documents which are linked below.

Practical Strategies for Managing Behavioral Health Needs of Nursing Home Residents.
An Easy Pill to Swallow: Nonpharmacological Interventions for Long-Term Care Residents.
Schizophrenia in Nursing Facilities: Validating Diagnosis and Planning for Appropriate Care
Comfort Menu to identify individualized non-pharmacological approaches to reduce psychotropic medication use.

Regulatory Review Article – Right to Refuse a Transfer to Another Room

The next regulation in the resident rights regulation is F560 and allows the residents to refuse certain transfers within the nursing home. There are three indications for a room change in which the resident can refuse:

To relocate from a distinct SNF area of the building to a non-SNF area.
To relocate from a distinct NF area of the building to a SNF distinct area.
For the convenience of staff.

The regulation also indicates that if a resident refuses to transfer to a different distinct area of the building, that it does not affect their eligibility or entitlement to Medicare or Medicaid benefits. However, the interpretative guidance outlines the financial responsibility of the benefits if the residents decline the move.

First, we need to define distinct areas within the nursing home setting as most nursing home providers who accept Medicare and Medicaid services are known as dually certified. According to Appendix PP in the State Operations Manual (SOM) a distinct unit is part of a larger complex, it is physically distinguishable from the larger building and may be comprised of one or more buildings, or parts of buildings (such as wings or floors). A distinct part must include all beds within the designated area and cannot consist of a random collection of individual rooms or beds that are scattered throughout.

If the resident refuses to transfer to the other area of the building because they now qualify or are eligible for Medicare or Medicaid services, the staff are responsible for notifying the resident or the representative of the resident’s eligibility and what the financial responsibility may be. If the resident is unable to pay for those services, the staff may issue a notice of discharge and assist with a safe discharge or transfer.

In addition, the residents are allowed to refuse transfers that are solely for the convenience of staff. When considering this specific requirement, remember back to the pandemic as this specific requirement was included in the 1135 waivers and no longer allowed for the residents to refuse to transfer to another area of the building. In these situations, residents are being asked to move to possibly cohort individuals based on the type of care they need. As an example, the A hall has residents who only require the assistance of one staff member, therefore when Joe began needing two staff, the nursing home asked him to move to a different room. This type of move would be solely for the convenience of staff as the area that Joe currently resides in does not have a specific license which only allows for assistance of one staff member.

HUD Postpones HOME Final Rule

In a forthcoming announcement by the Department of Housing and Urban Development (HUD), the agency will delay the effective date for a recent final rule overhauling the HOME Investment Partnerships Program. The updates in the January 6 final rule were supported by LeadingAge and were slated to take effect in early February, but have been delayed until April 20 in response to the Trump Administration’s current regulatory freeze. You can find more information from LeadingAge here.

CMS Ends Implementation of the Hospice Special Focus Program

According to a statement released on the Center for Medicare and Medicaid Services (CMS) website, effective February 14, 2025, implementation of the Hospice Special Focus Program for CY 2025 has ceased so that CMS may further evaluate the program. LeadingAge has continued to advocate for the revision of this program and we look forward to working with the administration on this effort. Read LeadingAge’s press release here.

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: Our Medical Director would like us to administer PCV 21 Pneumonia vaccines instead of PCV 20. Is this acceptable?

A: Yes, typically surveyors follow the recommendations of the Centers for Disease Control and Prevention (CDC). The current guidance from the CDC indicates that providers should administer PCV15, PCV20, or PCV21 to any adult 50 or older if they have not previously received a pneumonia vaccine, or their vaccination status is unknown. If the resident has previously been vaccinated with a PCV15 vaccine, the CDC recommends using a PPSV23 vaccine a year after the PCV15 was administered with a few indications for the PPSV23 sooner than a year. LeadingAge IL now has a template policy on Pneumonia Vaccines that members may use!

Have a question? Email yours now.

Become a 2025 LeadingAge Illinois PAC Partner

Special Thanks to Sloan Bentley for being the first Chair’s Circle member of 2025.

Your continued support of the LeadingAge Illinois PAC is paramount to our success. With your help, we can amplify our voice, advance our 2025 public policy priorities, and shape the future of older adult care and services in Illinois. Collectively, we can make a difference and propel our priorities through the legislative process and fight off burdensome proposals that threaten the field of older adult care and services.

We must continue to leverage our PAC to educate legislators, to reduce burdens, and implement solutions that impact YOU.

Each contribution, no matter how small, makes a difference. Like our voices, our contributions collectively make a significant difference in providing the ability to influence public policy related to aging services.

Last year, the PAC was instrumental in helping move forward our public policy priorities to unanimous passage in the Illinois General Assembly.

Become a PAC Partner and help us advance our public policy priorities and defeat harmful and burdensome legislation that would have a negative impact on member communities.

There are a number of ways to engage in the LeadingAge Illinois PAC.

Monthly Contribution (most popular). You can contribute smaller amounts each month, spreading your total contribution over the year. Select “make this a monthly donation” when processing your payment.
Make a one-time contribution – Visit our webpage online to make a one-time contribution.
Chair’s Circle. Along with maintaining a sound presence for the LeadingAge Illinois PAC, an annual contribution of $500 qualifies you for our Chair’s Circle!! Chair Circle members receive special recognition at LeadingAge Illinois events as well as making our PAC the strongest ever. You can make your chair’s circle contribution all at once or monthly by checking the box that says “make this a monthly donation.” Contribute online now.

*Nonprofit 501c(3) organizations cannot by law fund the PAC with a corporate check. Donations must come from individual contributions. We recommend sharing this communication with your staff to encourage personal contributions.

**Contributions to PAC are not deductible as charitable contributions for tax purposes.

***A copy of our report filed with the State Board of Elections is available on the Board’s official website or for purchase from the State Board of Elections, Springfield, Illinois.

Get Connected! Emerging Leaders 2025 Lunch & Learn
Ready to grow your leadership skills and expand your network?

If you’re a LeadingAge Illinois member looking to grow in your career, the Emerging Leaders group is for you! Whether you’re just starting out, stepping into a new role, or looking to sharpen your leadership skills, this group provides an incredible opportunity to connect with like-minded individuals and grow together.

Meet every other month for engaging sessions packed with industry insights, fresh ideas, and expert advice. Plus, join us for an in-person luncheon at the LeadingAge IL Annual Meeting to deepen connections and build your professional network.

This isn’t just for “up-and-coming” leaders — it’s for anyone passionate about learning and improving. No matter where you are on your leadership journey, you’ll find value in this supportive community.

Brought to you by LeadingAge Illinois, in collaboration with Sara Hawkins (she/her), Director of Membership at ClarkLindsey, and Brit Vipham (they/them), Director of Project Management at The Admiral at the Lake.

Not a member yet? Reach out to LeadingAge Illinois to join today and start unlocking your potential!

2025 Schedule
12:00 – 1:00 pm Thursdays: April 17th, June 19th, August 21st, October 16^th