The Lead January 11, 2024
From the Desk of Angela Schnepf, President and CEO
Welcome the first edition of The Lead in 2024. The Lead has a new look and some new additions.
Did you know that there are 300 new laws taking effect in January, 2024? Some are language clarifications while others are brand new. We encourage you to visit the full listing here as well as see our summary of those impacting you here.
Kindest regards,
Angela
Top Stories
CMS Approves Adult Day Increase
CMS has given approval to implement rate increases for Adult Day Service Providers per unit increase from $15.30 to $16.84 and Adult Day Transportation per unit increase from $11.29 to $12.44. Adult Day Service providers do not need to make any changes to their billings as the Illinois Department on Aging (DoA) has made the required changes allowing providers to be reimbursed at the new rates.
The rate increase was a legislative priority in 2023 for LeadingAge Illinois, advocating alongside the Illinois Adult Day Services Association (IADSA) and AARP to ensure inclusion in the State Budget.
Long Term Care Facilities are Eligible for a FREE One-Time Bulk Shipment of Rapid COVID-19 Antigen Tests from the State of Illinois-Test Requests are due by Friday, January 12, 2024
Click here for more information.
Prevention of Spousal Impoverishment Standards for 2024
The Illinois Department of Healthcare and Family Services (HFS) is informing long term care providers that effective January 01, 2024, pursuant to Public Act 102-1037, the Community Spouse Maintenance Needs Allowance (CSMNA) and Community Spouse Resource Allowance (CSRA) will increase annually.
The term “spousal impoverishment” includes the standards for the Community Spouse Resource Allowance (CSRA) and the Community Spouse Maintenance Needs Allowance (CSMNA). The prevention of spousal impoverishment standards should be included in the oral and written information that must be provided to residents and potential residents about how to apply for and use Medicaid benefits. Facilities are required by federal regulations (42 CFR 483.10) and State statute (210 ILCS 45/2-211) to give an explanation of resident rights at the time of admission and at least annually thereafter.
The CSRA standard will change from $120,780.00 to $129,084.00. This is the maximum amount of resources a resident may transfer to a community spouse or to another for the sole benefit of a community spouse. The actual amount a resident may transfer is determined by deducting non‑exempt resources of the community spouse from the standard of $129,084.00.
The CSMNA standard will change from $3,715.50 to $3,853.50. This is the maximum amount of monthly income a resident may give to a community spouse. The actual amount a resident may give is determined by deducting any gross income of the community spouse from the standard of $3,853.50.
The CSMNA and CSRA will increase every year based on the Federal Poverty Level (FPL) amounts posted annually by the Federal government.
Reminder: The CSRA determination only occurs once. If the CSRA was already determined at application or long term care determination, then the previously determined amount will not be updated.
Questions regarding this change should be directed to the HFS Bureau of Long Term Care toll free at 844-528-8444.
IDPH Proposes Changes to Control of TB Code
The Illinois Department of Public Health (IDPH) has proposed rule changes for the Control of Tuberculosis Code (77 IAC 696; 48 Ill Reg 437) that incorporate recommendations from the federal Centers for Disease Control and Prevention, update testing and reporting requirements for suspected and confirmed cases of latent tuberculosis infection (LTBI) and include symptom evaluation in the screening process for newly hired health care workers.
Persons whom IDPH states may be at greater risk for LTBI include foreign-born persons from countries outside of the U.S., Canada, Australia, New Zealand, or western and northern Europe; persons who reside in or have traveled to areas with high prevalence of active tuberculosis; close contacts of persons known to have active TB; local populations with a higher incidence of active TB, which may include medically underserved populations or persons with substance use disorders; and infants, children, and adolescents who are exposed to higher risk adults.
IDFPR Proposes More Continuing Education for Alzheimer’s and Dementia
The Illinois Department of Financial and Professional Regulation (IDFPR) has proposed rules requiring continuing education (CE) regarding Alzheimer’s Disease/dementia and cultural competency for health care professional licensees, including registered nurses, advanced practice registered nurses, and licensed practical nurses, physical, occupational, and speech-language therapists; professional and clinical professional counselors; and behavior analysts and assistant behavior analysts.
At least one hour of CE in cultural competency will be required each license renewal cycle beginning January 1, 2025. This training must be provided by a DFPR-approved entity (which may include a hospital or other health care provider; an accredited community college, four-year college or university; or a State, county or municipal agency) and must instruct licensees in how to care effectively for patients from diverse cultures, groups and communities.
IDPH MGT-346, EOC Operations and Planning for All-Hazards Course
The Illinois Department of Public Health (IDPH) Office of Preparedness and Response (OPR), in conjunction with Texas A&M Engineering Extension Service, invites you to register for EOC Operations and Planning for All-Hazards.
The course focuses on the core functions, processes and best practices necessary to ensure effective and repeatable performance of an emergency operations center at any level. The core functions and processes are reviewed and demonstrated via facilitated discussion and classroom activities. The participants gain practical experience via a series of interrelated activities and exercises supported by a state-of-the-art computer simulation system and are coached by instructors who have extensive emergency operations and management experience.
Posting of Medicaid Rates Delayed
The posting and programming of the Medicaid rates for Nursing Facilities, County Nursing Facilities, and Supportive Living Program providers effective January 1, 2024, has been delayed. The Illinois Department of Healthcare and Family Services (HFS) expects to have the rates posted and programmed by mid-January. We are told the delay is due to a data format change on the MDS data used to set the acuity portion of the nursing home rates. They have been working on getting the data realigned so they can do the nursing home rate calculation.
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.
IDPH Reports Urgent Need to Increase Immunization Coverage for Influenza, COVID-19, and RSV
Click here for official information from the Illinois Department of Public Health (IDPH).
Provider Relief Fund Reporting Continues – Reporting Period 6. The Provider Relief Fund (PRF) Reporting Portal opened January 1 and will remain open through March 31 at 10:59 p.m. CST for providers to submit their reports for Reporting Period 6. This impacts providers who received one or more PRF (General or Targeted) and/or American Rescue Plan(ARP) Rural payments exceeding $10,000, in the aggregate, from July 1 to December 31, 2022, must report on their use of these funds during Reporting Period 6 to comply with PRF Reporting Requirements. Failure to submit the required report will result in providers being required to return the funds. More information and resources can be found on the PRF Reporting webpage.
Medicaid Ready to Renew Toolkit
The Ready to Renew messaging toolkit can be found at the Ready to Renew Toolkit Webpage of HFS or document from IAMHP. You can use these materials through your communication channels to help people who use Medicaid get ready to renew their coverage.
This week, Governor Pritzker held a press conference to reaffirm Illinois’ commitment to protect coverage for eligible Medicaid customers, as annual eligibility verifications resume. Medicaid customers haven’t been through a redetermination in over three years, which is why it’s so important that they’re ready when their renewal date comes up. We are firmly committed to offering as much assistance as customers need to get through this process because the State wants everyone who is eligible for Medicaid to continue to be covered, without any disruption. Click here for the full press release.
Member Announcements
Member Announcements – What’s happening at your Organization?
For our LeadingAge Illinois member providers, we’ve created a new feature highlighting members’ updates such as: promotions, retirements, announcements, and any changes you’d like to share with the member network. We will be including these shout-outs each week in The Lead and on our social media channels. Please send your announcements to info@leadingageil.org. If you have any questions, please contact Sloane Grubb, Director of Membership
Life Plan Communities/CCRCs
LPC January Member Network Meeting
Join us for our LPC member network meeting on Thursday, January 18 from 1-2 p.m. CT. Our panel of financial strategy and market experts will discuss LPC Trends to Watch for 2024. This year’s powerhouse panel features Dan Hermann, Ziegler; Stuart Jackson, Greystone; and Dana Anders, CliftonLarsonAllen. The discussion will center on finance, market, and strategy trends for LPCs in the coming year. If you have not yet received the invitation, email Dee Pekruhn at LeadingAge National.
Supportive Living
SLP Expansion for Dementia Care
The Illinois Department of Healthcare and Family Services (HFS) approved 11 applications to proceed towards certification in the Supportive Living Program for Dementia Care Settings. The applicants next must meet the Department’s certification requirements; successful applicants must become operational within 180 days.
HFS Staffing Update
LaTatia Danner on the team in central office at the Illinois Department of Healthcare and Family Services (HFS) has accepted another position. Raymond Horn will now be sending correspondence from HFS Fair Hearings related to appeals. All other matters can be directed to Kara Helton.
Nursing and Rehabilitation
Provider Assessment Rates for Calendar Year 2024
Click here for more information.
HFSRB 2024 Annual Questionnaire for CY 2023
John Kniery, the new administrator for the Illinois Health Facilities and Services Review Board (HFSRB) has provided us with the Annual Facility Questionnaires. We will meet with John and staff this month on the questionnaire and other concerns.
The Illinois Department of Healthcare and Family Services (HFS) posted a notice that 90-day rehabilitation stays within a nursing facility setting shall be covered only by HealthChoice Illinois managed care organizations (MCOs) for the Health Benefits for Immigrant Adults (HBIA) and Seniors (HBIS) programs.
The transition of most HBIA and HBIS customers from fee-for-service to managed care beginning January 1, 2024, was outlined in a provider notice dated December 28, 2023. The coverage policy for short term nursing facility rehabilitation stays is only applicable to HBIA/HBIS customers assigned to MCOs and is strictly limited to 90 days. HBIA/HBIS individuals do not qualify for regular/federally matched Medicaid except for emergency services due to citizenship/immigration status; therefore, long term care (LTC) services are not covered. Previously, only rehabilitation stays in a hospital setting were covered.
MCOs will be working to educate nursing facilities in their provider networks regarding rehabilitation stays, including medically necessary utilization management requirements. An initial 30-day prior authorization is required. HBIA/HBIS customers will not be entered as an admission in the Medical Electronic Data Interchange (MEDI) or have group care credit (GCC). These customers will not be listed on the patient credit file. NFs should bill using the rehabilitation room and board accommodation revenue codes 0118, 0128, 0138, 0148, or 0158. MCOs will determine what information is required on the claim to bypass the admissions requirements. Any admission transaction for an HBIA or HBIS customer entered in MEDI will be rejected.
It will be the responsibility of the nursing facility and the MCOs to work together to ensure the patient is discharged within 90 days. No payments will be made after 90 days according to HFS.
Any questions regarding this change should be directed to the MCO or the Bureau of Managed Care (BMC) at hfs.MCOOperations@illinois.gov.
Home and Community Based Services (HCBS)
Dragoo Named Interim Director at DoA
Effective Jan. 1, Becky Dragoo will serve as Interim Director of the Illinois Department on Aging (DoA). Becky has served as the agency’s Deputy Director since January 2023.
A registered nurse, Becky began her career in state government at the Attorney General’s office, where she worked closely with their litigation team on workers’ compensation claims and medical issues arising out of correctional facilities. After a couple of years, Becky moved to the compliance assurance division at IDPH, became certified as a surveyor under the federal government’s requirements, and took on a new role in enforcement related to deficiencies in nursing homes. She has maintained parallel careers for much of her working life, spending 13 years in acute nursing care and completing a master’s degree in nursing, while looking for a way to blend her interests in medicine and the law. She is currently completing a PhD in public administration. Her dual passions led to Becky first joining IDoA as Division Manager of Home and Community Services in January 2020. After a two-year period serving as IDPH’s Deputy Director for the Office of Health Care Regulation, Becky returned to assume the role of Deputy Director of IDoA.
CMS Publishes Hospice Special Focus Program User’s Guide
The Centers for Medicare and Medicaid Services (CMS) has published a user’s guide covering the algorithm and public reporting process for the hospice special focus program (SFP) which was finalized in the CY2024 Home Health Rule. The guide includes details on the algorithm data sources, eligibility for the SFP, and how the data is prepared, standardized, and weighted for the selection of hospices. The guide does not modify or supersede the policy discussed in the final rule or future rulemaking.
Housing
HUD Releases Funding for 160 New Service Coordination Programs
On December 13, the Department of Housing and Urban Development (HUD) released new funding for Service Coordination programs in affordable senior housing. LeadingAge was instrumental in securing the funds for the much-anticipated expansion of HUD’s Service Coordination programs. Service Coordinators offer critical support to older adults with low incomes as they age in community, including by referring HUD-assisted residents to health and educational resources.
Other
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This is a comprehensive quick-read report of forecasting trends across all industries, food, textiles and MRO’s that our members use:
Food Flash Trends – January 2024
Direct Supply – January 2024 Promo’s
New Partner – CalTek:
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Food Distributors:
Through its partnership with HPSI, Value First is pleased to announce it has expanded its selection of Food Distributors. If you would like to conduct a cost study to determine the best pricing with your trusted vendor, please contact Terry Romin. To view a list of our food distributors, click here.
Who is Value First:
Value First is owned by LeadingAge and its 25 state affiliates. Value First is a free service for our LeadingAge members. Our Participation Agreement is non-exclusive, with no minimum purchases or fees to participate AND gives you access to over 900+ vendors. To make sure you have a current Value First Purchasing Agreement please contact Terry Romin at 224.230.7265.
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.
For evacuation drills in assisted living, do residents need to be taken outside in the colder months?
The Code requires the actual evacuation to an assembly point. Although the code does not directly state the word “outside” the term evacuation would be interpreted by many life safety code officials as leaving the building in which the drill or fire incident may be occurring. Staff must assess the conditions they will be placing their residents in during the colder months or even the warmer months.
Have a regulatory question? As the expert.
Member Spotlight: Dan Merriman, Life Care Services (LCS)
In our first Member Spotlight of 2024, we feature Dan Merriman, senior compliance and public policy analyst at Life Care Services (LCS). He has been a standout contributor in advocacy efforts for the association and LCS.
Dan joined LCS and the industry in 2010. Since then, he has seen the continued evolving of what the continuum of care looks like. “Assisted living, dedicated memory care, and even assistance in residential living continue to grow and evolved,” said Dan. “It’s both a challenge and an opportunity to have some distinct identity on what a community is, how it serves residents, and how it positions itself for the next generation of residents.”
Dan has been heavily engaged in LeadingAge Illinois, serving on the Public Policy Committee and is also a member of the LeadingAge Illinois PAC Board. He has routinely reached out and coordinated outreach to legislators at the state and federal levels on issues that impact senior living residents, staff, and communities as a whole.
Dan is proud to be the lead for the LCS legislative and advocacy issues. “It’s great to see how awareness has grown throughout our community leaders. While I get satisfaction from attending advocacy meetings myself, it’s a greater moment when I see an Executive Director follow that lead and take part in their first advocacy meeting with a state legislator or Member of Congress.”
He spends most of his time in the LCS corporate office and does not get a lot of interaction with residents. “The times that I do get to communities to interact with residents and someone personally thanks me is always special.”
Life Care Services (LCS) was established in 1971 and currently manages over 140 communities in 30+ states. “We’re proudly serving over 40,000 seniors annually,” said Dan. The 140 communities include a mix of CCRCs and rental-based Independent, Assisted Living, and Memory Care communities. The LCS family of companies includes both third party management and their own investment communities; LCS Development, also formed in 1971, provides the design and construction management for new and expanding communities as well as repositioning; and Care Purchasing Services, is one of the larger Group Purchasing Organizations in the industry.
“The latest addition to the family of companies is the LCS Foundation, which serves three pillars: develop future leaders of the senior housing and care profession, support Alzheimer’s care and research initiatives, and provide financial relief for personnel during crisis situations,” said Dan.