The Lead January 12, 2023

From the Desk of Angela Schnepf, President and CEO
Top Stories:
LeadingAge Illinois Helps Secure Massive Win for Nursing Homes2
Public Health Emergency Extended
Spring Session Set to Begin
Impending Deadlines

Nursing and Rehabilitation:
Medicaid Rate List for Nursing Facilities Effective January 1, 2023

Supportive Living:
Supportive Living Program Rates Effective January 1, 2023

Home and Community Based Services (HCBS):
CMS Releases Home Health Preview Reports and Star Rating Preview Reports for the April 2023 Refresh

From the Desk of Angela Schnepf, President and CEO
The Centers for Medicare & Medicaid Services (CMS) is planning to issue a proposed rule to establish national minimum staffing levels for nursing homes. The long-term care sector is already facing dire workforce shortages, limiting new admissions and forcing organizations to close. We need real solutions that build the domestic and international pipelines for applicants, and funding increases to recruit and retain additional staff. Please join us in writing an email to CMS Administrator Chiquita Brooks-LaSure opposing the adoption of a minimum staffing ratios mandate without the necessary workforce investments and reimbursement levels to ensure that residents and patients receive the care they deserve! We encourage you to personalize the email template by including any information or stories that highlight the impacts of workforce shortages and the proposed rule on your community and its residents.

Kindest regards,

Angela

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Top Stories:

LeadingAge Illinois Helps Secure Massive Win for Nursing Homes
The 102nd Illinois General Assembly wrapped up the Lame Duck Session this week. The Inauguration for the 103rd was yesterday and we are officially be in the 2023 Spring Session. There was a major success in the Lame Duck as Skilled Nursing Facilities staffing fines will be delayed until 2025! This is an important successful change as our workforce continues to recover from the impacts of COVID.

The language for the delayed fines was in HB240 (Healthcare Omnibus), which passed both houses yesterday. LeadingAge Illinois attended the applicable hearings and chamber voting during the Lame Duck. After language including the delaying of fines was included in the omnibus, we received word that it could be amended in the House after passing in the Senate, rewriting the language. LeadingAge Illinois took action and was involved in discussing the bill with legislators and staff and helping to ensure passage.

Staffing Fines:
• Pending the Governor’s signature or automatically becoming law after 60 days, no monetary penalty may be issued for noncompliance prior to the revised implementation date, which shall be January 1, 2025.
• If a facility is found to be noncompliant prior to the revised implementation date, the Illinois Department of Public Health (IDPH) shall provide a written notice identifying the staffing deficiencies and require the facility to provide a sufficiently detailed correction plan that describes proposed and completed actions the facility will take or has taken, including hiring actions, to address the facility’s failure to meet the statutory minimum staffing levels. Monetary penalties shall be imposed beginning no later than July 1, 2025, based on data for the quarter beginning January 1, 2025 through March 31, 2025 and quarterly thereafter.

• The Department shall provide a written notice identifying the staffing deficiencies and require the facility to provide a sufficiently detailed correction plan that describes proposed and completed actions the facility will take or has taken, including hiring actions, to address the facility’s failure to meet the statutory minimum staffing levels.

• No facility may appeal a notice of noncompliance issued during the revised implementation period.

• Along with the violations, the reporting and posting requirements remain in the statute.

Provider Tax:
Also advocated for by LeadingAge Illinois was a special $7 tax rate for county nursing homes, along with the existing carve out for non-profits without certified beds. The passage of this bill helps ensure that county nursing homes, which are reimbursed Medicaid costs versus the incentives negotiated earlier this year, are not penalized as part of the Medicaid rate reform bill.

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Public Health Emergency Extended
The Public Health Emergency (PHE), first declared in January 2020 and extended continually for 90 day periods since then, has been extended for another 90 days. It would have expired today, January 11, without the extension. The Administration has promised to give at least 60 days’ notice if it is going to end the PHE; many observers believe this could be the final extension. The unwinding of the PHE has many implications for health care financing and delivery, including the ending of some waivers that have been in place since 2020, private insurance and government health plans taking on COVID costs for most Americans, and loss of Medicaid coverage for millions of Medicaid beneficiaries.

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Spring Session Set to Begin
With the 103rd Illinois General Assembly sworn in yesterday, we are set to enter the 2023 Spring Session. The Governor’s State of the State/Budget Address is February 15. The plan is to adjourn early again. This time on May 19. LeadingAge Illinois’ policy team will track bills that affect members, lobby legislators and advocate for our public policy priorities. It is critical that you and your staff respond to member alerts when asked to contact your legislators. The marathon months of session are here and LeadingAge Illinois will be involved every step of the way and will keep you abreast of all activity. If you have any questions, please contact Jason Speaks, director of government relations.

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Impending Deadlines
Each week, we will keep you abreast of important deadlines.
• January 31, 2023: This is reportedly when the Illinois Department of Public Health (IDPH) will issue the staffing fines.
• January 31, 2023: HUD is currently accepting reimbursement requests from housing providers for COVID expenses completed or committed by January 31, 2023. LeadingAge has complied FAQs with HUD’s latest answers to our questions on CSPs; LeadingAge will also host an additional “Office Hours” session on January 19 at 2pm ET. Members can register here for the CSP Office Hours

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Nursing and Rehabilitation:

Medicaid Rate List for Nursing Facilities Effective January 1, 2023
The Illinois Department of Healthcare and Family Services (HFS) has released the Medicaid Rate List for Nursing Facilities Effective January 1, 2023.

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Supportive Living:

Supportive Living Program Rates Effective January 1, 2023
The Illinois Department of Healthcare and Family Services (HFS) has released the Supportive Living Program rates effective January 1, 2023.

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Home and Community Based Services (HCBS):
CMS Releases Home Health Preview Reports and Star Rating Preview Reports for the April 2023 Refresh
For the April 2023 refresh, Home Health (HH) Outcome and Assessment Information Set (OASIS) will be based on the standard number of quarters. Due to the COVID-19 reporting exceptions, the claims-based measures have been calculated excluding Q1 and Q2 2020 data from measure calculations.

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