The Lead March 6, 2025
From the Desk of Angela Schnepf, President and CEO
CMS Releases an Informational Bulletin Rescinding Guidance on HRSNs
CDC Resources for Norovirus
LeadingAge Illinois Submits Comment Letter on Proposed HIPAA Cybersecurity Changes
IDPH Monthly Updates
HHS Secretary Eliminates Public Comment Process on Certain Rules and Regulations1
New Emergency Preparedness and Life Safety Code HelpDesk Emails for CMS
Provider Five Star Reports are Now Available on LeadingAge’s Website
CDC Issues Food Safety Alert on Nutritional Supplements Causing Listeria Infection
Upcoming IDPH Education
IDPH Office of Health Care Regulation Monthly Educational Webinars
Send us your MCO Issues
Supportive Living Program Rates Effective January 1, 2025
Updated Nursing Facility Estimated Quality Incentive Payments Listing and Rates
LeadingAge Asks CMS to Delay Appendix PP Revision Effective Date
IDPH Issues Memo on Updated XDRO Website
Upcoming Center of Excellence for Behavioral Health Training
HUD to Cut Field Office Staff by May 18
CMS Ends Implementation of the Hospice Special Focus Program
Elevate Your Nonprofit’s Success with UST’s Innovative Workforce Solutions
Ask the Expert
From the Desk of Angela Schnepf, President and CEO
On March 4, LeadingAge issued an action alert to urge congress to protect and preserve the tax exemption for municipal bonds during budget reconciliation negotiations. Lawmakers are considering elimination of the tax exemption for interest earned on municipal bonds as a way to generate revenue to help pay for a budget reconciliation package that would extend expiring tax reductions, reduce taxes in other ways, and increase spending in areas such as border security and defense. Read and respond to the action alert here.
Kindest Regards,
Angela
CMS Releases an Informational Bulletin Rescinding Guidance on HRSNs
The Centers for Medicare & Medicaid Services (CMS) released an informational bulletin rescinding guidance on Health-Related Social Needs (HRSNs). Rescinding this guidance does not negate existing approvals.
Norovirus activity has been higher than anticipated in recent months with many outbreaks reported in long-term care settings. The Centers for Disease Control & Prevention (CDC) offers several resources to assist health care providers in managing norovirus outbreaks including the Guideline for the Prevention and Control of Norovirus Gastroenteritis Outbreaks in Healthcare Settings and the NoroSTAT Data which includes information on norovirus outbreaks nationally.
LeadingAge Illinois Submits Comment Letter on Proposed HIPAA Cybersecurity Changes
Based on feedback from LeadingAge Illinois and Iowa members and business partners, we submitted a comment letter to the Federal Register in response to the proposed rule changes. Thank you to the members and business partners that participated in and provided feedback on the proposed rule!
On February 27, LeadingAge IL along with other long-term care associations met with the Illinois Department of Public Health (IDPH) staff where the department provided answers to several questions/comments that the associations submitted. License renewals were a hot topic during the call including that licenses are not being provided timely causing problems for providers with various entities such as insurance credentialing. The department indicated they are working through the license renewal process, however, if you have problems with receiving your renewal timely please reach out to either Kellie Van Ree or Jason Speaks. In addition, the topic was addressed that non-profits are being required to list an owner when completing license renewal applications even when there is not an owner. The associations advocated to the department to review the wording of the question to prevent someone from fraudulently listing someone for this question. Discussion was held on the duties of the designated registered agent including assigning this role to an attorney who then is responsible for notifying the department of leadership changes. The department is reviewing all these topics and will provide updates to the associations when available.
A common problem identified across multiple associations is the lack of response from the department when submitting questions to the email addresses identified for various topics. IDPH is going to send a current list of email addresses for providers to the associations and we will post this information when available to ensure everyone has the correct email addresses.
Another hot topic discussed was the staffing fines that will be issued based on the first quarter of 2025. The department will begin working on the fines and issuing notices in June. The department indicated that the current submission process with the smart sheets is working including receiving RN waiver requests and unforeseen circumstance notifications. Providers should receive a read receipt when information is submitted using this method.
LeadingAge Illinois also asked for an update on the assisted living advisory committee. The department indicated they are nearing the finish line of the project. In addition, members expressed concerns regarding the perception that the department is using the survey cycles to maximize enforcement action against providers. The department asked for additional details, which will be provided without identifying the providers specifically expressing this concern and reiterated that they are not purposefully extending the survey cycles. LeadingAge Illinois will continue to work with the department on this as necessary.
HHS Secretary Eliminates Public Comment Process on Certain Rules and Regulations
On Monday, March 3, the Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr published a policy statement in the Federal Register eliminating the public comment process on rules and regulations. According to the policy statement, the Administrative Procedure Act (APA) establishes procedures for issuing rules and regulations including that an agency is generally required to publish a notice of proposed rulemaking, give interested parties the opportunity to participate in the process by submitting written data, views or arguments, and then publish a final rule that is accompanied by a statement of the rule’s basis and purpose. However, the APA exempts “matter(s) relating to agency management, personnel, public property, loans, grants, benefits, or contracts”. In addition, the APA permits agencies to forgo these requirements for “good cause” when the agency finds that the procedures are “impracticable, unnecessary, or contrary to public interest”.
In 1971, the Department adopted a policy that waived the APA’s statutory exemption from procedural rulemaking requirements for rules and regulations relating to public property, loans, grants, benefits, or contracts (Richardson Waiver). The Richardson Waiver required the Department to use the notice and comment rulemaking procedures for these types of matters and instructed the good cause exception to be used “sparingly”.
In the policy statement published on March 3, the Secretary is rescinding the Richardson Waiver based on the APA, citing that the “extra-statutory obligations of the Richardson Waiver impose costs on the Department and the public, are contrary to the efficient operation of the Department, and will impede the Department’s flexibility to adapt quickly to legal and policy mandates”. Therefore, effective immediately, agencies and offices of the Department will have discretion to apply notice and comment procedures to these matters but are not required to do so, except as required by law. Additionally, the good cause exception will be used in appropriate circumstances in accordance with the APA.
LeadingAge quickly responded to the policy statement on February 28 and will continue to advocate on behalf of members and the older adults served in member communities.
New Emergency Preparedness and Life Safety Code HelpDesk Emails for CMS
The Centers for Medicare & Medicaid Services (CMS) shared two new HelpDesk emails for providers with questions about Life Safety Code and Emergency Preparedness issues. General questions can be sent to EP-LSC@cms.hhs.gov. Non-deemed providers with questions regarding the Fire Safety Evaluation System (FSES) or waivers can email LSC-Waiver-FSES@cms.hhs.gov.
Provider Five Star Reports are Now Available on LeadingAge’s Website
In partnership with LeadingAge New York, LeadingAge has a new Report Portal for members to access their most recent CMS Five Star Reports. The great news is that it now includes additional levels of care. Providers can use this portal to:
- Implement quality improvement activities,
- Identify strengths and weaknesses for staff training,
- Improve star ratings,
- Provide governance boards with data driven comparisons on performance,
- Bolster payer/provider negotiations.
LeadingAge Illinois will continue sending quarterly nursing home reports to members directly but now you can access your data at any time!
CDC Issues Food Safety Alert on Nutritional Supplements Causing Listeria Infection
On February 24, the Centers for Disease Control & Prevention (CDC) issued a Food Safety Alert along with the Food and Drug Administration (FDA) as they are investigating a multistate outbreak of Listeria infections linked to supplement shakes that are distributed in institutional care settings. According to the map included on the website, the majority of the sick individuals appear to be in Texas, however, there are several in the Midwest including Minnesota, Illinois, Indiana, and Missouri. The recalled products include Lyons Magnus LLC frozen supplement shakes including Sysco Imperial and Lyons ReadyCare.
What you should do:
- Check any nutritional supplement products you have for the recalled brands. If you have any, throw them away or return them to the food vendor as directed.
- Clean refrigerators, containers, and surfaces that the supplements may have touched as Listeria can survive in refrigerators and easily spread to other foods and surfaces.
- If anyone has consumed any of the recalled products, monitor for symptoms including headache, stiff neck, confusion, loss of balance, convulsions, fever, muscle aches, and tiredness.
- Listeria can be especially harmful in pregnant women including pregnancy loss or premature birth along with serious illness or death in newborns.
- Symptoms of Listeria usually present within two weeks; however, they may start as early as the same day of consumption up to 10 weeks after.
Additional resources are linked here for Listeria (CDC) and the FDA investigation.
The Healthcare Associated Infection team is hosting upcoming webinar events for long-term and congregational care settings:
- 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.
- March 19 from 1 – 2 p.m. Identifying and Reporting Abuse
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.
Supportive Living Program Rates Effective January 1, 2025
Updated Nursing Facility Estimated Quality Incentive Payments Listing and Rates
LeadingAge Asks CMS to Delay Appendix PP Revision Effective Date
In a letter to the Centers for Medicare & Medicaid Services (CMS) on February 26, LeadingAge requested a delay in implementation of Appendix PP Surveyor Guidance for Long-Term Care Providers. CMS released significant revisions to the guidance in November 2024, with an effective date of February 2025. In January 2025, a revision to the memo delayed the effective date to March 24, 2025. However, the Trump Administration’s pause on external communications from federal agencies including CMS has prevented them from holding any public forums or communications to review changes, answer questions, or provide clarification. LeadingAge is advocating that the effective date of the guidance be delayed until after the communications pause is lifted for a period that is equal to the amount of time lost due to the pause.
IDPH Issues Memo on Updated XDRO Website
The Illinois Department of Public Health (IDPH) released a memorandum on February 20, 2025, to notify providers of changes to the Extensively Drug-Resistant Organism (XDRO) Registry. The updated website is now https://xdro.dph.illinois.gov for access to existing resources, training videos, and information on reporting requirements. You can access the XDRO Registry by using the new IDPH web portal address at https://partners.dph.illinois.gov.
Skilled nursing and intermediate care providers are required to query new admissions to the XDRO registry. If you do not already have access, you must register here: https://portalhome.dph.illinois.gov. In addition, IDPH will present on the XDRO Registry as part of the ongoing Infection Prevention and Control Updates and Q&A on Friday March 7, from 1-2 p.m. You can register for the education here.
If you have any questions please email DPH.XDROregistry@illinois.gov.
Upcoming Center of Excellence for Behavioral Health Training
There are several upcoming trainings hosted by the Center of Excellence for Behavioral Health which are free for nursing home providers.
- Question, Persuade, Refer (QPR) Suicide Prevention Training on March 13 from 1 – 2:30 p.m. CT.
- Person-Centered Care in Nursing Facilities: How to Make it Work on March 11 from 1-2 p.m. CT
- An Overview of Bipolar Disorders for Nursing Facility Staff on March 18, 1 – 1:30 p.m. CT.
- Addiction 101 – What It Is and What It Isn’t on March 20 from 1-2 p.m. CT
- Changing Behaviors from a Rolling Boil to a Simmer: De-Escalation Strategies to Defuse Difficult Situations on March 25 from 1 – 2 p.m. CT
- Mental Health First Aid (MHFA) on March 28 from 10 a.m. – 3:30 p.m. CT (Registration is limited, please only register if you can attend and complete additional work outside of the live session).
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.
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.
Elevate Your Nonprofit’s Success with UST’s Innovative Workforce Solutions
Discover an Exclusive UST Workforce Solutions Member Benefit Offering
UST Workforce Solutions has partnered with leading nonprofit associations across the country for over 40 years to provide members a wide variety of cost-saving HR, unemployment and workforce solutions designed to meet the unique needs of nonprofit organizations.
UST will be hosting a short webinar—offered on several dates—highlighting the exclusive benefits available to our members through our longtime partnership. Register today to learn more about a little-known tax exemption available exclusively to 501c3 nonprofits and discover how you can streamline HR processes, ensure compliance, and create operational efficiencies—all while mitigating risk and unnecessary expenses.
Register to learn how you can:
- Save money on unemployment expenses
- Effectively manage unemployment claims, protests, and hearings
- Access HR resources that help to improve efficiencies and productivity
- Partner with UST to address your nonprofit’s unique needs
Whether your primary focus is to ensure compliance, keep your employees engaged, better manage unemployment claims, or have more control over your unemployment costs, this webinar will provide expert insights and invaluable resources for addressing your current needs.
Don’t miss this opportunity to join us for a fresh look at the benefits UST offers our members. Can’t attend any of the dates offered? Register anyway, and you’ll receive a recording of the session to watch at your convenience.
To Register, Click Here: https://www2.chooseust.org/2025/affinity-uws-webinar
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: How many on duty staff are we required to have that are CPR certified?
A: The Federal regulations for nursing homes do not require a certain number, but that there are sufficient quantities. However, the Illinois codes are different.
The assisted living and sheltered housing code requires that at least one direct care staff must be on duty. The CPR training must be specific to adults and include a demonstration of CPR with current certification.
The nursing home code requires that if you staff two or more individuals at a time, that two staff must be certified to perform CPR. However, if you only have one staff member on duty, that person must be certified in CPR. The nursing home code is not specific to roles (such as “direct care” must fulfill this requirement).
Have a question? Email yours now.