LeadingAge Illinois eNews

The Lead May 29, 2025

From the Desk of Angela Schnepf, President and CEO
SNF Staffing Ratio Census Reports Due June 1
LeadingAge Illinois Holds Press Conference at Capitol Opposing Bed Tax Proposal
Help Drive Future Regulatory Changes
CMS Releases 2025 SSI and Spousal Impoverishment Standards
LeadingAge State Partners Advocate on CMP Reinvestment Program
LeadingAge Highlights Medicare Advantage, PACE Concerns in Comments to Department of Justice
What You Need to Know About Measles
Monthly IDPH Meeting
LPC Webinar: How States’ Statuses Impact Financial Solvency
Upcoming IDPH Webinars
SNF Regulatory Review – F566 – Residents Providing Services for the Nursing Home
Upcoming COE-NF Behavioral Health Training
CMS Releases Draft MDS Item Sets 1.20.1v3-Section_R_Removed
CMS Releases HOPE Manual Version 1.01
Home Health Members Can Now Access the LeadingAge Report Portal
Ask the Expert

From the Desk of Angela Schnepf, President and CEO

With about 72 hours left in the legislative session, we urgently need your voice to help stop SB1606/HB2858—a proposal that would impose a new bed tax on nursing homes. This tax is intended to raise $70 million, matched by state general revenue funds, but it would result in significant financial losses for our members, who are the most quality homes in the state.

Our legislative team has been at the Capitol day and night this week advocating for members. We need your help in the final stretch.

We strongly oppose this proposal—and we need YOU to join the fight.

Here’s why rejecting the bed tax is critical:

  • Our sector is under pressure. Long-term care providers are still recovering from the pandemic, facing skyrocketing inflation and staffing costs that continue to outpace funding.
  • It penalizes progress. Providers that have invested in quality care and staffing under the new rate reform model will bear the brunt of this tax—discouraging improvement and innovation.
  • It ignores core funding principles. Sustainable funding must be based on resident needs and outcomes—not on broad-based taxes that punish commitment and performance.

Take Action Today: Call Your State Representative and Senator. Don’t know who your legislators are? Click here to find out (enter your address).

Contact them at both their Springfield and district offices and urge them to say NO on the nursing home bed tax proposal.

If you have any questions or need help reaching out to your legislators, contact Jason Speaks.

 

Kindest Regards,

Angela

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SNF Staffing Ratio Census Reports Due June 1

Census data for the 2nd quarter (January 1 – March 31, 2025) is due to IDPH no later than the close of business on June 1, 2025.

Census data must be submitted to the Department on the attached Excel spreadsheet and sent to DPH.LTCDailyCensus@illinois.gov.

Failure to submit a required daily census report by the close of business on June 1, 2025, will result in the Department calculating staffing requirements utilizing the facility’s number of licensed beds and the skilled direct care staffing ratio.

Questions and technical difficulties may be directed to DPH.LTCDailyCensus@illinois.gov.

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LeadingAge Illinois Holds Press Conference at Capitol Opposing Bed Tax Proposal

Jason Speaks, director of government relations at LeadingAge Illinois and Matt Feucht, CEO of Apostolic Christian Skylines in Peoria were joined by State Representative Yolonda Morris at a LeadingAge Illinois Press Conference held last week at the State Capitol. The purpose of the event was to detail our opposition to a proposed new bed tax for nursing homes.

“Increasing the bed tax on nursing homes places an unfair burden on facilities that are already working tirelessly to provide compassionate, high-quality care to our most vulnerable citizens,” said Feucht. “Instead of penalizing providers, we should be finding sustainable ways to support long-term care that honors our seniors with dignity and respect.”

“We strongly, adamantly oppose this, hard stop”, added Speaks. “It unfairly places the burden on high-performing providers, while allowing underperforming facilities to benefit without meaningful change.”

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Help Drive Future Regulatory Changes

For many years, long-term care providers (including HCBS services such as Home Health) have felt that the industry is one of the most regulated sectors. While we are caring for individuals, which is a special service that all of us take very seriously, there are many duplicative regulations and requirements at we question the intention and necessity to follow.

President Trump’s “Unleashing Prosperity Through Deregulation” Executive Order is the perfect time for you to personally advocate on our own experiences and help shape the practices for tomorrow. There are currently several opportunities for you to comment on along with resources from LeadingAge Iowa and LeadingAge to support you in developing your own comments. Now is the time to make an impact and leave your mark on the industry that you know and love!

Department of Health and Human Services – HHS seeks input from all interested parties on how to dramatically deregulate across all areas the Department touches. HHS also welcomes other submissions explaining how regulations, guidance, paperwork requirements, and other regulatory obligations can be repealed. Comments must be received no later than 10:59 p.m. CT on July 14, 2025. Reference Docket ID – AHRQ-2025-001

Centers for Medicare & Medicaid Services – CMS seeks input on approaches and opportunities to streamline regulations and reduce administrative burdens on providers, suppliers, beneficiaries, Medicare Advantage, Part D plans, and other stakeholders who have interest in the Medicare program. Comments can be submitted on the RFI website and LeadingAge Illinois/Iowa developed a toolkit for anyone to use to help comment. The RFI does not indicate a deadline to submit comments, but we are urging everyone to submit comments no later than June 10, which is consistent with comments on the SNF PPS Proposed Rule comment period.

If you have any questions on submitting comments for these RFI’s please reach out to Kellie Van Ree.

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CMS Releases 2025 SSI and Spousal Impoverishment Standards

On May 28, the Centers for Medicare and Medicaid Services (CMS) released the 2025 Supplemental Security Income (SSI) and Spousal Impoverishment Standards. This guideline serves as a informational purposes only as it provides information to the States as they determine Medicaid financial eligibility rules that apply when married individuals seek coverage of certain long-term services and supports.

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LeadingAge State Partners Advocate on CMP Reinvestment Program

LeadingAge state affiliates jointly sent a letter to the Centers for Medicare & Medicaid Services (CMS) on May 8, advocating for changes to the Civil Monetary Penalty Reinvestment Program (CMPRP). In 2023, CMS issued new guidelines for the program, including caps on spending and a lengthy list of non-allowable expenses. CMS stated that these changes were to ensure equity within the program, citing examples such as individual quality innovation programs being funded at vastly different levels in different states and large amounts of CMP funds being spent to fund virtual reality and other advanced technologies in individual nursing homes when other nursing homes within the same state did not even have electronic health records. In December 2024, CMS relocated the role of application reviews and approvals from CMS regional offices to the federal level to streamline workflows and further ensure equity among the use of program funds. LeadingAge state affiliates expressed to CMS concern over these program policies, explaining how they present barriers that stifle innovation and impede improvements in care, and urging CMS to remove funding restrictions and return fund management and grant processes back to states. Read the letter from LeadingAge state affiliates, including LeadingAge Illinois/Iowa CEO Angela Schnepf here.

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LeadingAge Highlights Medicare Advantage, PACE Concerns in Comments to Department of Justice

On May 27, LeadingAge submitted comments to the United States Department of Justice (DOJ) Antitrust Division, responding to a request for information from the Department’s Anticompetitive Regulations Task Force concerning barriers to competition and impacts on businesses and consumers. The letter emphasized the risks and challenges that the market dominance and operational practices of national Medicare Advantage plans are posing for providers and Medicare beneficiaries and offered policy recommendations to address these issues. LeadingAge also addressed regulatory barriers impacting Programs for All Inclusive Care for the Elderly organizations (PACE) and encouraged the DOJ to issue updated antitrust guidance relating to collaboration and partnership among healthcare and aging services providers. You can read the LeadingAge letter to the DOJ here.

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What You Need to Know About Measles

According to the Centers for Disease Control & Prevention (CDC), the number of measles cases has increased in the last few months. CDC attributes this to a lower number of kindergarteners being vaccinated (below the 95% threshold). Additionally, global measles activity is increasing, which places unvaccinated individuals at a higher risk of contracting the virus. However, the number of breakthrough infections (those with the virus who are fully vaccinated which is approximately 5%) is consistent with previous years. The CDC has several resources available on the Measles Cases and Outbreaks website and the Interim Infection Prevention and Control Recommendations for Measles in Healthcare Settings.

What do you need to know?

Prevention:

Evaluate residents for vaccination and discuss vaccination if they have not been previously vaccinated. We know that communal living settings are always at higher risks for outbreaks of any illness, so prevention is the key! You can read more about Measles Vaccination here. Vaccination for Measles is typically achieved using the Measles, Mumps, and Rubella vaccination, however, younger individuals may have the Measles, Mumps, Rubella, and Varicella vaccine instead. Two doses of a combination of the vaccine is considered up to date, unless the physician recommends additional doses based on individual circumstances.

Symptoms:

Symptoms usually present 7-14 days after contact with the virus and include:

  • High fever
  • Cough
  • Runny nose
  • Red, watery eyes.

2-3 days after initial symptoms begin, infected individuals will develop Koplik spots which are tiny white spots inside the mouth.

3-5 days after symptoms begin, individuals will develop a measles rash which starts as flat red spots that appear on the face and hairline and then spread downward to the neck, trunk, arms, legs and feet. When the rash appears, the person’s fever may spike to more than 104 degrees.

Complications:

Common complications include ear infections and diarrhea. Severe complications can include hospitalization, pneumonia, encephalitis (swelling of the brain), and death. Individuals who are pregnant and contract measles may experience a premature birth or have a low-birth-weight baby.

Diagnosis:

Healthcare providers who suspect measles should immediately notify their local public health department and arrange for testing.

Isolation:

Anyone suspected of having measles should be placed in airborne precautions until 4 days after they develop a rash.

You can read more about treatment of measles here.

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Monthly IDPH Meeting

LeadingAge Illinois staff met with the Illinois Department of Public Health (IDPH) on May 22, 2025, and IDPH provided the following updates.

The LLCS Portal incoming emails have been cleared up by the department staff. If you are having issues with the LLCS portal, please email them using the DPH.LLCS@illinois.gov email address. Additionally, IDPH reports that they are in the process of training a couple staff to provide assistance over the phone as another option for providers to receive answers and assistance to portal questions.

If you have submitted questions and have not received an answer via email, please resend the email. You can always email Jason or Kellie at LeadingAge Illinois for assistance with communication to IDPH.

Finally, IDPH is in the process of updating the regions across the state. Currently, they are not providing a timeline of when the process will be completed but hope to know more at our next meeting in June.

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LPC Webinar: How States’ Statuses Impact Financial Solvency

Join LeadingAge and an expert panel for a nuanced and provocative discussion on States’ statuses that govern the financial management of Life Plan Communities (LPC), and how those statutes and current legislative activities together can drive the financial success or failure of a LPC. The webinar is scheduled for Wednesday, June 4, 1 – 2:30 p.m. CT and will feature Bethany Ghassemi (Chief Legal Officer, Human Good), Brian Lawrence (CEO, FellowshipLife) AV Powell (AV Powell & Associates), and Jaime Roberts (CEO, Arizona LeadingAge). LeadingAge’s Dee Pekruhn will lead the presentation and facilitate the discussion. To learn more and register, visit the LeadingAge LearningHub.

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Upcoming IDPH Webinars

The Illinois Department of Public Health announced the following upcoming webinars. Registration is required and attendance is limited. If you’re unable to attend, email Michael.moore@illinois.gov as the webinar will be recorded and can be distributed following the event.

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SNF Regulatory Review – F566 – Residents Providing Services for the Nursing Home

F566 includes that residents have the right to choose or refuse to perform services in the nursing home. The nursing home must not require the resident to perform services as part of admission or ongoing residency. If the resident chooses to perform services, the nursing home must ensure that:

  • They documented the resident’s need or desire to perform work in the care plan.
  • The care plan includes the nature of services performed, whether the service is voluntary or paid, and that the resident agrees to the arrangement.
  • If the resident receives compensation for the services, the rates must be at or above prevailing rates.

As an administrator there are a couple times that I recall this being used including when a resident expressed a desire to help fold laundry as this was something they enjoyed. For infection control purposes we had the resident fold items that were appropriate such as rags used in the kitchen for cleaning that were placed in sanitizer buckets. The other example was a resident that was younger and required to perform at least one hour of service for compensation to maintain Medicaid eligibility. In both examples, we ensured that the above information was clearly outlined in their care plan and when providing compensation we maintained documentation of the compensation amounts in the resident’s file.

In Illinois, the Skilled Nursing Code (Section 300.1430) outlines resident work programs and has fairly strict guidelines outlined below.

  • The program is only allowed if they are oriented toward adjustment and therapeutic benefits and must be approved in writing by the department.
  • When seeking approval, the program must be provided to the Department in a written format and indicate the program objectives, possible work assignment, duties, policies, agency involvement and supervision.
  • Residents shall only be included if they meet the Department’s requirements for persons functioning in this position and cannot be used to replace employed staff.
  • Documentation shall include appropriateness of the program for the individual resident, their response to the program and any other pertinent observations and placed in the residents record.
  • Additionally, these programs must be in compliance with the State and Federal Departments of Labor.

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Upcoming COE-NF Behavioral Health Training

The Center of Excellence for Behavioral Health in Nursing (COE-NF) has the following FREE trainings upcoming:

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CMS Releases Draft MDS Item Sets 1.20.1v3-Section_R_Removed

The Centers for Medicare & Medicaid Services (CMS) announced Friday, May 23, that the draft Minimum Data Set (MDS) 3.0 Item Sets version (v) 1.20.1v3-Section_R_Removed and Item Matrix are now available in the Downloads Section on the CMS Resident Assessment Instrument (RAI) website. This version of the MDS does not include items R0310, R0320, R0330 and replaces item R0340 with item A1255. The final MDS items sets v1.20.1 will be posted later in the summer, depending on the Skilled Nursing Facility (SNF) Prospective Payment Status (PPS) rulemaking. The proposed SNF PPS rule for FY 2025 can be located here.

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CMS Releases HOPE Manual Version 1.01

The Centers for Medicare & Medicaid Services (CMS) released an updated Hospice Outcomes and Patient Evaluation (HOPE) Guidance Manual and accompanying Change Table. There are a number of clarifications on HOPE Update Visits (HUV) and Symptom Follow Up Visits (SFV) which are not conducted within the expected timelines. One item was replaced, A0800 Gender items for A0810 Sex item, which is consistent with other post-acute settings.

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Home Health Members Can Now Access the LeadingAge Report Portal

The LeadingAge Report Portal Tool which was developed in collaboration between LeadingAge and state partner LeadingAge New York, home health members can now easily access valuable data from the Centers for Medicare and Medicaid Services (CMS) to help assess quality improvement needs and inform strategic decision-making. Updated quarterly, this new report will display each of the home health publicly reported quality measures and compare the provider’s rates to other benchmark rates. Additionally, labeling will help providers navigate which measures are OASIS-based or Claims-based and ether they are used in the Home Health Quality Reporting Program (QRP), Value Based Purchasing (VBP), or the Quality of Patient Care Star Rating.

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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: What signs are required in the building if there is electronic monitoring in use by a resident or their family? 

A: The Authorized Electronic Monitoring in Long-Term Care Facilities Act indicates that signage must be placed at all building entrances that are accessible to visitors. The signage must be titled “Electronic Monitoring” and state “The rooms of some residents may be monitored electronically by or on behalf of the residents.”

Additionally, each resident that has an electronic monitoring device must have a sign on their door that states “This room is electronically monitored”.

The act does not indicate the size of the sign or the font size; however, states that it must be “in large easy-to-read type”.

Have a question? Email yours now.

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