The Lead September 17, 2020 - LeadingAge Illinois

Life Plan Communities/CCRC:
Member Spotlight: Meridian Village

Nursing and Rehabilitation:
Training with BD Experts on Veritor Plus COVID-19 Testing
Training with Quidel Experts on Sofia COVID-19 Testing
Infection Commission Report Released
Free Telligen Nursing Home Training

Assisted Living:
LeadingAge Illinois Sends Letter to Illinois U.S. Senators on Prioritizing Senior Living in COVID-19 Legislation
Argentum Sends Letter to HHS with COVID-19 Recommendations
Argentum Announces New Senior Vice President of Public Affairs

Supportive Living:
MCO Notifications

Independent Affordable/Subsidized Housing:
LeadingAge Illinois HUD Member Regional Monthly Meetings

Home and Community-based Services:
Private Duty Home Care Symposium Speaker Proposals Due September 18

Other:
LeadingAge Voting Plan Toolkit and Civic Action Center
Lutheran Life Communities Names New CEO

Top Stories:

CMS Issues Visitation MemoLate yesterday, CMS issued revised Visitation Guidance. The memo, effective immediately, will allow indoor visitation to begin. Visitation can be conducted through different means based on a facility’s structure and residents’ needs. The guidance requires screening of all who enter the community, but it does not require testing. Visitation is based on county positivity rates. The memo authorizes the use of CMP funds to help support in-person visits. A maximum of $3,000 per nursing home may be used for tents and clear dividers. We are reviewing and analyzing the memo as well as seeking information from the Illinois Department of Public Health (IDPH) on how the guidance will be applied in Illinois.

CMS National Stakeholder Call Today Monday
This week, the Centers for Medicare & Medicaid Services (CMS) received the final report from the independent Coronavirus Commission for Safety and Quality in Nursing Homes (Commission), which was facilitated by MITRE. CMS also released an overview of the robust public health actions the agency has taken to date to combat the spread of the coronavirus disease 2019 (COVID-19) in nursing homes.

The Commission’s findings align with the actions the Trump Administration and CMS have taken to contain the spread of the virus and to safeguard nursing home residents from the ongoing threat of the COVID-19 pandemic. This announcement delivers on the Administration’s commitments to keeping nursing home residents safe and to transparency for the American people in the face of this unprecedented pandemic.

CMS Chief Medical Officer Lee Fleisher, MD and agency officials will hold a National Stakeholder Call with Nursing Homes to discuss the announcement, Monday, September 21 from 1:00 – 1:30 p.m. CST.

Toll Free Dial-In Number: 833.614.0820
Conference ID: 7883929

Conference lines are limited, so we encourage you to join via webcast.

HFS Issues Notice of First Round Distribution of CARES Act Funds
We have a few updates today on the federal provider relief funds.

HHS extended the deadline for private-pay only assisted living and nursing homes to submit their applications to September 21 at close of business, which typically has meant 10:59 p.m. CST. The only task these providers need to accomplish by the deadline is to submit their tax identification number for validation. LeadingAge has an article on this topic that includes supporting resources for members who are applying as part of this phase.

For those members who have applied, payments are going out every day and HHS is still approving TINs. You should not panic if you have not received a communication yet that your TIN has validated. Once approved, you will receive a DocuSign email with steps for completing the application process. You might want to check your junk mail file just to make sure the email wasn’t redirected.

HHS confirmed that there will be a third tranche of funds for “clean up.” It is not clear if this will be an application or an automatic distribution yet. More likely, an application process. Once we know more, we will share the information about that process in The Lead. We do not know how much money is left in the fund to be distributed but do not expect it to be much. This may be the last round of distributions unless Congress appropriates more in a future Stimulus bill. Private pay members who have not yet applied or accessed Provider Relief Funds can provide their information to Nicole Fallon at LeadingAge who will provide it to HHS to facilitate the TIN validation process for this third tranche

Finally, LeadingAge is still waiting for more information to drop from HHS on the details of the SNF infection control incentive payments and the details on how performance scores will be calculated, eligibility for the payments (e.g. performance benchmarks), and how much will be distributed each month. HHS was finalizing these details late last week and over the weekend. LeadingAge provided input and expect those final details to be shared soon.

Provider Relief Fund Update
The deadline for private pay-only licensed assisted living providers and nursing homes to apply for Provider Relief Funds has been extended to Monday, September 21 by close of business day (typically, this has meant 10:59 p CST). Learn more about the extension.

Antigen Testing and False Positives
As you may know, LeadingAge and the American Health Care Association (AHCA) conducted a survey this week to gauge the degree to which false positive test results are occurring with the BD Veritor (and the Quidel Sofia). With over 1,000 respondents nationwide, it looks like the number of false positives, which is the same with BD and Quidel, is about what would be expected with antigen tests, which are 98-99% accurate.

The problems came quickly to the fore because: (a) the CMS rule took effect September 2; and (b) the antigen machines were distributed to nursing homes – so there was a lot of testing done. LeadingAge learned that:

About 85% of nursing homes in the sample received a BD and 15% a Quidel analyzer.
About 90,000 tests have been conducted so far with these machines.
With 98% specificity, 1,800 false positives would be expected; that’s almost exactly the number reported on the survey, for both machines. The numbers are consistent with large volume testing. Any provider experiencing one or two false positives falls within this expected range.
There remains concern about providers who report clusters of false positives. BD is investigating these instances. So far, it appears that the providers are conducting the tests correctly. LeadingAge hopes to know more very soon.
51% of those with BD analyzers expect to run out of testing supplies within the next 1-2 days, 26% within 3 days, and 25% in more than 3 days; all have been told there will be a wait for additional test kits.
The wait for Quidel test kits is not as onerous because there are fewer of the machines, thus less demand.

We encourage members to use the antigen machines HHS provided and to maintain a varied testing program, rather than relying on one type of testing (antigen machines and Abbott BinaxNOW cards, PCR).

Most important, LeadingAge is working aggressively with HHS to get written information out to address what to do in the case of false positives, whether from antigen or PCR tests. This includes recommendations for cohorting and isolation; reporting to the state and to the NHSN; not treating a false positive as an outbreak; implications for Provider Relief Fund performance incentive payments.

Admiral Brett Giroir, MD, HHS Assistant Secretary for Health will be on the LeadingAge Coronavirus Update Call on Monday, September 21. Members should send questions to Joe Franco at LeadingAge ahead of time if they would like to try to include them in the interview.

Abbott Sends Invoices By Mistake
LeadingAge National has heard from several assisted living and nursing home members that they had received invoices for Abbott BinaxNOW (Abbott cards) tests. LeadingAge has learned from Abbott that these invoices are a mistake. Do not pay them! HHS is providing the test cards at no cost. Abbott has agreed to conduct a training for LeadingAge members on using the test kits; more information on that once it’s set up. Remember, you must have a CLIA waiver to use these tests; this includes assisted living providers as well as nursing homes.

IDPH Check-In Meeting Recap
Each week, LeadingAge Illinois and the associations meets with the Illinois Department of Public Health (IDPH) on long term care and COVID-19. Yesterday, a number of issues were discussed and we wanted to update you on the discussions.

Cases:
The Department reported that there has been a 95% drop in cases in long term care facilities since the peak in mid-April. Long term care accounts for 2% of Illinois cases currently.

Testing:

For a number of meetings, we have asked about the potential of testing surveyors before they enter facilities for surveys. IDPH is still reviewing this issue internally and the final review and decision will be made soon by IDPH Director Ngozi Ezike.
IDPH reported they have about 150 facilities that have yet to submit their testing plans. If you have not yet submitted yours, the Department encourages you to submit as soon as possible.
Many facilities have CLIA Certificate of Waivers for various tests such as glucose monitoring. IDPH said today that you must update your valid CLIA Certificate of Wavier to include COVID-19 testing.

Reopening Guidance:
IDPH will be issuing amended reopening guidance soon. Dr. Catherine Counard, an IDPH consultant, reported that the final internal meeting on the guidance was held on Thursday and the Governor has been briefed. As soon as we have the new guidance, we will distribute to the membership.

Point-of-Care Testing:
Angela Tang from IDPH will present on this issue in today’s IDPH webinar. She will give a high-level overview. The reporting structure will be outlined in an upcoming IDPH webinar. A SIREN alert will be released soon and we will analyze the information for members.

Rules:
The Department has filed rules on the following:

Renewed the TNA program, effective September 15.
Renewed the use of inactive and out-of-state CNAs and military medics, effective August 24.
Renewed the suspension of the involuntary transfer/discharges for late or non-payment.
Renewed the suspension of CNA training requirements.
Repealed the suspension of annual site visits and licensure surveys, effective September 15.

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Governor’s COVID-19 Briefing Recap
At least once per week, Governor Pritkzer holds a briefing on COVID-19. The briefing this week was held on Wednesday afternoon. LeadingAge Illinois virtually attends each briefing to monitor the state’s response and direction as well as listen for any information pertaining to older adult care and services.

Here is a recap of this week’s briefing:

Testing:
The State continues to complete about 50,000 test results per day. To date, they have completed over 4.8 million tests.

Mitigation:
As we reportedly previously, Region 4 (Bond, Clinton, Madison, Monroe, Randolph, St. Clair, and Washington counties) and Region 7 (Will and Kankakee counties) were two of the first regions to undergo the State’s mitigation measures. The Governor reported Wednesday that Region 7 has brought their positivity rate down to 6.4%. Region 4 has been above the 8% positivity rate since August 11. Their rolling 7-day average has went from 9.6% to 8.9% as of Wednesday. Every region in the state is seeing a stable or declining positivity rate at this time.

State Finances:
The Governor said the state budget in Illinois, like many states, is being hurt by COVID-19. He sent a letter to the Illinois Congressional Delegation, outlining the potentially bleak picture for the Illinois state budget if federal relief does not come through.

On Tuesday, the Governor directed all state agencies to come up with a potential 5% cut of their operating budgets this year and potentially 10% for next year. He also mentioned the potential for state employee layoffs and essential services reductions.

Evictions:
The Governor announced that he is extending the eviction moratorium for another 30 days. The Governor said he will use every legal tool available to keep people in their homes.

Life Plan Communities/CCRC:

Member Spotlight: Meridian Village
Meridian Village, a Lutheran Senior Services (LSS) community, was founded in 1995 in Glen Carbon. The mission-driven, nonprofit CCRC serves 350 older adults. LSS, which has senior living communities in Illinois and Missouri, believes in older adults living life to the fullest. Along with Meridian Village, LSS has communities in Peoria (Lutheran Hillside Village) and Springfield (Concordia Village).

Three years before Meridian Village opened, Colleen Bottens began her career in caring. Even before she entered the industry 28 years ago, she gained valuable experience as a CNA in high school and college. Her current role is executive director at Meridian Village. She is a people person and that is what she enjoys most about her career, working with residents, families and her team members. “It’s never boring,” said Colleen. “No two days are ever the same.”

Colleen has been a leader in LeadingAge Illinois for several years. She is currently the president of the CCRC Cabinet and annually hosts Partners in Quality visits with her legislators to not only educate them on CCRC/Life Plan Communities, but show them firsthand what quality older adult care and services in action looks like. She most recently helped lead a virtual congressional visit where she urged Congress to provide relief for aging services providers to cover additional costs for PPE, cleaning supplies, staffing, and other needs associated with the coronavirus response.

Starting as a CNA and now serving as a community executive director, she understands from experience the climb on the career ladder. She is seeing it currently in two of her direct report leaders who aspire to become executive directors within LSS. “It is such a privilege to watch talented leaders learn and grow their careers,” said Colleen.

Throughout her career, she has watched the industry grow as well as change. LSS has embraced the changes in the industry. Older adults are benefitting from care and services in a full continuum. Colleen has a vision for keeping her organization’s buildings, programs, and services relevant for the next generation of older adults. “I am excited for the future of senior living,” said Colleen.

Nursing and Rehabilitation:

Training with BD Experts on Veritor Plus COVID-19 Testing
Today, (September 18) at 2 p.m. CST, LeadingAge is partnering with BD to host a LeadingAge exclusive training on the BD Veritor System. This free training will provide key info on:

Rapid antigen testing for COVID-19,
How the BD Veritor Plus System works, and
Key information on how to get support from BD on test results and accuracy.

There will be a demonstration from BD staff and then a live Q and A session for members. The second part of the training will be with LeadingAge staff and cover Infection Control and other key topics. Please register for the training here.

Training with Quidel Experts on Sofia COVID-19 Testing
This training is set for Thursday, September 24 at 2 p.m. CST. LeadingAge will partner with Quidel to offer a LeadingAge exclusive training on the Quidel Sofia analyzers. As with the BD Veritor training, Quidel trainers will demonstrate how to use the machine, provide details on batch testing, and answer member questions. LeadingAge staff will answer member questions about the CMS Interim Final Rule and other topics. You can register for the training here.

Infection Commission Report Released
This week, the Coronavirus Commission for the Safety and Quality of Nursing Homes released its final report describing the infection control challenges faced by nursing homes and offering 27 recommendations to address them, each with a series of action steps that can be taken immediately or within the next six months. Notably, most recommendations that involve new spending include some reference to the need for financing to support the action steps.

Concurrently, in response to the report, CMS issued a press release and a comparison of Administration actions and the Commission’s recommendations. The title of the press release summarizes the Administration’s view of how it’s doing: “Independent Nursing Home COVID-19 Commission Findings Validate Unprecedented Federal Response.” Notably, the comparison document talks about new visitation guidance that is forthcoming. This guidance should be out soon.

The Commission’s 25 members represented a wide range of interests, positions and areas of expertise. The well-referenced report addresses challenges, public comments, and recommendations under 10 themes:

testing and screening;
equipment and PPE;
cohorting;
visitation;
communication;
workforce ecosystem- resident safety;
workforce ecosystem – strategic reinforcement;
technical assistance and quality improvement;
facilities; and
nursing home data.

About half the members of the Commission endorsed the report in full, one did not endorse it, and the others endorsed it with reservations.

Free Telligen Nursing Home Training
Telligen is now offering nursing home teams a 30-minute free Root Cause Analysis (RCA) Training every Tuesday. RCA is the first step in understanding the reasons for a problem, near miss or repeating incident before you build a plan to fix the problem. Attendees will gain knowledge and resources that will help mobilize a team into action and start mitigating challenges with lasting success using RCA.

Assisted Living:

LeadingAge Illinois Sends Letter to Illinois U.S. Senators on Prioritizing Senior Living in COVID-19 Legislation
Karen Messer, President & CEO of LeadingAge Illinois sent a letter to U.S. Senators Tammy Duckworth and Richard Durbin on Wednesday, urging the Senators to prioritize senior living in COVID-19 legislation.

Here’s a look at what was in the letter:

“Senior living communities in Illinois are caring for those most vulnerable to COVID-19. Of the more than 35,000 residents in these communities, many require assistance with activities of daily living (ADL), such as eating, dressing, and bathing, which put them in close contact with direct care workers, and nearly half suffer from some type of cognitive impairment. Communities are doing everything they can to care for the residents, but they need more support.

With your help we can and will continue to protect Illinois seniors. Senior living providers are not nursing homes yet they are facing similar and immediate financial pressures. The increased expenses they are facing are unsustainable – from PPE, testing, infection control, and staff support – and the relief they just received represents only 2% of a community’s annual revenue, not nearly enough to meet these increasing demands.

On behalf of LeadingAge Illinois, the state affiliate of Argentum, I am asking you to ensure senior living is prioritized in forthcoming legislation.”

Argentum Sends Letter to HHS with COVID-19 Recommendations
Argentum and the American Senior Housing Association sent a letter to the U.S. Department of Health and Human Services (HHS) on Tuesday recommending the following:

Streamline and expand opportunities for use of the CLIA Certificate of Waiver.
Provide tests for family members of residents.
Provide resources and education for testing administration.
Reimburse senior living communities for ongoing testing and PPE costs.
Provide legal protection for administering COVID-19 tests.

Read the letter here.

Argentum Announces New Senior Vice President of Public Affairs
Argentum announced that Maggie Elehwany, J.D., has joined the association in the newly created role of senior vice president of public affairs. In this role, she will be responsible for leading Argentum’s public policy team and working closely with Argentum’s Public Policy Committee to build upon the association’s government relations efforts and strengthening its public affairs strategy.

“We are delighted to welcome Maggie to Argentum,” said James Balda, Argentum president & CEO. “We believe her leadership and expertise will be vital in elevating awareness of the public policy priorities most critical to the senior living industry’s long-term health.”

Maggie joins Argentum from the National Rural Health Association (NRHA), where she has served since 2007 as vice president, government affairs. At NHRA, she developed and implemented federal policy for the 22,000-member national health care association. Most recently, she successfully advocated for $10 billion in relief funding from the CARES Act for rural providers to assist them with preparedness and financial losses due to COVID-19.

During her extensive career, which has included positions as legislative counsel for Sens. Lisa Murkowski, Frank Murkowski, and Bob Packwood, as well as assistant director of government affairs at the American Medical Association, Maggie has developed extensive familiarity with health care, Medicare, and Medicaid payment policy; health care workforce issues; and health care reform. She has also cultivated close relationships with staffers, lawmakers, and influencers on Capitol Hill among key offices, agencies, and committees.

Maggie received her Juris Doctor degree from the University of Oregon School of Law and her Bachelor of Science degree in journalism from Oregon State University. She is a member of both the Washington State Bar Association and the U.S. Supreme Court Bar Association.

Supportive Living:

MCO Notifications
Kara Helton at the Illinois Department of Healthcare and Family Services (HFS) has indicated that some providers have experienced issues with faxes not going through to MCOs. If you are having any fax issues, you can also e-mail the MCOs at:

Aetna Better Health: ILLTSSCaseManagement@Aetna.com
Blue Cross Blue Shield: ILMMAIICPCareCoordinationManagementTeam@bcbsil.com
CountyCare: countycarewaivers@cookcountyhhs.org
Humana: HumLTSSTransitions@humana.com
lliniCare Health Plan: HCBS@centene.com
Meridian Health Plan: ltss@mhplan.com
Molina HealthCare: LTSSETI@MolinaHealthcare.com
Next Level Health Plan: nlhphcbs@nlhpartners.com

Independent Affordable/Subsidized Housing:

LeadingAge Illinois HUD Member Regional Monthly Meetings
The monthly calls take place every third Thursday at 12 p.m. CST, each month and include members and staff from Illinois, Indiana, Minnesota and Missouri. The calls feature important updates from Linda Couch, vice president of housing policy and Juliana Bilowich, director, housing operations and policy at LeadingAge, Washington, D.C. To RSVP, contact Jason Speaks.

Click here for the slides from this month’s call.

Home and Community-based Services:

Private Duty Home Care Symposium Speaker Proposals Due September 18
Co-sponsored by LeadingAge Illinois, the Illinois HomeCare & Hospice Council, and the Illinois Chapter of the Home Care Association of America, the Private Duty Symposium is one of the industry’s premier events in Illinois. Over 200 home care owners, administrators and clinical staff from across the state attend this educational and networking seminar each year.

The sponsoring organizations are seeking presentations that enable participants to share with and learn from one another. To create a rich, engaging learning experience, sessions should incorporate interactive educational methods, provide replicable hands-on knowledge, and demonstrate measurable outcomes/results. The event will be presented in a virtual format.

We are currently accepting speaker submissions for the 2020 Private Duty Symposium. Applications will be accepted through Friday, September 18, 2020. If you are interested in speaking, submit a proposal here.

Other:

LeadingAge Voting Plan Toolkit and Civic Action Center
LeadingAge has prepared a voting plan toolkit and has a civic action center for members to utilize for the 2020 election.

What’s Your Voting Plan Toolkit:
This year is a major election year and the COVID-19 pandemic has changed the way that voters can access the polls this year. LeadingAge has developed a “What’s Your Voting Plan” toolkit that provides an easy to use self-assessment for both aging services providers and individuals to develop a plan to vote for this year’s election.

Civic Action Center:
LeadingAge has developed an online Civic Action Center that will provide accurate and reliable information about voting and the upcoming election. By visiting the center, members of the public will be able to:

Check their status as a registered voter
Provide tools to register to vote in the voter’s home state
Give access to the forms and deadlines to request a mail-in (absentee) ballot to be submitted through the mail or dropped off at an election collection point
Find out the location of their local polling station
Learn about the candidates running for office in the upcoming election

Many states have started mail-in voting and early voting will be starting soon. Download the LeadingAge “What’s Your Voting Plan” toolkit today and ensure that you have a plan to make your ballot count this election.

Lutheran Life Communities Names New CEO
Lutheran Life Communities has named Sloan Bentley as the new president and CEO, effective September 14. She has worked in the industry for over 30 years and will lead the organization that began prior to the 1900’s. The organization, headquartered in Arlington Heights, has five senior living campuses. Please join LeadingAge Illinois in welcoming Sloan to her new role.