May 1, 2020
Stay Connected - LeadingAge Illinois COVID-19 Resources
Stay up to date on state and federal COVID-19 information and updates by accessing the LeadingAge Illinois COVID-19 Resources page. You can also engage with other Illinois members through our listservs, connecting you with your peers by provider type. We have now added a COVID-19 listserv . Contact LeadingAge Illinois if you’d like more information about the listservs or would like to join one.

TOP STORIES
IDPH Response to Nursing Home Plan for Coronavirus Pandemic
The Illinois Department of Public Health (IDPH) has provided a summary of the State’s response to COVID-19 for nursing homes. 
 
The summary includes:
  • Support for Frontline Workers
  • Testing
  • Personal Protective Equipment (PPE)
  • Staffing
  • Illinois Helps and Serve Illinois
  • Infection Control Guidance
  • Regulations 
Executive Order on Civil Immunity Amended to Include Assisted Living and Supportive Living
LeadingAge Illinois was successful in a request to the Governor’s office to amend an April 1 Executive Order exempting health care workers from Civil Liability unless such Acts would demonstrate willful or wanton misconduct. The initial order included only nursing homes. 
 
However, LeadingAge Illinois met with the Illinois Department of Public Health (IDPH) and the Governor’s team and requested adding Assisted Living, Supportive Living to the order. 

The example used to the Department and Governor’s staff of why we need this is that IDPH just issued guidance for congregate communities recommending universal masking. Given the shortage of PPE’s right now, many facilities will run out and plaintiff’s lawyers will jump on this “failure” as a basis for liability under this extreme health care crisis.
 
The order has now been amended to include Assisted Living and Supportive Living.  
CMS Releases the Interim Final Rule
On April 30, CMS released the Interim Final Rule (IFR) that includes reporting requirements for the SNF Quality Reporting. It will likely be published in the Federal Register in the next day or two; provisions of the IFR have different effective dates. The rule establishes explicit reporting requirements for SNFs to report information on COVID-19 cases among residents and staff.
 
The reporting requirements are effective the date the IFR is published in the Federal Register. The reporting must include: suspected and confirmed COVID-19 infections among residents and staff; total COVID-19 deaths among residents and staff; PPE and hand hygiene supplies in the facility; ventilator capacity and supply; resident beds and census; access to COVID-19 testing in the facility; and staffing shortages. The information will be submitted no less than weekly through the CDC National Healthcare Safety Network. The rule includes many other provisions related to home health, DME, and quality reporting. Participation in the COVID-19 Module for LTCFs requires facilities to be actively enrolled in National Healthcare Safety Network (NHSN).
 
LTCFs that are currently enrolled in NHSN’s LTCF Component have immediate access to the new module and may begin reporting. If your facility previously enrolled, but is no longer able to gain access, contact NHSN user support for assistance. Please do not re-enroll a previously enrolled facility. A facility should only enroll into NHSN once.
 
LTCFs that are not enrolled in NHSN may gain access to the COVID-19 Module by completing the enrollment steps .
 
CDC offered free training this week and will repeat on May 4 & 5. The sessions were recorded. Check out the CDC website for details.
Updated COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers
On April 30, CMS released an updated list of blanket waivers . The latest updates pertaining to skilled nursing include updates to QAPI, in-service training for CNAs, detailed information sharing for discharge planning for LTC facilities, clinical records, physical environment for multiple providers/suppliers and flexibility for telehealth.
N95 Mask Decontamination Service
Governor Pritzker announced on Wednesday the State has acquired a new decontamination system for N95 masks. The equipment was acquired to stretch Personal Protective Equipment (PPE) further. The service is based in Waukegan and is free with a 24-hour turn around.  Up to 20 times, an N95 masks can be cleaned and sanitized. The Illinois Emergency Management Agency (IEMA) has submitted instructions to local health departments and long term care facilities can take advantage of this fast and free service. Contact David Giles at 614.424.5612 to receive an account number. Masks are dropped off with this account number and identified for pick up with the same. 
IDPH Issues Updated Guidance on Communicating About COVID-19
Updated guidance from the Illinois Department of Public Health (IDPH) addresses notification procedures by long-term care facilities to residents, residents’ family, guardians, or emergency contacts, and to staff members, when a resident or a staff member is diagnosed with COVID-19. The guidance also addresses notification to a resident’s family, guardian, or emergency contact when that resident has died from COVID-19.
LeadingAge CEO Attends White House Event
Katie Smith Sloan, President and CEO of LeadingAge, was at the White House yesterday for a small, invitational event on Protecting America’s Seniors. In President Trump’s remarks, he reviewed key provisions of the CARES Act affecting older people and the programs that serve them. 
 
He referred to nursing homes as a “weak spot….where things are happening that we are not happy about.” Seema Verma of CMS announced the creation of the Commission for Safety and Quality in Nursing Homes, to prepare for the “Reopening of America.” Further, she emphasized the quality and reporting oversight measures, and specifically the new reporting requirements to CDC.
 
It was announced that FEMA will send Personal Protective Equipment “Care Packages” to every Medicare/ Medicaid licensed nursing home in the country (15,400 Skilled Nursing Facilities). These include:
  • Initially, a seven (7) day supply of masks, gowns, gloves. Amounts determined by each SNFs average census, staffing ratios, and burn rates.

  • SNFs in high density areas will be prioritized: New York, New Jersey, Chicago.

  • A second seven (7) day supply will arrive within 60 days;

  • All SNFs will receive their two shipments by or before July 4, 2020.
STATE
COVID-19 Updates and Q&A Webinars for Long-Term Care and Congregate Residential Settings
The Illinois Department of Public Health (IDPH) is hosting webinars to provide COVID-19 updates and answer questions from long-term care and congregate residential settings.
 
To register, click on dates below:
 
 
 
 
 
Webinar attendance is limited. If you cannot register or get in, email Michael Moore .
IDPH will be recording the webinars and sending out the links of the recordings.
SLP Temporary Absence Days
Kara Helton with the Illinois Department of Healthcare and Family Services (HFS) is requesting that Supportive Living providers give her a count of residents who have chosen to stay with family/friends during the COVID-19 emergency or who are experiencing extended hospitalizations (even if not related to COVID-19) who are/were utilizing paid temporary absence days. She would like a separate count for both of these groups, meaning a count of those with family/friends and a count of those in the hospital. 
New Workers’ Compensation Rule Repealed
A Sangamon County judge recently issued a temporary restraining order that blocked an Illinois Workers' Compensation Commission rule that granted benefits to essential employees who contract COVID-19; presuming they got it due to working. After the ruling, which was the result of a lawsuit, the Commission unanimously voted to repeal the rule.  
Governor Pritzker Daily Press Conferences
Governor JB Pritzker is conducting daily press 2:30 p.m. conferences on COVID-19. Click here to listen daily.

Yesterday's medical update included:

Cases:
  • 2,563 new cases (52,918 total)
  • 141 new deaths (2,355 total)
 
Hospitalizations:
  • 4,953
  • 1,289 in ICU
  • 785 on ventilators
SIREN Notifications
To get the most up-to-date guidance from the State of Illinois, you can register to receive SIREN - State of Illinois Rapid Electronic Notifications .  SIREN provides regional, State and Federal partners with a comprehensive information sharing, collaboration, alerting and notification solution. If you have difficulties registering please contact SIREN .
Source: SIREN
FEDERAL
CMS Adds New Coverage Requirements to MA Plans Under COVID-19
An April 21 CMS memorandum to Medicare Advantage Organizations(MAOs) amends prior guidance and establishes new requirements and temporary flexibilities during the COVID-19 national emergency, which include coverage for COVID-19 testing and test-related services and for Medicare services received from out of network providers.
 
Specifically, for tests or services on or after March 18 through the national emergency period, MAOs are required to cover the following without cost sharing to the plan enrollee:
  • Clinical laboratory tests for the detection and diagnosis of the virus strain that causes COVID-19 and the associated administration of the test
  • Specified COVID-19 testing-related services under Medicare Part B provided by: physicians, hospital outpatient departments, critical access hospitals, rural health clinics and federally qualified health centers for the following HCPCS evaluation and management codes : ◦Office and their outpatient services
  • Hospital Observation services
  • Emergency department services
  • Nursing facility services
  • Domiciliary, rest home or custodial care services
  • Home services
  • Online digital evaluation and management services.
  • COVID-19 vaccines and their administration, once available. This will be covered under Medicare Part B drugs not Part D
 
In addition, MAOs are prohibited from imposing prior authorizations or other utilization management requirements during this time period for the above-listed items.
 
This memo supersedes the March 10 memorandum previously provided to MAOs related to COVID-19 flexibilities and requirements.
 
In addition, the April 21 memorandum now also requires MAOs to:
  • Cover Medicare Part A & B services and supplemental MA benefits provided at non-contracted Medicare facilities (a.k.a. out-of-network providers);
  • Waive, in full, requirements for gatekeeper referrals, where applicable;
  • Charge the same contracted-facility cost sharing to enrollees for services regardless whether the service was received at a non-contracted facility;
  • Make changes that benefit the enrollee effective immediately without the 30-day notification requirement;
  • Suspend all quantity and days’ supply limits under 90 days for all covered Part D drugs with the exception of safety edits.
 
Finally, CMS also provided MAOs a number of new temporary flexibilities that they have the option of adopting including:
  • Reducing/waiving additional cost sharing in COVID-19 impacted areas: is encouraging plans but not requiring them to waive or reduce enrollee cost sharing (e.g. co-pays or co-insurance) for COVID-19 treatments and other services for enrollees in areas impacted by the outbreak.This flexibility must be tied to the COVID-19 outbreak.
  • Allow more than 14-day supply of Part D drugs to long term care facilities: CMS will use its enforcement discretion to allow Part D drug plans to approve pharmacies dispensing greater than a 14-day supply for all applicable Part D drugs to provide more flexibility to LTC facilities and pharmacies to coordinate with each other.
  • Delay involuntary disenrollment of enrollees absent from their plan service area for more than 6 months when the absence is the result of COViD-19 national emergency.
  • Continue enrollees SNP eligibility and not disenroll enrollees if unable to recertify their status (e.g. duals – Medicaid eligibility) as a result of the COVID-19 emergency.
  • Waiving or relaxing prior authorization policies at any time to facilitate access to services and/or Part D or other formulary drugs to reduce burden on enrollees, plans and providers.
 
For MA and Part D beneficiaries unable to pay their plan premiums during this time, CMS is encouraging plans to use flexibilities afford to them to not disenroll an enrollee for failure to pay their plan premiums and/or to extend their existing non-payment grace period in order to ensure continued access to needed care for these individuals during the COVID-19 emergency.
Source: LeadingAge
CDC & HUD Webinar on Cleaning and Disinfecting
The CDC and HUD are offering a webinar on cleaning and disinfecting to protect individuals residing in HUD-assisted multifamily properties. A representative from HUD’s Multifamily Housing in conjunction with representatives from the CDC and Washington State Department of Health will deliver presentations on their interim guidance on facility cleaning when a person with coronavirus infection is present or suspected. 
 
Here’s the information from HUD:
 
TARGET AUDIENCE: Managers and maintenance staff of HUD-assisted multifamily housing properties
When: May 4, 2020
Time: 12:00 pm to 1:00 p.m. (LeadingAge will have a Housing Advisory Group call on 5/4 from 11:30 a.m. – 12 pm, FYI).
Advance Questions: Submit questions here https://www.surveymonkey.com/r/NHHCRH9
Panelists:
Christie Newhouse, Acting Dir., Assisted Housing Oversight, HUD Multifamily Housing;
Nancy Bernard, WA St. Dept. of Heath; and
CDC Representative
 
They will highlight CDC recommendations on the cleaning and disinfection of facilities where persons possibly infected, or those with confirmed COVID 19 reside, or may be in self isolation. It is aimed at limiting the survival of the virus in the environment. These guidelines are focused on common areas in multifamily housing settings and are meant for the property managers and maintenance staff who service buildings where the COVID 19 disease may be present.
OTHER NEWS
Start Using RESIDE Admissions Software in 3 Simple Steps
The admissions process has always been challenging for facilities to manage and overly complicated for residents and families to complete. Before COVID-19, more than 90% of all long-term care facilities still used an outdated paper admissions process. RESIDE’s platform provides an unparalleled, revolutionary antidote to an age-old problem. The transition from your paper process to RESIDE is easy and can be done in three simple steps. Request a demo.
 
Holly Kasnetz is the VP of Strategy and Implementation at RESIDE Admissions.
Civil Money Penalty (CMP) Application for Communicative Technology Requests
Recognizing that visitor restrictions may be difficult for residents and families during COVID-19, CMS has developed this application template and application approval level for requests for the use of Civil Money Penalty (CMP) Reinvestment funds to provide residents with adaptive communicative technologies.
 
Applicants shall submit this CMP Reinvestment Application to the applicable state agency (SA). The SA shall make a determination on the potential of the project to benefit nursing home residents and improve their quality of care or quality of life. The applicant will be notified by the SA about a funding decision, and applicants may contact the applicable SA with questions about their CMP Reinvestment Application. For additional information review the CMP Application for Communicative Technology Requests Frequently Asked Questions (FAQs) for State Medicaid Agencies .
Source: CAST
Housing Calls
Be sure to take part in these upcoming calls for housing members:
 
LeadingAge Housing Advisory Group:
May 4
11:30 a.m.
 
LeadingAge Illinois Monthly HUD Member Call:
May 13
12 p.m.
RSVP to Jason Speaks
Value First – Ideas to Honor Your Nurses
Our nursing and healthcare teams have been busy caring for everyone. May 6-12 is the week to show our nurses that we care about them. American Solutions for Business is a Value First/Vizient provider who has put together an offering to help you show them some love. Contact information and a few ideas from their many in stock items are listed here to place your orders. You do not need to be a Value First member to take advantage of this offer.
 
Please continue reaching out to Value First for the needs of your community. Also, visit the Value First Website or their resource page for up-to-date information for your community.
Contact: Terry Romin at 224.230.7365
Recognize Your Heroes
During this time of crisis, it is important that we recognize the heroes working in your organizations that are making a difference in the lives of residents. To all those on the front lines keeping Illinois seniors safe, LeadingAge Illinois says "Thank you"! Tag your staff or organization on our Facebook page here to say thank you or share your own post to the Facebook page .
New QuickCast on Dementia just released on the Hub
In this 18-minute QuickCast, Teepa Snow discusses Positive Approach to Care (PAC) strategies to support people living with dementia when sheltering in place. Care and Coping with Dementia and COVID-19.
LeadingAge Live Online Coronavirus Daily Member Update
LeadingAge is hosting daily live online updates each weekday afternoon. Subscribe to "LeadingAge Need to Know" via communications preferences in your MyLeadingAge account to receive email updates. Register for live online updates 5 days/week at 2:30 p.m. through May. You can find an archive of all member updates here

Also, if you’re a member of both LeadingAge Illinois and LeadingAge National, stay connected with other LeadingAge National Members and share information and resources through the MyLeadingAge Member Community: COVID-19 . This is a place to connect with your peers to share and discuss everyday practices related to the coronavirus. Take a moment now to log into your my.leadingage.org account and join the group to stay connected. LeadingAge also has a COVID-19 webpage with the latest updates, information and resources for members.
EDUCATION