March 29, 2024

Featured News

*Member Benefit* Money Available for Small and Single Site Worker Recruitment

As part of the Gateways to Care initiative, LeadingAge Ohio wants to partner with small and single sites to help bring awareness to careers in aging.

Beginning in May, the LeadingAge Ohio Foundation will match up to $1,000 per month through the summer for digital marketing ads and streaming radio spots that drive jobseekers to the Gateways to Care career center, highlighting open positions at small and single site providers. 

If your organization is interested in learning more, contact Molly Homan at mhoman@leadingageohio.org. There are a limited number of opportunities available and requests will be first-come, first-serve.

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You Asked... We Answered

You Asked... We Answered

You Asked... 

What is the specific CDC-targeted multidrug-resistant organisms (MDRO) that require enhanced barrier precautions (EBP)?

We Answered… 

CMS provides this guidance in the QSO-24-08-NH memo on page 4 which directs providers to the CDC’s webpage, “Implementation of Personal Protective Equipment (PPE) Use in Nursing Homes to Prevent Spread of Multidrug-resistant Organisms (MDROs).”

CDC notes that the MDROs for which the use of EBP applies, and do not otherwise require contact precautions, are based on local epidemiology. At a minimum, they should include resistant organisms targeted by CDC but can also include other epidemiologically important MDROs as listed below:

Examples of MDROs Targeted by CDC include:

  •       Pan-resistant organisms,
  •       Carbapenemase-producing carbapenem-resistant Enterobacterales,
  •       Carbapenemase-producing carbapenem-resistant Pseudomonas spp.,
  •       Carbapenemase-producing carbapenem-resistant  Acinetobacter baumannii, and
  •       Candida auris.

Additional epidemiologically important MDROs may include, but are not limited to:

  •       Methicillin-resistant Staphylococcus aureus (MRSA),
  •       ESBL-producing Enterobacterales,
  •       Vancomycin-resistant Enterococci (VRE),
  •       Multidrug-resistant Pseudomonas aeruginosa, and
  •       Drug-resistant Streptococcus pneumoniae.

CDC isolation guidance states the following situations require contact precautions situations when residents infected or colonized with an MDRO:

  • Presence of acute diarrhea, draining wounds or other sites of secretions or excretions that are unable to be covered or contained.
  • For a limited time period, as determined in consultation with public health authorities, on units or in facilities during the investigation of a suspected or confirmed MDRO outbreak.
  • When otherwise directed by public health authorities.

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LeadingAge Ohio News

*Partner Feature* - Save Your Spot at Technology and Innovation Summit

Discover the future of culinary and dining operations at the Technology and Innovation Summit - an immersive experience featuring progressive technology. Registration is fast filling, so we encourage members to reserve their space today! 

Hosted by LeadingAge Ohio partner Link-age Solutions, along with CCL and Strategic Dining Services, this Summit will showcase the right technologies to enhance consumer experience, drive efficiencies, and ultimately differentiate your communities. 

Join Link-age and subject matter experts on April 23 in central Ohio for this can’t-miss culinary tech event! 

Learn more here.

STARS Nomination Deadline This Week!

Is STARS Part of Your Employee Recognition Program?

This year, LeadingAge Ohio is bringing back the LeadingAge Ohio STARS program for the first time since pre-pandemic times. STARS recognizes the frontline team members that have the biggest impact on patient and resident care. 

Why STARS?

  • STARS offers members a “plug and play” program to elevate your best employees. No need to schedule your own event, plan catering or figure out gifts– we have done that for you! 
  • STARS takes the recognition statewide. Our best employees deserve not only to be lifted up in the eyes of their immediate peers and supervisors, but also as care leaders in the wider community. STARS recognition means they’re the best of the best in Ohio. 
  • STARS connects them to the wider aging services community. STARS isn’t limited to nursing homes, but recognizes exceptional care across settings. Nominate an exceptional hospice aide or housing service coordinator to show them how they are knit into the big picture of aging and end of life services.
  • STARS allows you to customize the program to your community. Some organizations make nominations a resident affair, building committees to evaluate nominees. Others make it a morale-booster among peers, as groups of team members decide how to nominate. You can build your own processes and recognition into STARS. 

The dates for this year’s STARS Awards are:

  • South/Southwest Region: Twin Towers Senior Living Community, Cincinnati- May 5 at 11:30AM
  • Central/MidEast Region: United Church Homes Chapel Hill Community, Canal Fulton- May 29 at 11:30AM
  • Northeast Region: Jennings, Cleveland- June 20 at 11:30AM
  • Northwest Region: Otterbein Pemberville, Pemberville- June 13 at 11:30AM

Nominate up to 6 STARS from your organization today!

Communicators and Marketers: Save the Date!

Mark your calendars for the next Marketing, Communications, and Outreach Network meeting on April 25 at 11:30AM. 

Sharon Houghton of Marketing Barn, LLC will join us to talk about current and future trends with digital marketing, while deciphering best practices with geofencing, retargeting, media channels, and more. 

Sharon has extensive knowledge with all things media, with the niche of digital media. Sharon's experience includes digital strategist for Time Warner Cable, creator and developer of online news companies, digital media negotiations, and Columbus-based NBC4's digital and advertising representative.  

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LeadingAge News

Change Healthcare Town Hall Recording & Survey

LeadingAge hosted a members-only town hall to provide the latest information and insight on the cyberattack on Change Healthcare. Attendees completed a very brief survey to help give LeadingAge a better understanding of the impact of the outage. LeadingAge is asking those who did not attend to also take the survey here.

Members can access the recording of the town hall here and keep up on the latest developments through the Change Healthcare serial post.

Next Level Leadership & Dementia Inclusion Series Filling Up Fast

Explore two upcoming virtual learning series before you miss your chance! 

Next Level Leadership is a virtual leadership development series for emerging and aspiring leaders. Back by popular demand for a second cohort, the series only has five spots remaining.

Plus, LeadingAge’s new Shared Learning Series: Embracing Dementia Inclusion is already more than 60% full. Both series are first-come, first-served.

Statement of Support for Care in the Home for Rural and Underserved Communities 

LeadingAge submitted a statement for the record on March 26 in response to a House Ways and Means Committee hearing, "Enhancing Access to Care at Home in Rural and Underserved Communities." The hearing highlighted critically important gaps in home-based care for these communities and LeadingAge took the opportunity to support several topics discussed at the hearing:

  • Ensuring that these models include the cost of training for patients and family caregivers especially with continuing shortages in staffing.
  • Supporting the extension of the hospital at home waiver with support for more collaboration between hospitals and home health agencies.
  • Reiterating a clear message of support for telehealth and supporting the Connect for Health Act and the telehealth modernization act.

LeadingAge will continue to advocate for LeadingAge members to be included in future policy developments directed at care at home.

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State News

Ombudsman Issues Final Notice for Consumer Guide, Bed Fees

The Ohio Department of Aging mailed final notices for long-term care facilities with outstanding 2023 Long-Term Care Consumer Guide Fee or LTC Ombudsman Bed Fee payments. Both payments were due November 1, 2023.

Learn more, including where to pay, here.

Costs for Alzheimer’s and Dementia to Increase Drastically While Workforce Lags

An article from the Journal-News summarized startling recent stats from the Alzheimer Association, including:

  • The number of Alzheimer’s deaths in the U.S. more than doubled between 2000 and 2021.
  • Half of health care workers say their industry is not fully equipped to handle the growing dementia population.
  • 236,200 individuals in Ohio have Alzheimer’s, equating to 11.3% of Ohioans over the age of 65.
  • Ohio’s mortality rate is 42%, exceeding the national rate of 36%.
  • Alzheimer’s is the 7th leading cause of death in Ohio.
  • The cost for caring for those with dementia is projected to increase by $15 billion this year.
  • In Ohio, a 229.4% increase in dementia care specialists will be needed to care for the state’s population by 2050.

Read more about the recent findings here. 

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Federal/National News

CMS Releases Final Rule on Streamlining Medicaid Eligibility Determination Processes

On March 27, the Centers for Medicare & Medicaid Services (CMS) announced its release of the Streamlining Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes (CMS-2421-F2) final rule.

This rule is intended to simplify and streamline the eligibility and enrollment processes for underserved populations, including older individuals, and individuals who have a disability and, by doing so, limit coverage disruptions, reduce administrative burden on states and applicants, and increase enrollment and retention of eligible individuals. One key change would be for CMS to track state timeliness in completing Medicaid application processes, hopefully leading to earlier identification and intervention in state backlogs. 

LeadingAge commented on the proposed rule in 2022 and is reviewing the final rule. LeaidngAge will provide additional information in the coming days.

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Nursing Facility News

Survey Tip of the Week: Antibiotic Time Out

F-881 Antibiotic Stewardship Program (ASP) citations in Ohio are frequently a result of prescribing antibiotics unnecessarily and the failure of the ASP to monitor and review antibiotic use to determine if the antibiotic is still indicated or if adjustments should be made (e.g., antibiotic time-out).

An antibiotic “time out” is a formal process designed to prompt a reassessment of the ongoing need for and choice of an antibiotic once more data is available. CMS recommends facilities use the Centers for Disease Control and Prevention’s (CDC) “The Core Elements of Antibiotic Stewardship for Nursing Homes” guide.  In this guide, CDC notes that antibiotics are often started empirically in nursing home residents when the resident has a change in physical or mental status while diagnostic information is being obtained. However, providers often do not revisit the selection of the antibiotic after more clinical and laboratory data (including culture results) become available. ODH citation examples included not reviewing antibiotic orders upon admission or readmission and upon record review there was not an indication for use based on evidenced-based criteria.

CMS in the State Operations Manual Appendix PP  states that the facility must incorporate monitoring of antibiotic use, including the frequency of monitoring/review. Monitor/review response to antibiotics, and laboratory results when available, to determine if the antibiotic is still indicated or adjustments should be made (e.g., antibiotic time-out); when the resident is new to the facility; when a prior resident returns or is transferred from a hospital or other facility.

CMS also recommends facilities utilize the Agency for Healthcare Research and Quality’s “Nursing Home Antimicrobial Stewardship Guide.” Facilities should consider using the Infection Prevention, Control & Immunizations survey pathway to evaluate compliance with the regulation. 

This survey pathway can be found in the Survey Resources zip file on the CMS Nursing Home webpage and under the downloads section on this CMS webpage. The State Operations Manual Appendix PP provides additional guidance on the antibiotic stewardship program.   

LeadingAge has developed webinars and resources on the requirements of participation which are located on the LeadingAge learning hub. LeadingAge continues to add QuickCasts on the regulatory groups.  Updated resources have also been added on the Nursing Home RoP Tools and Resources webpage.  

For more information about the updated requirements of participation and citations occurring in Ohio, please join us on the monthly STAT: Survey Tips and Tactics call. Register now for the April 10 call at 11:00AM. LeadingAge Ohio is sharing tips to assist members during the survey process. Send questions you would like addressed in future Tips of the Week to Stephanie DeWees at sdewees@leadingageohio.org

Ohio Nursing Home Task Force Reconvenes; Plans to Deploy Technical Assistance, Develop Career Ladders

This week, the Governor’s Nursing Home Quality & Accountability Task Force reconvened for the first time since 2023, marking one year since the first meetings of the Task Force held in March of last year. Ohio Department of Aging Director Ursel McElroy reported on progress made by the administration on Task Force-identified priorities, including the launch of the Nursing Home Quality Navigator earlier this year and increased funding and restructuring of the State Long-term Care Ombudsman. 

Initiatives on the near-horizon include launching a technical assistance program to support targeted nursing homes, and improving the survey process. Notably, Ohio has been selected for two CMS pilots: one which use AI to error-correct survey data, and another which allows fewer days and surveyors for select facilities’ annual surveys. Finally, ODA reported that they have formed a new workforce working group which has decided to focus efforts on STNA recruitment and stabilization of the Director of Nursing role. 

All of the efforts build directly off of the Recommendations Report of the Nursing Home Quality & Accountability Task Force published last spring. Questions regarding the Task Force may be directed to Susan Wallace at swallace@leadingageohio.org.

Review of CMS’s SNF QRP: Achieving a Full APU

The Centers for Medicare & Medicaid Services provided a deep-dive on the skilled nursing facility quality reporting program on a March 26 webinar. SNF QRP: Achieving a Full APU reviewed:

  • Updates to the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP),
  • Data submission requirements and deadlines,
  • Reports that can be run in iQIES to assist providers in identifying issues that may prevent a full annual payment update (APU), and
  • How and when to request reconsideration.

Providers will find the review of reporting deadlines and iQIES reports particularly helpful. The slide deck for this presentation is available here. A recording of this webinar will be uploaded in the future to the SNF QRP training page on the CMS website.

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Hospice & Palliative Care News

Vaccine Clarification for Hospice Patients in Skilled Nursing Facilities

The Centers for Medicare & Medicaid Services (CMS) recently released a Medicare Billing Guideline for vaccination when an individual is in a skilled nursing facility (SNF). 

When a resident is in a skilled facility under Medicare Part A (including a hospice patient) the SNF should be billing Part B for the resident’s flu, pneumococcal, and COVID vaccines. If the resident has Medicare Part D, then the RSV vaccine should be billed to the Part D plan by the skilled nursing facility.

While flu, pneumococcal, and COVID vaccines are not covered by the hospice benefit, hospices can bill for these outside the benefit per Medicare Claims Processing Manual Chapter 11: Processing Hospice Claims, 30.5 – Hospice Claims for Vaccine Services. 

LeadingAge received clarification from CMS that the SNF is required to submit the bill for Part A stays. If the hospice administers the vaccine, the hospice would need to make billing arrangements with the SNF. Regardless of who furnishes the vaccine to the patient, if the patient is in a Part A covered SNF stay, then the SNF remains the billing entity.

Sign Up to Receive Important Updates on the Hospice Quality Reporting Program

Swingtech sends informational messages to hospices related to the Quality Reporting Program (QRP) on a quarterly basis. Their latest outreach communication can be found on the HQRP Requirements and Best Practices webpage.

In the most recent message, the following topics are reviewed: 

  • Annual payment and FY2025 Hospice Quality Reporting reminders, and 
  • New resources for HQRP, and health equity updated resources. 

If you would like to receive Swingtech’s quarterly emails, then add or update the email send an email to QRPHelp@swingtech.com with the name of your facility and the Centers for Medicare & Medicaid Services (CMS) Certification Number (CCN).

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Home Care News

CMS Issues Technical Revisions to Home Health Appendix B

On March 15, the Centers for Medicare & Medicaid Services (CMS) issued (QSO-24-07-HHA) revisions to Appendix B of the State Operations Manual used to inform surveys of Home Health Agencies. 

The updated interpretive guidelines and updates to Appendix B of the SOM includes conforming revisions to the regulatory tags and interpretive guidelines following several final rules which have updated Conditions of Participation (CoPs). Additionally, CMS is also combining the HHA survey protocol and interpretive guidelines into one document, updating Level 1 tags, and making clarifications and technical corrections to other guidance areas based on stakeholder feedback.

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Housing News

OHFA Board Approves Financing for Seven Developments

Last Wednesday, the Ohio Housing Finance Agency (OHFA) Board approved financing from various programs for seven housing developments to create or preserve affordable housing units throughout the state. Among the awards was Hebron Senior Apartments, a National Church Residence project that will construct 42 new units for older Ohioans in Licking County. 

To review a complete list of the awards, click here.

LeadingAge Hosts Overview of HUD FY23 Section 202 NOFO

LeadingAge hosted an overview of HUD’s current Section 202 Notice of Funding Opportunity (NOFO) on March 25. During the session, experts shared insights on the current (fiscal year 2023) application round for Section 202 funding to create new affordable senior housing units. Applications are due by June 20, 2024.

The call featured discussions on:

  • Differences between this year and last year’s Section 202 funding opportunity,
  • Best practices for applying,
  • How HUD rates and awards the funding, and
  • How the housing providers are bringing these projects to completion. 

There was also discussion around advocacy opportunities to revive the program after Congress omitted new Section 202 funding from HUD’s budget for Fiscal Year 2024 and the President’s budget request declined to include new funds for fiscal year 2025.

The call recording and slides are available for members to view.

Management Fees in HUD-Assisted Housing - LeadingAge Network Call

Join LeadingAge’s Housing Network Call on April 1 at 12:30 p.m. ET for a discussion on issues related to management fees in HUD-assisted Multifamily Housing.

LeadingAge will review recent HUD approaches to management fees in various HUD regions and collect feedback for HUD leadership.

The Housing Network meets weekly on Mondays at 12:30pm ET and participation in the Network is open to all provider members of LeadingAge. For details on joining the Network, contact Juliana Bilowich.

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Life Plan Community News

Shifting Regulatory Landscape for Life Plan Communities

As Life Plan Community (LPC) / Continuing Care Retirement Community (CCRC) providers know, regulations for these communities vary vastly state to state. Many states with little to no regulations are beginning to roll out new requirements and in the shifting landscape, providers can look to LeadingAge for support. Join LeadingAge April 8 for a live event sharing insights on the complex regulatory issues facing providers and operators of CCRCs and LPCs.

 Learn more and register here.

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Education and Resources

Check Out the LeadingAge Ohio Education Calendar!

LeadingAge Ohio holds valuable education webinars and in-person events throughout the year. Opportunities are added weekly. See the complete schedule of events here.

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Education & Events

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Upcoming Education Events

April 10, 2024
11:00AM - 12:00PM EST

STAT: Survey Tips and Tactics

Facility Assessment

Webinar

April 11, 2024
1:00PM - 4:15PM

2024 Palmetto Home Health Medicare Workshop

Medicare Home Health: Back with More in 2024

WEBINAR

View All Events