COVID-19

COVID-19 Latest News, Guidance & Resoruces

We are closely monitoring the news and guidance concerning COVID-19 and are working with the Governor’s office, the Indiana Department of Health and AHCA/NCAL, to ensure our member providers receive the necessary guidance to care for the most vulnerable Hoosiers during this public health emergency. Visit this webpage daily to access the latest updates.

To request an Indiana Department of Health Strike Team, please click here.
COVID-19 Benefits of Vaccination Flyer
COVID-19 Vaccination Resources
Return to Work Decision Tree (Updated Feb. 16, 2021)
LTC Staff Travel Decision Tree (May 4, 2021)
COVID-19 LTC Toolkit (September 9, 2021)

September 24: Pfizer Booster Dose Information

On September 24, 2021 the Centers for Disease Control and Prevention (CDC) as well as the Food and Drug Administration (FDA) approved a booster shot of the Pfizer-BioNTech COVID-19 vaccine for certain groups of individuals, including residents and health care workers in long-term care. This decision by the CDC and DFA offers another layer of protection that we need to fight the coronavirus that uniquely targets our vulnerable long-term care population.

The Indiana Department of Health (IDH) also supports the administration of Pfizer vaccine booster dose to people 18 years and older who completed the Pfizer COVID-19 vaccine as their primary series, and it has been at least six months since receiving the second dose, and they attest to meeting CDC guidelines as outlined here.

September 20: Indiana Medicaid Announces New Reimbursement for COVID-19 Ready Nursing Facilities

On the afternoon of September 20, 2021, Indiana Medicaid released a new policy increasing reimbursement for COVID-19 Ready nursing facilities. The policy is in response to the need to ease the growing stresses on the state’s hospital capacity by helping nursing facilities offset the growing and large costs for operating COVID-19 units. The effective dates for qualifying providers are dates of services between September 20, 2021 and October 16, 2021.

The temporary increases are 4% per patient day (all Medicaid patients in the facility) for facilities that attest to being COVID-19 Ready and an additional $230 per COVID-19 positive resident.

September 16: Additional Details for Provider Relief Fund (PRF) Phase 4 and Rural Distribution

Yesterday, the Health Resources and Services Administration (HRSA) released additional details on the $25 billion September 10th announcement composed of the $17 billion Phase 4 distribution and the $8.5 billion rural distribution. The announcement yesterday also provided information on Phase 3 distribution reconsiderations and a PRF grace period for reporting.

September 16: NHSN LTCF Updates Set for September 18

The Centers for Disease Control and Prevention (CDC) National Health Safety Network issued this summary of updates coming to the LTCF Module beginning Saturday, September 18, 2021. Key updates are listed below:

Resident Impact and Facility Capacity Pathway Updates: Enhancements to the POC test reporting tool and COVID-19 pathway data reporting are included in the updates. Revised forms, instructions, FAQs and CSV templates are part of the updates. NHSN will hold as webinar on Monday, September 20, 2021 from 1-2pm ET to discuss these updates. You can register in advance for the webinar.

Vaccine Data Module Updates: In addition, the NHSN notice included changes to the COVID-19 vaccination data modules and listed new categories that would be required to be reported. A webinar reviewing these changes for long-term care facilities will be held on September 23, 2021, from 2-3 PM ET. Facilities can register at the link below:

Read the full update here.

September 16: IDH Reminder on Monoclonal Antibody Distribution and Use

IDH’s LTC Medical Director, Dr. Vuppalanchi, provided a reminder on the distribution and use of monoclonal antibody treatments. Please see below for Dr. Vuppalanchi’s article:

The U.S. Department of Health and Human Services (HHS) transitioned from the direct ordering process for MAB to a state-coordinated distribution system, similar to that used from November 2020 to February 2021.

LTC facilities or pharmacies with capability to provide monoclonal antibody (MAB), please complete this REDCap survey to be added to the Indiana Department of Health’s monoclonal antibody therapeutics distribution list.

September 10: Indiana Department of Health Issues Important Updates to Guidance Documents for Long-Term Care Providers Health

The Indiana Department of Health has updated the COVID-19 Clinical Guidance document, COVID-19 Regulatory Visitation and Activities Guidance and COVID-19 LTC Infection Control Guidance. All three of these new guidance documents have also been incorporated into the COVID-19 LTC Toolkit. The IHCA/INCAL team has summarized the key reminders as reflected in the updated documents for our member providers. To access IHCA/INCAL guidance summaries, please click on the links below:

IDH Updates LTC COVID-19 Clinical Guidance

IDH Updates LTC COVID-19 Infection Control Guidance

IDH Issues Updated Visitation and Activities Guidance

September 10: HHS Distributes Phase 4 Provider Relief Fund

Today, the U.S. Department of Health and Human Services (HHS) announced it will be releasing Phase 4 of the Provider Relief Fund (PRF). Phase 4 consists of $17 billion for providers who can document revenue loss and expenses associated with the pandemic. HHS has also created an option for reconsideration of Phase 3 awards and extended the due date for the first PRF Reports, formerly due on September 30, 2021, by 60 days. It is also possible rural SNFs and assisted living communities may be eligible for the $8.5 for rural providers.

September 10: Prior Authorization Waiver Re-instated for Indiana Medicaid

Effective for dates of service (DOS) on or after Sept. 8, 2021, and until further notice, the Indiana Health Coverage Programs (IHCP) is reinstating temporary changes in the skilled nursing facility (SNF) prior authorization (PA) requirements for Medicaid managed care health plans. This change is in response to the recent increase of coronavirus disease 2019 (COVID-19) cases and hospitalizations across the state of Indiana.

September 10: CMS Updates Medicare COVID-19 Billing Guidance

On September 8, 2021, the Centers for Medicare and Medicaid Services (CMS) Updated MLN Matters Article SE20011 titled Medicare FFS Response to the PHE on COVID-19. In the billing guidance CMS DID NOT change the longstanding blanket 3-day qualifying stay or spell-of-illness waivers for beneficiary eligibility for SNF Part A coverage.

September 9: CMS to Require Vaccination for all Medicare and Medicaid-Certified Health Care Facilities

On September 9. 2021, the Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC) announced that the emergency regulations requiring vaccinations for nursing home workers will be expanded to include hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies, among others, as a condition for participating in the Medicare and Medicaid programs.

ACCESS IDH GUIDANCE & RESOURCES

COVID-19 Vaccine Updates

IHCA/INCAL has developed this page to list relevant COVID-19 vaccine resources. As we receive more information, we will continue to update this page with latest information.

Latest Updates

September 9: CMS to Require Vaccination for all Medicare and Medicaid-Certified Health Care Facilities
August 23: Pfizer COVID-19 Vaccine Receives FDA Full Approval
August 23: COVID-19 Vaccine: Boosters vs. Additional Doses for Immunocompromised
August 6: COVID-19 Vaccination Toolkit for LTC Medical Directors
May 25: AHCA/NCAL Best Practices on Compliance with COVID-19 Vaccine Final Rule
May 21: AHCA/NCAL Resource on Vaccination Status and HIPPA
May 11: CMS Rule Requires COVID-19 Vaccine Procedures and Reporting Beginning May 21, 2021
May 5: It is Time for Your Facility COVID-19 Vaccination Data Check-up
April 26: FDA and CDC Lift Recommended Pause on Johnson & Johnson (Janssen) COVID-19 Vaccine Use Following Thorough Safety Review
April 14: CDC and FDA Pause Johnson and Johnson COVID-19 Vaccine
April 6: COVID-19 Vaccine Data Reporting to NHSN
March 16: Hoosiers 16 Years & Older Eligible to Receive Vaccine
March 21: Maintenance Access to COVID-19 Vaccines for LTCFs
December 23: PREP Act Immunity Coverage for COVID-19 Vaccine Administration

Vaccine Guidance & Resources

HHS

Invest in Trust: A Guide for Building COVID-19 Vaccine Trust and Increasing Vaccination Rates Among CNAs (ahrq.gov)

Indiana Department of Health

CDC

AHCA/NCAL

IHCA/INCAL

American Medical Directors Association

Pharmacy Partnerships for LTC Providers

CDC

CDC Overview and Facts

Walgreens

CVS

Janssen COVID-19 Vaccine Information (Revised to include information about the risk of thrombosis-thrombocytopenia syndrome)

Moderna COVID-19 Vaccine EUA Issued

The Food and Drug Administration issued the Emergency Use Authorization (EUA) for Pfizer’s COVID-19 vaccine on December 18, 2020. This EUA Fact Sheet is now available and will help you communicate with residents, family and staff regarding the vaccine.

Pfizer COVID-19 Vaccine EUA Issued

The Food and Drug Administration issued the Emergency Use Authorization (EUA) for Pfizer’s COVID-19 vaccine on December 12, 2020. This EUA Fact Sheet is now available and will help you communicate with residents, family and staff regarding the vaccine.

FDA Emergency Use Authorization for REGEN-COV2

The federal Food & Drug Administration (FDA) has issued an emergency use authorization (EUA) to permit the use of REGEN-COV2 (Casirivimab and Imdevimab together) for post exposure prophylaxis of COVID-19 in individuals who are at high risk for progression to severe COVID-19, including hospitalization and death. It is expected to be effective against circulating variants, including the Delta variant. REGEN-COV2 is not a substitute for vaccination against COVID-19 and is not authorized for pre-exposure prophylaxis. Helpful links on REGEN-COV2 are as follows:

Testing Guidance & Updates

Ordering Testing Supplies – Langham Portal

Latest Updates

April 30: Updated: COVID-19 Testing of NF Staff & Residents
Feb. 18: Testing Supplies Available to Order through Langham Logistics
Feb. 17: IDH Announces CDC COVID-19 Data to be Utilized for Testing & Visitation
Feb. 10: Reporting of POC Antigen Test Results to NHSN Changed to Optional – Test Results Must Still Be Reported
January 11: Important: IDH Updates COVID-19 Data Submission Guidelines
December 8: BinaxNOW™ Request Guidance for Long-Term Care Facilities & Assisted Living Memory Care Unit Testing
October 29: IDH Issues Clarification on Administering COVID-19 Tests
October 7: CDC Guidance on Testing in Nursing Homes
September 23: CMS Updates County COVID-19 Positivity Data | Sept. 3-16, 2020
September 8: Point of Care COVID-19 Test Reporting Guidance
September 4: COVID-19 Lab Contacts from ISDH
September 4: POC test results tracking form and update on ISDH’s reporting mechanism for lab results
September 2: Antigen Tests for Assisted Living Communities
August 27: Important: County Positivity Data for NF Staff Testing Now Available
August 27: Requirements of Reporting by CLIA Laboratories
August 25: Important: CMS Issues Interim Final Rule on COVID-19 Testing of NF Staff & Residents – Additional Guidance to Come Before Implementation (Updated August 26, 2020)
August 25: Targeted COVID-19 Training for Frontline Nursing Home Staff & Management
August 17: Important Updates from ISDH on COVID-19 Testing for Nursing Facility Staff
August 12: New NHSN Data Elements on Testing
August 7: Updated: COVID-19 Testing of Nursing Facility Staff Required in August/September
June 18: Nursing Facility Staff Testing Portal to View Results and Report Tests
June 8: Nursing Facility Staff COVID-19 Testing Registration
June 8: Urgent: ISDH Issues Nursing Facility Staff COVID-19 Testing Dates and FAQ

Regulatory Requirements and Important Resources

POC Antigen Test and PCR Test Decision Tree
CMS Testing Requirements: Steps to Get Started
Summary of CMS Testing Requirements
AHCA’s list of labs that can provide testing with a 48-hour turnaround time.
COVID-19 Lab Contacts from ISDH
Reporting False Positives in COVID-19 Testing
BinaNOW COVID-19 Ag Card and NAVICA App Fact Sheet

Important Contacts

Probari Phone number: Please call 317-804-4102 with any questions/issues.
ZOTEC Help Desk: Please call 866-254-4628 with any questions/issues related to registration.
Patients Choice Laboratories (PCL): PCL, based in Indianapolis, Indiana, is a leading provider of comprehensive laboratory testing services throughout the United States. For more info, please visit www.pclabsdx.com.

Antigen Testing

Latest Updates

August 19: POC/Antigen Testing Decision Tree
Feb. 10: Reporting of POC Antigen Test Results to NHSN Changed to Optional – Test Results Must Still Be Reported
January 11: Important: IDH Updates COVID-19 Data Submission Guidelines
October 30: COVID-19 Guidance for Point-of-Care COVID-19 Testing Reporting
October 16: New Pathway to Report POC Test Results through Electronic Lab Reporting Process
September 25: ISDH Provides Antigen Testing Guidance
September 16: BinaxNOW COVID-19 Cards – REDCaps Reporting Required

Guidance and Important Resources

IDH Guidance & Resources

Cohorting Guidance

Weekly Webinars

Upcoming Webinar | September 30, 2021 from 12-1 p.m. EST

As of April 15 the Indiana Department of Health will be unable to participate in the webinars on a weekly basis. However, IHCA/INCAL staff will continue to host the webinars to answer your questions and provide guidance. IHCA/INCAL will engage IDOH on issues that cannot be answered during each webinar and also plan with IDOH on the times that they can participate in some of the webinars.

HOW TO JOIN THE WEBINAR

Microsoft Teams meeting

Join on your computer or mobile app

Click here to join the meeting

Or call in (audio only)

+1 463-900-4253,,240786210# United States, Indianapolis

Find a local number | Reset PIN

Webinar Recordings and Handouts

September 23. 2021

ACCESS WEBINAR HANDOUT

ACCESS WEBINAR RECORDING

September 16, 2021

ACCESS WEBINAR HANDOUT

ACCESS WEBINAR RECORDING

September 9, 2021

ACCESS WEBINAR HANDOUT

ACCESS WEBINAR RECORDING

September 2, 2021

ACCESS WEBINAR HANDOUT

ACCESS WEBINAR RECORDING

To access archive recordings of the webinars, please click here.

Infection Control SOP & Toolkit

September 10: IDH Updates LTC COVID-19 Infection Control Guidance
December 18: Updated Infection Control FAQs
December 2: Infection Prevention FAQs on Close Contacts, Exposure, & More

EMResource

EMResource is a web-based resource management and communication tool used to monitor and notify changes in resources statuses. IDH is asking you to update your PPE supplies daily in this tool so that resources can be distributed efficiently.

Please request your user account here.
Please access the user manual at this link.
EMResource Troubleshooting – Email Eric Shelley at the Indiana Department of Health – eshelley1@isdh.in.gov

Coordinate account registration with your facility administrator. We recommend designating at least two individuals that can track and input data into EMResource.

ECHO Hub

Project ECHO is actively recruiting nursing homes around the country to join an interactive community of practice to advance improvements in COVID-19 preparedness, safety and infection control. Supported by the federal Agency for Healthcare Research and Quality (AHRQ), and in collaboration with the Institute for Healthcare Improvement (IHI), the AHRQ ECHO National Nursing Home COVID-19 Action Network is open to any nursing home across the country at no cost. Explore Project ECHO’ website and resources here and download an informational flyer here.

Project ECHO Resources

Payment & Reimbursement Resources

General Resources

Medicare

Medicaid

September 10: Prior Authorization Waiver Re-instated for Indiana Medicaid
May 28: CARES Act COVID-19 Relief for A&D Waiver Assisted Living Providers – Applications Due by July 31, 2021
May 13: Medicaid Resident Liabilities Update
April 20: OMPP Announces Extension of 3% Rate Enhancement for NF
November 16: Mass Adjustment for Certain $115 Add-on Claims
September 8: New MDS Assessment Requirements
September 8: UPL Q4 Interim Payment and COVID-19 add-ons
September 8: Nursing Facility COVID-19 Rate Enhancements
September 8: New COVID-19 Positive $115 Add-on Billing Instructions
August 3: FSSA Updates Administrative Code on Medicaid Recipients and Eligibility
August 3: Indiana Medicaid Updates HIP to Fee for Service (FFS) Transition Policy
June 8: Indiana Medicaid Clarifies How to “De-Attest” COVID-Ready Status
March 20: Indiana Medicaid Announces Filing Extensions for Cost Reports and Other Filings

CARES Act Provider Relief Fund

Latest Updates

September 16: Additional Details for Provider Relief Fund (PRF) Phase 4 and Rural Distribution
September 10: HHS Distributes Phase 4 Provider Relief Fund
July 1, 2021: PRF Reporting Portal Now Open
June 11: HHS Releases Updated PRF Reporting Requirements
May 28: CARES Act COVID-19 Relief for A&D Waiver Assisted Living Providers – Applications Due by July 31, 2021
April 21: NHSN COVID-19 Resident Impact Historical Data
February 15: HHS Releases Facility Level Detail for CARES November and December 2020 Quality Incentive Program
January 15: HHS Opens PRF Reporting Portal for Registration
January 8: HHS Extends Public Health Emergency
December 23: Update on HHS Phase 3 Provider Relief Fund TIN Validations
December 16: HHS Announces CARES Phase 3 Payments to AL and SNF
December 8: Nursing Home Quality Incentive Program Methodology
December 1: HHS Publishes Facility-Specific List of COVID Quality Incentive Payments
November 22: NHSN Reporting Changes Effective Nov. 23rd
November 17: CARES Act Quality Incentive Payment Program
November 17: NHSN To Update Reporting Pathways
November 10: New Update: HHS NHSN Reporting Requirements
October 22: Updated Reporting Requirements to the Provider Relief Fund
October 5: Important: Phase 3 General Distribution from the HHS Provider Relief Fund – All Providers Encouraged to Apply
September 23: HHS Releases Provider Relief Fund Reporting Guidance
September 18: New Details on Incentive Payments for Nursing Facilities
September 15: Assisted Living Funding Allocation Deadline Extended to Sept. 21
September 9: HHS Announces $2 Billion Quality Incentive Program for Nursing Homes | Access AHCA Summary
September 4: AHCA/NCAL Webinar on CMS COVID-19 Performance Payment Plan | Tuesday, Sept. 8
September 2: Provider Relief Fund Allocation for Private Pay Assisted Living
August 31: HHS SNF Awards – Terms & Conditions of Infection Control Provider Relief Fund Allocation
August 18: HHS ECHO Partnership for $5B Provider Relief Fund Distribution to NFs
August 12: Changes to Medicaid Tranche Eligibility – Applications Due August 28, 2020
August 10: HHS Opens CHOW Portal
August 3: HHS Release FAQs on Provider Relief Fund Transfers and Audits
July 31: Deadline Extended: Medicaid Applications for Provider Relief Fund Due August 28, 2020
June 26: Updated CARES Act Funding for Waiver Assisted Living Providers
June 18: HHS Offers Medicaid Allocation Application Tutorials
June 9: HHS Releases $15 Billion for Medicaid Provider Relief
June 3: HHS Releases Guidance on Important CARES Fund Questions
May 26: CARES Attestation Window Extended

Workforce Resources

IHCA/INCAL Contact: Zach Cattell| zcatell@ihca.org

Latest Updates

June 28: OSHA’s Emergency Temporary Standard for Health Care Workers

May 24: Emotional PPE Project

March 23: Extension of Temporary Health Care Licenses

November 23: Criminal History and Fingerprinting Requirements during the PHE

November 17: OSHA Releases Frequently Cited Standards Related to COVID-19 Inspections

November 9: OSHA Releases Respiratory Protection Guidance for LTCFs

November 6: IDH Issues Certified Nurse Aide Training Program Orders

October 19: Indiana Health Care Reserve Workforce

September 14: Update to Paid Leave Requirements of the Families First Coronavirus Response Act

August 20: Influenza Vaccinations as a Condition of Employment

August 12: OSHA Increases Scrutiny on Long-Term Care Facilities

July 1: Nursing Licensure Compact – Effective July 1, 2020

Temporary Aide Programs

Workforce Resources

March 29: Hiring and On-Boarding Workforce Resources

March 29: Department of Labor Guidance on New Leave Benefits

Federal Reporting Requirements

NHSN Reporting

August 9: Fall 2021 Changes to NHSN COVID-19 Vaccination Reporting
June 17: Qsource Tip Sheet on NHSN COVID-19 Reporting
May 11: CMS Rule Requires COVID-19 Vaccine Procedures and Reporting Beginning May 21, 2021
April 6: COVID-19 Vaccine Data Reporting to NHSN
January 11: Reporting of POC Antigen Test Results to NHSN Changed to Optional
November 22: NHSN Reporting Changes Effective Nov. 23rd
November 17: NHSN To Update Reporting Pathways
November 10: New Update: HHS NHSN Reporting Requirements
October 22: Updated Reporting Requirements to the Provider Relief Fund
September 2: Updates to NHSN LTCF COVID-19 Module Resident Impact and Facility Capacity Pathway
August 12: New NHSN Data Elements on Testing
August 4: How You Can Avoid Errors When Reporting Data to NHSN
July 1: NHSN Reporting Problems, Tags, and Penalties
June 11: NHSN Reporting Compliance Tips – Avoid CMPs and Nursing Home Compare Points
May 26: NHSN Reporting Update and FAQs
May 11: NHSN: Accurately Report Staffing & PPE Shortages
May 6: CMS Releases Memo on Interim Final Rule Updating Requirements for Reporting and Notification of Confirmed and Suspected COVID-19 Cases Among Residents and Staff in Nursing Homes
May 4: Getting Started with NHSN Reporting on COVID-19
May 3: Effective Date of CMS Interim Final Rule on COVID-19 Reporting for Nursing Homes
May 1: CMS Issues Interim Final Rule with New Requirements for COVID-19 Reporting for Long-Term Care Facilities

Related Regulatory Requirements

Resources

LTCF COVID-19 Module

Waivers & Emergency Orders

Public Health Emergency

August 30: Governor Holcomb Extends Public Health Emergency to September 30, 2021
July 29: Indiana Extends Public Health Emergency to August 30, 2021
July 19: HHS Extends Public Health Emergency to October 18, 2021

Waivers

September 1: Governor Holcomb issues Executive Order to Extend Temporary Health Care Licensure, Requires Hospital Elective Changes, and Seeks Waiver of Prior Authorization from Insurers
August 13: IDH Blanket Waivers Effective for 45 Days Following End of PHE
April 9: Federal Waivers on Transfer Notices, Care Planning, and MDS Assessments to Expire on May 10, 2021
November 2: Summary of COVID-19 Emergency Orders and Waivers for Comprehensive Care Facilities from ISDH
November 2: Summary of COVID-19 Waivers, Guidance, and Emergency Orders for Residential Care Facilities from ISDH
October 27: IDH Issues Certified Nurse Aide Training Program Orders
July 24: State and Federal Government Extend Waivers for Long-Term Care Facilities
July 1 CMS Updates SNF Billing Guidance Related to Three-Day Stay, Spell-of-Illness Waivers
June 26: CMS Ends Blanket Waiver on Staffing Data – Q2 Staffing Data Due August 14, 2020
May 11: Additional COVID-19 Emergency Declaration Waivers for Nursing Facilities
May 3: CMS Issues Additional Blanket Regulatory Waivers
April 22: Updated CMS Waiver on Physician Services for Nursing Facilities
April 22: AHCA Skilled SNF Coverage Decisions Under COVID-19 Waivers Flowcharts
April 20: IHCA/INCAL Summary on Fifth Blanket Waiver for Residential Care Facilities and Additional Temporary Nurse Aide Guidance
April 18: SIXTH EMERGENCY ORDER GRANTING TEMPORARY BLANKET WAIVERS FOR COMPREHENSIVE CARE FACILITIES
April 3: FAQs on Alignment of SNF Regulatory Waivers, MDS Guidance, and Payment During COVID-19 Resident Isolation
April 4: COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers
March 25: CMS Approves Indiana’s 1135 Waiver
March 21: 2nd Emergency Order Granting Temporary Blanket Waivers for CCFslity Regulatory Waivers
March 21: 2ND Emergency Order Granting Temporary Blanket Waivers for RCFs
March 13: 3-Day Stay Waiver Guidance
March 3: CMS Issues Blanket Regulatory Waivers

Personal Protective Equipment (PPE)

EMResource

Please request your user account here.
Please access the user manual at this link.
EMResource Troubleshooting – Email Eric Shelley at the Indiana Department of Health – eshelley1@isdh.in.gov

Coordinate account registration with your facility administrator. We recommend designating at least two individuals that can track and input data into EMResource.

OSHA

Using and Conserving PPE

FEMA COVID-19 Pandemic Response: Nursing Home PPE Packages

ACCESS HERE

Vendors

PPE Vendors and Assistance
Sanitizing Floor Mat Information

Disposable Masks and Safety Equipment
- Calderon Textiles | 6131 W 80th St, Indianapolis, IN 46278
- Contact: Josh Ellis, PPE Specialist | jellis@calderontextiles.com | 317-902-7031