Affordable Senior Housing News 2026October23

Here is your weekly Home Health Weekly Recap from National. Here is your weekly Hospice Weekly Recap from National.

OIG to Focus on OAA Supportive Services The Department of Health and Human Services Office of Inspector General (OIG) have included Older Americans Act Program (OAA) Title III-B supportive services on their work plan. The plan update indicates that recent audits of the Home and Community Based Supportive Services Program “highlighted compliance and monitoring challenges in OAA programs.” OIG is investigating if states met compliance thresholds when claiming certain expenditures within the program. Enhanced scrutiny on states’ administrative policies could lead to new reporting requirements, increased administrative burden, or more oversight of providers and services as states ramp up attention to program integrity. In response to recurring attention to waste, fraud, and abuse (WFA) in Medicaid, LeadingAge developed a resource for providers. The tip sheet specifically speaks to background on Medicaid WFA and contains provider-level preparations for Medicaid Provider Revalidation; the same principles are applicable to OAA funded programs. The tip sheet could inform provider thinking about necessary internal policy changes, next steps, relationships with your local Area Agencies on Aging, and advocacy with your state Office on Aging; it can be found here .

We have no new Workforce updates to share this week. In the meantime, please see the links below for the latest Workforce Weekly Recaps from National. Here is your weekly Workforce Weekly Recap

CDC Releases Updated Return-to-Work Guidance. The Centers for Disease Control & Prevention (CDC) has released updated guidance outlining recommendations for work restriction for healthcare personnel related to respiratory viruses. LeadingAge has vigorously advocated for such guidance for years. The guidance replaces the Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 previously used for work restrictions for healthcare personnel exposed to or infected with COVID-19. The new guidance is based on recommendations from CDC’s Healthcare Infection Control Practices Advisory Committee (HICPAC), approved during the Committee’s last meeting in November 2024 before it was disbanded in March 2025. The new guidance applies to respiratory illnesses “not addressed elsewhere” in CDC guidance, including flu, respiratory syncytial virus (RSV), and COVID-19. According to this guidance, asymptomatic healthcare personnel who have been exposed to a respiratory illness do not need to be restricted from work but should wear source control from the day of first exposure through at least the fifth day after exposure. Healthcare personnel with a suspected or confirmed viral respiratory infection should be restricted from work until all four conditions are met: At least three days have passed since symptom onset (or first positive test, for asymptomatic infections), The individual is fever-free for at least 24 hours without the use of fever-reducing medications, Symptoms are improving, and The individual feels well enough to return to work. Testing to determine the specific respiratory illness is not required; however, CDC recommends following guidance specific to the respiratory pathogen should the individual opt for testing. LeadingAge is very pleased to see this updated guidance after years of advocacy and urges CDC to similarly update transmission-based precautions for healthcare settings and retire outdated guidance for SARS-CoV-2 infections among patients in healthcare settings, including residents in nursing homes. Provider can see the 10/8/26 presentation from ICAP with a summary of the requirements for health care providers regarding respiratory illness. Infection Control Guidance: Measles. With measles cases being reported across the U.S., LeadingAge members should be prepared to identify and address this highly contagious illness. Stay on top of case prevalence in your local area and coordinate with your local public health for guidance. The Centers for Disease Control & Prevention (CDC) also has resources available to help. Check out Healthcare Providers: Stay Alert for Measles and Measles Preparedness and Response in Healthcare Settings to get started. LeadingAge to Host CMS Conditions of Participation Listening Session November 18. At the next Hospice Quality and Compliance Workgroup meeting on November 18 at 1pm ET, staff from the Centers for Medicare and Medicaid Services (CMS) will join for a LeadingAge member listening session regarding changes to the Conditions of Participation (CoPs). If you missed the three listening sessions hosted in October by CMS you have a second opportunity to provide feedback on how to improve the quality, safety, and integrity of the program. This is also an opportunity to discuss the nonprofit, mission driven difference and how the quality we provide can be extended to all hospices. Sign up for the Hospice Quality and Compliance Network here.

We have no new Assisted Living updates to share this week. In the meantime, please see the links below for the latest LPC Weekly Recaps from National. Here is your Life Plan Community Weekly Recap .

Selecting Dates in POC DHHS Survey informed us they are receiving several requests to change the implementation/completion dates for components of the plan of correction. The date will likely default to 45 days for completion of a task. Facilities may change this date to fit the timeline they want to have the task completed. Facilities are contacting the survey department following approval to move the date up to avoid denial of payment days. DHHS is stating they will NOT change this date following approval without a significant reason. Facilities should select this date carefully and based on all information. Situations that may result in a date change would be if you were waiting on equipment that came in early or if there is a significant leadership change that was not involved with the plan of correction initially. Medline Recalls All Beds and Associated Parts On October 14, 2026, Medline released field notification letter R-25-242-X9 recalling all Medline brand beds and associated parts and accessories. The notice of voluntary field action to initiate product removal, discontinuation, and market exit issued on October 14 is an update to previous notifications that only affected certain product lines. According to the notice, the reason for recall is related to “electrical system safety risks that may result in fire and entrapment risk from the use of any bed accessories.” Medline advises: “Immediately unplug the bed and any associated battery packs or batteries from the bed or accessories,” and “Do not use the electrical functionality of the bed.” Medline states that the bed and mattress can continue to be used in manual mode until the bed can be replaced. Electrical adjustments should be made in emergency situations only. Should the bed be plugged back in for emergency use, extensions cords cannot be used. Bed accessories, including side rails, should also not be used. Adverse events should be reported to Medline QualityAssurance@medline.com . Medline will provide customers with a safety label to be placed on beds. Customers should contact the provider or distributor of the bed for information on removal and replacement of the bed. Find the field notification letter and Medline item list here . Proposed CMS Rule to Implement MA and Part D legislative provisions On October 16, the Centers for Medicare and Medicaid Services(CMS) announced it will publish on October 20 a proposed rule to implement aspects of the Consolidated Appropriations Act of 2026 related to Medicare Advantage provider directory verification processes, pharmacy benefit manager accountability and adjusting Medicare Part D copayments for generic drugs for full-benefit dual eligibles to $0. Of note, LeadingAge provided previous feedback to the Office of the National Coordinator for Health Information Technology (ONC) and CMS on some of their earlier thinking on the implementation of the MA provider directory verification requirements (a.k.a. Requiring Enhanced and Accurate Lists of (REAL) Health Providers Act) that we hope to see reflected in this proposed rule. The proposed changes will take effect for the Calendar Year 2028 MA and Part D benefit year and comments are due on December 15. LeadingAge will be reviewing the provisions of this proposed rule and follow up with a more detailed analysis in the coming week. CMS also noted that it plans to publish another proposed rule on MA and Part D policy and technical changes later this fall. NHSN Agreement to Participate and Consent. The Centers for Disease Control & Prevention (CDC) have updated the Agreement to Participate and Consent in the National Healthcare Safety Network (NSHN) application. Providers must accept the updated agreement by June 1, 2027, in order to continue accessing and reporting through NHSN. Upon logging into NHSN, users will see an alert prompting Facility Administrators to review and electronically accept the updated agreement on behalf of the nursing home by June 1, 2027. The agreement needs to be accepted only once per organization ID, meaning that additional acceptance will not be required for each NHSN user or each enrolled component. If the updated agreement has not been accepted by June 1, 2027, providers will be unable to report through the application, though they will remain active in NHSN and will not need to re-enroll upon acceptance. Instructions for Facility Administrators can be found here: 2026 Guidance for Accepting the Updated NHSN Agreement to Participate and Consent and 2026 Guidance for Accepting the NHSN Agreement on Behalf of Multiple Facilities. CMS Updates Risk-Based Survey Procedure Guide. The Centers for Medicare & Medicaid Services (CMS) has released an update to the Risk-Based Survey Procedure Guide. Updates include clarification on what procedures surveyors should undertake for general ombudsman concerns that are not specific to an individual resident and concerns regarding residents who have been discharged. While this update does not impact members’ procedures, reviewing the resource will be helpful in understanding the process should an issue like this arise during a Risk-Based Survey at your organization. The updates to procedures can be found on page two of the guide, which is located in the Surveyor Resources folder in the Downloads section here .

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Update with DHHS Survey Department LeadingAge Nebraska members had the opportunity to meet with DHHS Survey and other partners again this week on our monthly call. Slides from this presentation are available here. Below are a few highlights for Nursing Home members. ICAP Update CDC recently made changes to required testing as well as healthcare staffing requirements for respiratory illness. Dr. Ashraf explained that staff are restricted for a minimum of 3 days for respiratory infections and there is no testing requirement to return to work. PPE utilization should remain the same for COVID as it was previously. For Resident testing, there is no prescribed requirements or frequency for outbreaks. Residents should be tested if they have symptoms and should do a minimum of 10 days isolation for positive cases. Symptom screening of others should be conducted to determine testing needs based on symptoms. Broad based testing is no longer required. Providers are reminded that their policy and procedures can be combined for all respiratory illness, while separating for different protocol for each type of illness. Policy should be based on CDC and/or ICAP guidance. You can view ICAP’s webinar from 10/8/26 and slides for additional guidance. Life Safety Code Doug provided a reminder about not using space heaters. If you are having heating concerns, please contact the State Fire Marshal for short term solutions that are permitted. He also discussed egress exits, including exits off patios and how they should not be locked with a padlock or other means that cannot be removed. Delayed egress are always permitted but those that are not being restricted from the exit should always have access to exit. This may be with a code or other means to allow them to exit. You do not need to post the code on the door, but there needs to be a method that everyone is aware of so they know how to exit. Survey Trends There are two survey trends currently. Notification to the Ombudsman for discharges. Providers are reminded to send a copy of the discharge letter to the ombudsman’s office as they occur. Emergency discharges can be sent on a monthly basis. Providers do not need to do discharge notifications due to death. Second is the issue of informed consent for psychotropic medications. The resident and/or their representative must be informed at admission and for any dose change for psychotropic medications. Update the following call We received the following update regarding the discussion of if this applied to decreases in medications. Here is what was received from Larisa: I just wanted to follow up on the psychotropic medications and the question on decreasing needing informed consent. I have had a few people reach out to me as well on this. So F605 does primarily talk about the increases and changes to different medications. However, we still must look at F552 which is the right to be informed. So, if there was a decrease in the medication the resident/family/POA have the right to be informed in advance of any changes in treatment. F605 also speaks to even with increases and initiation of the medication resident has right to be informed if there is not documentation of that then we would cite F552. I copied the regulation below and highlighted what parts pertain to that. So next question I get is then do they have to have a form. Nor F605 or F552 require a form that is the choice of the facility and their policies, but it is required to be documented somewhere that can be accessible. F552 Planning and Implementing Care. The resident has the right to be informed of, and participate in, his or her treatment, including: The right to be fully informed in language that he or she can understand of his or her total health status, including but not limited to, his or her medical condition. The right to be informed, in advance, of the care to be furnished and the type of care giver or professional that will furnish care. The right to be informed in advance, by the physician or other practitioner or professional, of the risks and benefits of proposed care, of treatment and treatment alternatives or treatment options and to choose the alternative or option he or she prefers. Guidance is: The physician or other practitioner or professional must inform the resident or their representative in advance of treatment risks and benefits, options, and alternatives. The information should be communicated at times it would be most useful to them, such as when they are expressing concerns, raising questions, or when a change in treatment is being proposed . The resident or resident representative has the right to choose the option he or she prefers. Emergency Preparedness and 1135 Waivers Larisa presented on emergency preparedness and requirements of the 1135 waiver. This waiver only goes into effect when there is a federal declaration of an emergency for the area. Providers should include provisions for the 1135 waiver in their emergency preparedness policy. This waiver requires a provider to collaborate and support other emergency processes in their greater community. Providers should network with other healthcare providers as well as their emergency response center in their local area to know and understand emergency plans and how they will be able to contribute to the community in a collaborative way.