Assisted Living News 2026June19

Kierstin Reed • June 18, 2026

New Section 1115 Guidance Released

On June 11, CMS released a state Medicaid director's letter on budget neutrality and section 1115 waivers. One-third of Medicaid spending runs through section 1115 waivers. HR 1 required that the CMS Chief Actuary certifies that Medicaid section1115 waivers are budget neutral compared to the cost of running a Medicaid program absent the waiver. CMS says in the letter: "Overall, CMS’s intended approach to implementing section 1115(g) is tied to CMS’s current policy goals: ideally, section 1115 demonstrations should deliver better outcomes and operate as, or more, efficiently than the existing Medicaid program. This includes an approach to budget neutrality that is expected to reduce overall expenditures in section 1115 demonstrations, thereby reducing federal outlays." This appears to deviate from the existing approach of budget neutrality with a greater focus on achieving cost savings, but CMS notes there will be additional guidance, details and technical assistance prior to their change in approach which starts Jan 1, 2027. LeadingAge is reviewing the letter in more detail and will provide more analysis as needed.

Don’t miss our next Assisted Living Survey Session

LeadingAge Nebraska will be hosting Survey Readiness 365: Staying Ahead of Assisted Living Deficiencies on June 30th. This session is free for members and we will be discussing common areas of deficiency in Assisted Living surveys. This session will provide tips and resources to make your next survey the best one possible! Registration is open now. 


Updates from DHHS Survey Department

As a recap of our provider/surveyor call on Wednesday, here are your highlights. 

Life Plan Community Weekly Recap. Here is your weekly LPC Weekly Recap.

By Kierstin Reed June 18, 2026
**Thank You for Attending!** LeadingAge RAD for PRAC Peer-Sharing and Policy Discussion.
By Kierstin Reed June 18, 2026
CMS Issues Final Rule on Accrediting Organizations.
By Kierstin Reed June 18, 2026
HHS OIG Focus: Duplicate VA and Medicaid Payments.
By Kierstin Reed June 18, 2026
DHS Proposes Further Work Authorization Restrictions.
By Kierstin Reed June 18, 2026
COVID “Up to Date” Definition Will Not Change.
By Kierstin Reed June 18, 2026
Stability in Social Services: How prepared are you for social services turnover? Regulations require that nursing homes under 120 beds have someone meeting the criteria as their Social Services Designee. Nebraska allows those in this position to meet the criteria by taking a course of at least 35 hours in the skills needed. We have you covered! Sign up a team member today for our in-person course taking place August 3-7. Our week-long Social Services Designee Training is designed specifically for professionals like you, providing the knowledge, confidence, and practical tools needed to succeed in this essential position. Whether you’re new to the role or looking to strengthen your expertise, this course offers a comprehensive foundation to help you navigate the unique challenges of serving residents in a long-term care setting. Throughout the training, you’ll gain a clear understanding of your roles and responsibilities as a Social Services Director, learn how to effectively collaborate with your interdisciplinary team, and build skills in developing and implementing meaningful, person-centered care plans. We’ll also dive into strategies for addressing residents’ emotional, psychological, and social needs, while helping you confidently interpret and apply state and federal regulations. Designed for facilities under 120 beds, this course meets required training standards and equips you to make a lasting impact for both your residents and your organization.
By Kierstin Reed June 18, 2026
Would you like to meet with candidates?
By Kierstin Reed June 11, 2026
June 5 Update: STILL DELAYED - HUD-Required Immigration Eligibility Reverification in Multifamily Housing.
By Kierstin Reed June 11, 2026
GAO releases report on hospice payment.
By Kierstin Reed June 11, 2026
LeadingAge Submits Comments on Medicaid HCBS QMs.
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