HUD Expected to Resolve Funding Delays by Mid-November. The Department of Housing and Urban Development (HUD) is expected to resolve contract payment delays to housing providers by mid-November, according to information received by LeadingAge. Many LeadingAge members have reported delays for October and November Housing Assistance Payments (HAPs), which present to affordable housing providers as an “R26 Insufficient Funds” code in HUD’s tenant rental assistance certification system (TRACS), along with reported delays in contract renewals that expired beginning October 1. LeadingAge has learned that HUD was recently able to prepare a funding package to address the shortfalls. HUD’s solution should resolve outstanding payments from HUD for both October and November, as well as any forthcoming payments for both December and January. Beyond January, funding will depend on the ongoing congressional appropriations debate. In addition to ongoing staffing capacity issues at HUD that hinder the timely administration of rental assistance payments, the agency is currently funded through a Continuing Resolution (CR) that has created disruptions to the agency’s financial obligations to contracted housing providers, including the monthly HAPs that fund operations at affordable housing communities. The current CR expires on December 11, and the appropriations picture was shifted significantly by the 2026 mid-term elections. It is unacceptable to LeadingAge that HUD cannot consistently meet its financial obligations to housing communities across the country, and we will continue to hold HUD accountable for capacity and process improvements; LeadingAge will also continue to advocate in Congress for full funding for affordable housing programs for fiscal year 2027. Join Our Weekly Housing Network Call on November 9, 12:30 p.m. ET. Join us on Monday, November 9, at 12:30 p.m. ET, where we’ll unpack what the midterm election results mean for affordable senior housing. We’ll also discuss HUD’s solution for recent payment delays and the agency’s announcement to officially delay the compliance date for the Housing Opportunity Through Modernization Act (HOTMA). The Housing Network meets weekly on Mondays at 12:30 p.m. ET and is open to all provider members of LeadingAge. For details on joining the Network and other affordable housing groups that LeadingAge convenes, visit our website or contact Jules Bilowich or Brian Stromberg. Here is your weekly Affordable Housing Weekly Recap.
GUIDE Model Updates: A New GUIDE Finder Tool and Member Meetings with GUIDE staff. The Guiding an Improved Dementia Experience (GUIDE) model has entered year three of its 8-year model and Center for Medicare and Medicaid Innovation (CMMI) staff and LeadingAge members participating in the model are still eager to grow the program to reach more older adults and their caregivers, and engage more providers to deliver GUIDE services. Recently, an outside group set up an online tool where beneficiaries and their caregivers can find GUIDE participants (the lead organizations) in their area but it is not CMS sponsored and only includes a subset of GUIDE participants so far. Although other GUIDE participants can sign up to be added to the website. CMMI and CMS are developing their own government-sponsored finder tool. In addition, LeadingAge has been hosting meetings between CMMI GUIDE staff and members. Another opportunity is being finalized with CMMI GUIDE staff to meet with LeadingAge GUIDE participants and providers in December. For more information on these developments, check out this article here . Register Now for LeadingAge December 3 Meeting with CMMI GUIDE staff LeadingAge members, who are currently participating in the Center for Medicare and Medicaid Innovation (CMMI) Guiding and Improved Dementia Experience (GUIDE) model, are invited to attend a meeting hosted by LeadingAge with CMMI GUIDE staff on Thursday, December 3, 3 p.m. ET. This will be an opportunity for members to discuss challenges members have voiced and experienced, as GUIDE participants and providers, that were raised at the July 30 convening hosted by LeadingAge. Specifically, CMMI GUIDE staff have indicated they want this to be a discussion and problem-solving session examining the changes related to the Residential Care Communities requirements implemented in July 2026 and the challenges of finding respite care providers. Members are encouraged to bring other issues to the discussion. This presents an excellent opportunity for members to influence and shape current and future changes to the GUIDE model that can expand its reach to more Medicare beneficiaries and engage additional providers. The GUIDE staff are looking forward to hearing directly from LeadingAge members. Please register to attend as soon as possible, 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.
Potential Fee Increase for State Fire Marshal Health Care Surveys: A proposed increase may impact health care surveys completed by the State Fire Marshal Agency. Fees for this service have not increased for many years. Most fees are projected to double in cost. A public hearing will be hald to receive comments on the proposed fee increases. A hearing will be held on December 2nd starting at 9:30 am at the Nebraska Department of Water, Environment and Energy located at 245 Fallbrook Blvd, Hearing room 031 in Lincoln. Public comments can be in person, or email addressed to Doug Hohbein. Proposed increases are outlined below: Health care Facilities (nursing home, hospital, ALF): 50 beds or less: current fee $50*- proposed fee $100* 51 to 100 beds: current fee $100* – proposed fee $200* 101 or more beds: current fee $150* – proposed fee $300* Reinspection fee: current fee $50 for first hour; $25 each additional ½ hour not to exceed $150 – proposed fee: $100 for first hour; $25 for each additional ½ hour not to exceed $150. *Initial survey fee includes one revisit at no additional charge. Reinspection fee is second revisit, if necessary Assisted Living Member Network: November 18, 2 p.m. ET. Join us for the next Assisted Living Member Network call on Wednesday, November 18, 2 p.m. ET. Please note: we have shortened this call to 30 minutes to make it easier for members to attend. This month, we’ll be discussing the Quality in Assisted Living Collaborative’s (QALC’s) Emergency Operations Guidelines that will be released on Thursday, November 12 on the LeadingAge Assisted Living topic page. The Assisted Living Network meets on the third Wednesday of every month and is open to any interested LeadingAge members, state partners, and staff. Please email any questions or topics to be raised on the call to Jodi Eyigor jeyigor@leadingage.org . Not yet a member of the Assisted Living Network? Register here. Here is your Life Plan Community Weekly Recap .
CMS Issues Deregulatory Proposed Rule with Life Safety Code and Nursing Home Wins The Centers for Medicare and Medicaid Services (CMS) released a proposed rule on November 5 that aims to reduce administrative burden for CMS-certified providers through multiple deregulatory actions across settings. The rule is largely based on feedback to a Request for Information issued from the Department of Health and Human Services (HHS) in spring 2025. While some provider settings will be more pleased than others, nursing homes scored some significant wins through proposals to end respiratory illness reporting in the National Healthcare Safety Network (NHSN) and adoption of the 2024 edition of the National Fire Protection Association (NFPA) Life Safety Code. Read more in this LeadingAge article. The rule has a 60-day comment period, with comments being due to the Federal Register by early January. Potential Fee Increase for State Fire Marshal Health Care Surveys: A proposed increase may impact health care surveys completed by the State Fire Marshal Agency. Fees for this service have not increased for many years. Most fees are projected to double in cost. A public hearing will be hald to receive comments on the proposed fee increases. A hearing will be held on December 2nd starting at 9:30 am at the Nebraska Department of Water, Environment and Energy located at 245 Fallbrook Blvd, Hearing room 031 in Lincoln. Public comments can be in person, or email addressed to Doug Hohbein . Proposed increases are outlined below: Health care Facilities (nursing home, hospital, ALF): 50 beds or less: current fee $50*- proposed fee $100* 51 to 100 beds: current fee $100* – proposed fee $200* 101 or more beds: current fee $150* – proposed fee $300* Reinspection fee: current fee $50 for first hour; $25 each additional ½ hour not to exceed $150 – proposed fee: $100 for first hour; $25 for each additional ½ hour not to exceed $150. *Initial survey fee includes one revisit at no additional charge. Reinspection fee is second revisit, if necessary CMS Finalizes Expanded Authorities Regarding Medicare Provider Enrollment and Revocation Rules to Combat Waste, Fraud, and Abuse. The Centers for Medicare and Medicaid Services in the CY2027 Home Health Final Rule, issued on November 4, 2026, finalizes expansive changes to the Medicare program through enrollment revocations and denials. Though the Medicare enrollment provisions are in the home health final rule, the changes will impact all providers—not only home health agencies. Read our full analysis here .
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HUD Extends Annual Service Coordinator Reporting Deadline, Schedules Next Peer-to-Peer Call. The Department of Housing and Urban Development (HUD) has announced an extended annual reporting deadline of January 30, 2027, for the annual Standards for Success (SfS) reporting submitted by Resident Service Coordinators working in HUD-assisted senior housing communities. Service Coordinators assist older adults as they age independently in community by connecting them with services in the broader community or to other federal benefits, like health insurance. LeadingAge supports HUD’s move to align the reporting timeline with the calendar year performance period for Service Coordinator grants, and we urge HUD to publish anonymized, aggregated analysis of the reporting results. The reporting, which includes several types of resident-reported outcome metrics, such as Activities of Daily Living needs, hospitalizations, and more, is a key indicator of HUD-assisted resident outcomes, but the data is currently not published by HUD. For 2026 reporting, Service Coordinators should submit data from the entirety of calendar year 2026, which will result in a 14-month submission because of holdover from the previous cycle’s submission timing (October 1, 2025-December 31, 2026). The submission deadline shift accompanies several other HUD internal structural changes impacting Service Coordinator grantees, including a change in HUD’s use of its previous grants management software and a reorganization of grant specialist assignments. HUD has also launched a quarterly peer-sharing call on Service Coordination this fall, with the second call scheduled for December 9. HUD Posts Long-Awaited HOTMA Delay Notice. On November 2, the Department of Housing and Urban Development (HUD) officially delayed the compliance date for HUD-assisted Multifamily Housing communities for the Housing Opportunity Through Modernization Act (HOTMA) until January 1, 2028. The compliance deadline was previously set to January 1, 2027. Following the publication of the November 2 notice, full compliance with the HOTMA final rule and discretionary policies is mandatory for all resident income certifications with a January 1, 2028, date or later. Additionally, housing providers will not be penalized for HOTMA-related tenant file errors during Management and Occupancy Reviews (MORs) prior to January 1, 2028, and will receive observations instead. All housing providers should continue to follow their existing Tenant Selection Plans (TSPs) and Enterprise Income Verification (EIV) policies until they are fully HOTMA compliant. For questions regarding the notice , contact MFH_HOTMA@hud.gov. LeadingAge Q&A: HUD’s Emergency Call System Guidance - Exclusively for LeadingAge members! Join LeadingAge and staff from the Department of Housing and Urban Development (HUD) on December 3, 2 – 3 p.m. ET, for a Q&A on the agency’s new guidance related to Emergency Call Systems in affordable senior housing. LeadingAge applauds HUD for addressing the concerns of senior housing communities by providing additional flexibilities related to e-call systems. HUD staff involved in the guidance will be on hand to answer questions. Open to LeadingAge members only. Register here, and reach out to Jules Bilowich ( jbilowich@leadingage.org ) with questions. Here is your weekly Affordable Housing Weekly Recap.
Here is your weekly Home Health Weekly Recap from National. Here is your weekly Hospice Weekly Recap from National.
We have no new HCBS updates to share this week.
