HUD Report Highlights BABA Implementation, Monitoring Issues. On September 10, the Department of Housing and Urban Development (HUD) published a report by its own oversight entity, the Office of the Inspector General (OIG), evaluating the agency’s implementation of Build America, Buy America (BABA) requirements throughout HUD programs. The Buy America Preference within BABA requires federal agencies to limit federal infrastructure spending unless the iron, steel, manufactured, and construction products used were domestically sourced in the U.S., which has proven infeasible for LeadingAge members developing new affordable housing units. The report, titled “HUD Needs to Improve its Monitoring of the Buy America Preference of the Build America, Buy America Act,” called out HUD’s lack of compliance monitoring for BABA; OIG recommends that HUD designate an official responsible for overseeing BABA implementation and consistency across HUD program offices. BABA is applicable to four HUD program offices, including the Office of Multifamily Housing Programs, which administers the Section 202 Supportive Housing for the Elderly program, as well as the Green and Resilient Retrofit Program (GRRP), both of which are subject to BABA requirements. LeadingAge continues to urge HUD and Congress to fully exempt affordable housing developments from the Buy America requirements because they are too difficult to execute and the original statute did not intend to BABA requirements to affordable housing. HUD Publishes LeadingAge-Driven Flexibilities on Emergency Call Systems. On September 10, the Department of Housing and Urban Development (HUD) published new guidance, driven by concerns shared by LeadingAge, to create more flexibility within emergency notifications system requirements for affordable senior housing providers. Previously, the agency required owners of certain HUD-assisted senior housing communities to operate emergency call systems in independent living units, which could be used by residents to call for aid in the case of an emergency, like a fall or a medical event. However, LeadingAge members consistently reported issues with the call systems, including residents misusing the systems and property insurance providers limiting whole-building coverage because of the perceived liability risk associated with the medical nature of the emergency notification devices and systems. Further, many residents reported to housing providers that they prefer to utilize personally-worn emergency devices and view the property call system as overreach by housing providers. In its new guidance, HUD makes the systems optional and encourages owners to conduct wellness checks instead, which many LeadingAge affordable housing providers already do. LeadingAge confirmed with HUD that the removal of the now optional emergency notification systems is a project-eligible expense. We applaud HUD for addressing the concerns of senior housing communities, and we will work with our membership to ensure the highest quality of housing for HUD-assisted residents. Here is your weekly Affordable Housing Weekly Recap.
LeadingAge and Hospice Advocates Meet with OMB and DEA on Final Teleprescribing Rule
Federal District Court Vacates Multiple Provisions of HHS' Section 504 Rule Relating to the Integration Mandate
Coalition Partners to Host Webinar on El Salvador TPS. As many LeadingAge members know firsthand, the future of Temporary Protected Status (TPS) is creating significant uncertainty for employees, employers, and communities across the country. Two LeadingAge coalition partners – WorkPermits.US and the American Business Immigration Coalition (ABIC) – will host a virtual webinar on Thursday, September 17 at 3p ET that will provide U.S. employers with critical updates regarding the status of work authorization for Salvadoran employees with TPS. As of September 9th, El Salvador TPS is still in place , pending the government's decision on whether to extend the program. Nonetheless, for employers, changes to TPS can have real consequences for workforce stability, employee retention, recruitment, and business operations. It is important for employers to understand what these changes mean, what responsibilities they have, and how they can support their employees with TPS. During the virtual webinar, expert panelists will cover compliance responsibilities, employer legal obligations, and actionable advocacy steps to protect essential workers. Register here if interested in this topic, and as always, reach out to Associate Director for Immigration Advancement Shane Myers if you have questions or concerns. Here is your weekly Workforce Weekly Recap
ICAP Respiratory Guidance Updates
LeadingAge Assisted Living Study Underway Participation is officially open for the 2026-2027 Assisted Living Salary & Benefits Study . Now in its 29th consecutive year, the national survey is conducted by HCS in cooperation with LeadingAge . Below is a brief overview on the study: Submission Deadline : November 9th Report Publication : January 2027 LeadingAge Participant Pricing: $190 (pre-paid) / $210 (billed) vs. $400 non-participant rate Questionnaire Download : www.hhcsinc.com Below is a full press release with survey links to share with members. Kindly confirm receipt. Thank you! 2026 HCS Assisted Living Salary & Benefits Study Underway Hospital & Healthcare Compensation Service (HCS) is conducting its annual Assisted Living Salary & Benefits Study and requests your participation. Assisted Living/Personal Care/Residential Care providers are invited to complete and submit the study questionnaire by November 9th. The national study is published by HCS in cooperation with LeadingAge . There is no cost to participate. Survey respondents receive a substantial discount, with options to purchase the final results for $190 (pre-paid) or $210 (billed), compared to the $400 non-participant rate. Questionnaires are available for download on the HCS website at: www.hhcsinc.com . The results will be published in January 2027. Last year’s Report contained data from 1,057 communities nationwide. The results cover salaries, bonuses, and hourly rates for 50 positions, with data reported regionally by bed-size, profit type, and revenue, as well as by state and CBSA. The report also covers 18 fringe benefits, including health/dental/vision insurance, PTO/time-off policies, 401(k) plans, and educational assistance, while also covering critical metrics like turnover rates, granted/budgeted salary increases, shift differentials, and sign-on bonuses. If you should have any questions, or find you need additional time beyond 11/9 to submit your data, please contact Rich Cioffe at rjcioffe@hhcsinc.com , (201) 405-0075, ext. 10. HCS publishes ten annual compensation studies. Nationally known, their reports are recognized as the standard for reliable, comprehensive, and affordable compensation data for healthcare. Thank you for your continued support! Here is your Life Plan Community Weekly Recap .
PBJ Submissions- CMS Releases “Non submitter list” CMS reached out last week with a list of nursing homes that have not yet registered to submit PBJ data through iQIES. We are pleased to report there are NO LeadingAge Nebraska Nursing Homes on this list. On August 17, all PBJ submissions transitioned to iQIES and FY 2026 Quarter 4 data, due on November 14, must be submitted through this system. Nursing homes must request access through iQIES and be approved by the Provider Security Official in order to submit data. This process can take weeks, especially if the Provider Security Official is no longer working at the nursing home and a new one must be registered. Nursing homes are encouraged to follow the steps outlined in the CMS memo MA Disenrollment of SNF Residents in the Spotlight The Center for Medicare Advocacy reports that nursing homes are disenrolling residents from their Medicare Advantage plans without their knowledge and that the Centers for Medicare and Medicaid Services (CMS) have long-standing guidance that reinforces that these changes should only be initiated by the beneficiary or their authorized representatives. LeadingAge reminds members that such disenrollment actions by nursing homes can result in survey tags and investigations for fraud and abuse, while also can have wide-ranging implications for the beneficiaries. More details can be found in this LeadingAge article including links to the two CMS memos that outline what is permitted and the required steps that must be taken if nursing homes opt to assist beneficiaries and families with these decisions. CMS Updates HAI Measure to Include Claims Data. The Centers for Medicare & Medicaid Services (CMS) released an update to the Skilled Nursing Facilities (SNF) Quality Reporting Program (QRP) measure technical specifications on September 24, re-specifying the Healthcare-Associated Infections (HAI) Requiring Hospitalization measure. This measure will now include Medicare Advantage (MA) encounter data in addition to the Medicare Fee-for-Service data that was already included in calculations. The measure specifications also include updates to risk adjustment based on the inclusion of this data. Read the updated specifications in the technical specification report, available in the Downloads section of the SNF QRP Measures and Technical Information page. New HUB Resource for Hospice Care in Nursing Homes. LeadingAge is incredibly excited to share our new resource to help providers better coordinate care for nursing home residents receiving hospice services, Hospice Care in Nursing Homes: A Shared Responsibility. The education resource reviews five sections, relationship and communication processes, regulation and reimbursement including regulatory co-management expectations, navigating complex scenarios, care coordination, and tools for building contracts, which were developed from a series of listening sessions with both hospice and nursing home members. LeadingAge Comments on Proposed Medicaid Provider Tax Rule On September 21, LeadingAge submitted comments to the Centers for Medicare and Medicaid Services (CMS) on its proposed rule , Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes. In our comments, we make the case that the proposed rule extends CMS’ obligation to implement section 71115 of 2025’s HR 1, which modifies Medicaid health care-related (provider) tax rules, beyond the statutory text in key ways. LeadingAge urges CMS to realign its rulemaking in a manner that minimizes burden and financial exposure for both providers and states. Upon release of the proposed rule, we provided this article , touching on the relevant provisions in the rule. We dig deeper and urge CMS restraint in five key areas in our comments .
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HUD Report Highlights BABA Implementation, Monitoring Issues. On September 10, the Department of Housing and Urban Development (HUD) published a report by its own oversight entity, the Office of the Inspector General (OIG), evaluating the agency’s implementation of Build America, Buy America (BABA) requirements throughout HUD programs. The Buy America Preference within BABA requires federal agencies to limit federal infrastructure spending unless the iron, steel, manufactured, and construction products used were domestically sourced in the U.S., which has proven infeasible for LeadingAge members developing new affordable housing units. The report, titled “HUD Needs to Improve its Monitoring of the Buy America Preference of the Build America, Buy America Act,” called out HUD’s lack of compliance monitoring for BABA; OIG recommends that HUD designate an official responsible for overseeing BABA implementation and consistency across HUD program offices. BABA is applicable to four HUD program offices, including the Office of Multifamily Housing Programs, which administers the Section 202 Supportive Housing for the Elderly program, as well as the Green and Resilient Retrofit Program (GRRP), both of which are subject to BABA requirements. LeadingAge continues to urge HUD and Congress to fully exempt affordable housing developments from the Buy America requirements because they are too difficult to execute and the original statute did not intend to BABA requirements to affordable housing. HUD Publishes LeadingAge-Driven Flexibilities on Emergency Call Systems. On September 10, the Department of Housing and Urban Development (HUD) published new guidance, driven by concerns shared by LeadingAge, to create more flexibility within emergency notifications system requirements for affordable senior housing providers. Previously, the agency required owners of certain HUD-assisted senior housing communities to operate emergency call systems in independent living units, which could be used by residents to call for aid in the case of an emergency, like a fall or a medical event. However, LeadingAge members consistently reported issues with the call systems, including residents misusing the systems and property insurance providers limiting whole-building coverage because of the perceived liability risk associated with the medical nature of the emergency notification devices and systems. Further, many residents reported to housing providers that they prefer to utilize personally-worn emergency devices and view the property call system as overreach by housing providers. In its new guidance, HUD makes the systems optional and encourages owners to conduct wellness checks instead, which many LeadingAge affordable housing providers already do. LeadingAge confirmed with HUD that the removal of the now optional emergency notification systems is a project-eligible expense. We applaud HUD for addressing the concerns of senior housing communities, and we will work with our membership to ensure the highest quality of housing for HUD-assisted residents. Here is your weekly Affordable Housing Weekly Recap.
CMS' Technical Error in Final FY27 Hospice Wage Index
