Nursing Home News 2026June26

Kierstin Reed • June 25, 2026

Federal Monitoring Surveys for FY 2026

The Centers for Medicare & Medicaid Services (CMS) will be making adjustments to the number of Federal Monitoring Surveys being completed in FY 2026 as a result of the government shutdown at the beginning of the fiscal year during which surveys were not authorized. CMS is statutorily required to complete federal monitoring surveys in “at least 5% of the number of skilled nursing facilities surveyed by the state in the year, but in no case less than 5 skilled nursing facilities in the state.” CMS will continue to meet these requirements but is adjusting the basis for calculating the required number of surveys in each state. Fewer federal monitoring surveys will be conducted in FY 2026; however, at least 5 nursing homes in each state will be surveyed. Federal monitoring surveys will include both Resource and Support Surveys (RSS) and Health Comparative surveys. Life Safety Code / Emergency Preparedness federal monitoring surveys will additionally include desk audits. The CMS location will work with the state agency to identify nursing homes for surveys and will be focusing on nursing homes that provide good training opportunities. Priorities include those at risk for noncompliance, those with a history of noncompliance, those with allegations of noncompliance, CMS-specific concerns, and media attention. Health surveys will breakdown to 60% of federal monitoring surveys being conducted on complaint surveys and 40% being conducted on standard recertification surveys. For Life Safety Code / Emergency Preparedness, surveys will be split between 80% of surveys being completed on recertification surveys and 20% being completed on revisits. Recall that while the purpose of the federal monitoring survey is to evaluate state agency performance, federal surveyors may cite noncompliance and may impose enforcement remedies in comparative surveys, including suspension of the nurse aide training and competence evaluation program (NATCEP). More information, including actual numbers of surveys per state, can be found in CMS Administrative Information Memo 26-06-NH.


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.


Just Released! Nursing Home Survey Trends and Tools Webinar


Join us for a deep dive into current survey trends happening in Nursing Home services in Nebraska and opportunities members have to review data. We will review the state trends and look at ways to improve on practices that are negatively impacting providers in the state. CEO, Kierstin Reed will review the top 5 citations for Nursing Homes in Nebraska and provide insight into the cause and potential solutions to these areas.


We will also take a look at the LeadingAge Quality Metrics tools and the trend reports that are available to all LeadingAge Nebraska members, in addition to your 5 Star Analysis Report. The LeadingAge Quality Metrics system contains three tools, Nursing Home Quality Metrics, which analyzes quality metrics such as 5-star ratings, staffing, quality measures, and deficiencies in skilled nursing facilities using the most current publicly reported Nursing Home Compare data; and Home Health Quality Metrics, which analyzes quality metrics in categories such as Managing Daily Activities, Managing Pain and Treating Symptoms, Treating Wounds and Preventing Pressure Sores, Preventing Harm, Preventing Unplanned Hospital Care and Patient Satisfaction Survey results using the most current publicly reported Home Health Compare data and Hospice Quality Metrics, which studies quality measures in categories such as family experience of care and quality of patient care using the most current publicly reported Hospice Compare data.


Join us to learn what is happening in Nebraska survey and how to utilize these tools to benchmark your services and improve performance.

PBJ System Transitioning to iQIES in August:

The Centers for Medicare & Medicaid Services (CMS) announced on June 12, that the Payroll-Based Journal (PBJ) system will transition to internet Quality Improvement and Evaluation System (iQIES) on August 17, 2026. The PBJ system is the only system remaining in the previous QIES system while all other programs have transitioned to iQIES. iQIES is a secure, cloud-based system that CMS uses to collect and manage quality and compliance information. Effective on August 17, 2026, long-term care providers must submit all PBJ staffing data in iQIES. 


CMS will provide additional information before the launch through various email notifications regarding onboarding, training, details on what to expect, and more. Until then, please ensure that you complete the following (if you haven’t done so already): 


  1. Create a HCQIS Access Roles and Profile System (HARP) account.  Skip this step if you already have a HARP account. If you don’t have an account register here. 
  2. Request access to iQIES – submit your request early so your access is ready before launch. Although you may request your PBJ role before August 17 (CMS strongly recommends you do so), PBJ functionality will not be available before August 17, 2026. 
  3. Choose the correct PBJ role within iQIES –
  • Provider Security Official (PSO) – Can view, upload, edit PBJ data and run PBJ reports. This role also approves user access. 
  • PBJ Submitter (Provider or Vendor): Can view, upload, edit PBJ data and run PBJ reports. 
  • Provider Administrator: View – only access and run PBJ reports.
  • PBJ Viewer: View-only access and run PBJ reports. 
  • Additional information on roles can be found in the iQIES Onboarding Process – Provider User Roles Manual posted on the iQIES Reference and Manuals on the QTSO under iQIES Onboarding Guides. 

  4.  Get approval from your facility’s PSO – Your access will not become active until they approve it.               Each facility must have at least one PSO to manage access for additional users. 


Once you register for an iQIES account, be sure to log in regularly. If you don’t log in for 60 days, you’ll lose access to iQIES. Additional information on the iQIES Inactive User Policy can be found on QTSO. 


 Vendors must request access for each facility they represent and get approval from a PSO at each facility, using the facility’s CMS Certification Number (CCN). 


Policy questions should be emailed to nhstaffing@cms.hhs.gov 


Technical questions: Contact the iQIES Service Center at 800.339.9313 Monday – Friday 8 a.m. – 8 p.m. ET (7 a.m. – 7 p.m. CT) You may also request assistance via secure chat or schedule a call through CCSQ Support Central. Please note that Chat Support is currently limited to 8 a.m. – 4 p.m. CT Monday – Friday. 



Here is your NATIONAL Nursing Home Weekly Recap

By Kierstin Reed • September 24, 2026
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.
By Kierstin Reed • September 24, 2026
CMS' Technical Error in Final FY27 Hospice Wage Index
By Kierstin Reed • September 24, 2026
LeadingAge Nebraska Testifies at LR481
By Kierstin Reed • September 24, 2026
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
By Kierstin Reed • September 24, 2026
CDC Releases Updated Return-to-Work Guidance
By Kierstin Reed • September 24, 2026
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 .
By Kierstin Reed • September 24, 2026
Bipartisan Bill Seeks to Stop Medicare Advantage Payment Clawbacks Reps. Greg Landsman (D-OH) and Bob Onder (R-MO) introduced the bipartisan Protecting Approved Care Act, legislation aimed at preventing Medicare Advantage (MA) plans from retroactively denying or reducing payment for care that has already been approved and delivered. The bill would apply protections to prior authorizations, pre-service and concurrent determinations, and authorizations for transfers from hospitals to post-acute care settings. LeadingAge appreciates the bill’s focus on practices our nonprofit and mission-driven members increasingly encounter, including plans denying or making only partial payment for previously approved services and seeking lower payments than CMS-required assessments indicate. Providers should be able to rely on an MA plan’s approval when they furnish care in good faith rather than face burdensome appeals or legal action after services have already been delivered. LeadingAge is reviewing the legislation and its implications for members and will continue engaging with Congress on policies that ensure MA plans appropriately cover and pay for needed care. Here is the link to the recording of last week’s Joint Provider-Surveyor Training: https://vimeo.com/1226926568/a6ed3394ec?fl=tl&fe=ec&share=copy LeadingAge Nebraska Testifies at LR481 Senator Bostar held a hearing on Wednesday this week regarding LR481 with a purpose of examining the fiscal and operational issues related to the addition of long-term care services and supports to the Medicaid managed care program. LeadingAge Nebraska provided testimony that would caution the state against this implementation and would encourage them to proceed with thoughtful planning and collaboration prior to implementation. In his closing comments, Senator Bostar asked an important question, “Is it necessary?” He pointed out that the state has held off on implementing this for the long term care sector for a reason. Nebraska should examine the reason they want to implement this and the complications that could result from the implementation. LeadingAge Nebraska and our members continue to meet with MCO’s regarding this on a quarterly basis and we encourage members to participate in those meetings.
By Kierstin Reed • September 24, 2026
 FRIENDS OF LEADINGAGE NEBRASKA PAC - We need your support!
By Kierstin Reed • September 17, 2026
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.
By Kierstin Reed • September 17, 2026
CMS' Technical Error in Final FY27 Hospice Wage Index
Show More