Nursing Home News 2026May14

Kierstin Reed • May 14, 2026

HHS Takes Aim at De-prescribing

The Department of Health and Human Services (HHS) has announced a new initiative to curb “psychiatric overprescribing.” HHS Secretary Robert F. Kennedy, Jr. announced an action plan on May 4 aimed at preventing unnecessary initiation of psychiatric medications and supporting the tapering and discontinuation of medications for patients not experiencing clinical benefit. The plan includes three main pillars: education and outreach, program and policy, and research-to-practice initiatives. In a Dear Colleague letter also released on May 4, HHS encouraged providers to “prioritize informed consent and shared decision-making, and to regularly review the risks and benefits of psychiatric medications with patients.” HHS noted that the letter also highlighted non-pharmacological interventions and provided information on billing codes that could be used to support the delivery of evidence-based nonmedication treatments. While the HHS announcement referred several times to this initiative in relation to children and adolescents, it is worth taking note for nursing homes given the increased attention to psychotropic medications in recent years. Recall that the Centers for Medicare and Medicaid Services (CMS) released updated guidance in November 2024 that re-classified unnecessary psychotropic medications as chemical restraints, while continuing efforts to reduce the use of antipsychotic medications in nursing homes. As HHS pursues this agenda, it will be important for nursing homes to ensure they are continuing to follow requirements and best practices. Specifically, providers should pay attention to key areas of compliance such as informed consent, adequate clinical indications for use, and gradual dose reductions. Check out LeadingAge resources on psychotropic medications and preventing chemical restraints for assistance.


Building Momentum for Observation Stays Bill

LeadingAge continues advocacy on the Improving Access to Medicare Coverage Act (H.R. 3954). This bill would require all days spent in a hospital, regardless of inpatient or outpatient observation status, to count toward the three-day qualifying stay required for Medicare Part A coverage of a skilled nursing facility (SNF) stay. The House bill was originally introduced this congress by Reps. Joe Courtney (D-CT), Glen Thomspon (R-PA), Suzan DelBene (D-WA), and Ron Estes (R-KS) and currently has 33 co-sponsors. We hope to see a companion bill in the Senate soon. LeadingAge will continue working with congressional offices to build support for this and the forthcoming Senate bill.

 

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
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