Next week, LeadingAge Ohio members, partners, and friends will gather in Columbus for the 2025 Annual Conference & Trade Show—our biggest event of the year! To focus fully on welcoming attendees and delivering an unforgettable experience, The Source will take a short break and return the following week.
This year’s conference theme, “Ripples of Impact,” reflects the many ways our members shape lives, communities, and the future of aging services. Over three days, participants will enjoy:
- More than 60 interdisciplinary education sessions, offering timely knowledge and practical strategies for every role across the continuum of care.
- A moving keynote performance by Ryan Wotherspoon, blending story and music to inspire.
- A vibrant trade show floor with 90+ exhibitors, showcasing the latest products and services supporting aging services providers.
- Special events including the Annual Awards Luncheon, the ever-popular Game Night, and this year’s new Ice Cream Social.
We can’t wait to see so many of you at the Hilton Columbus at Easton, August 26–28. For last-minute details, updates, or to register, visit laoconference.org. Earlier this summer, federal courts ruled in favor of 19 state attorneys general and 20 LeadingAge state affiliates who were co-plaintiffs in a suit challenging the Centers for Medicare & Medicaid Services (CMS) nursing home staffing mandate. The ruling vacated requirements for 24/7 registered nurse coverage and minimum hours per resident day. However, following the ruling the enhanced facility assessment and Medicaid reporting provisions of the rule remained in place.
Now, the federal government has filed an appeal of that ruling. While a case number and briefing schedule have not yet been released, the appeal sends confusing mixed messages from Washington, where Congress just passed a 10-year moratorium on the rule as part of its “One Big Beautiful Bill” in early July.
LeadingAge, together with state partners including LeadingAge Ohio, will continue to monitor the appeal closely and keep members updated as developments occur. In the meantime, members with questions are encouraged to reach out to Susan Wallace at swallace@leadingageohio.org. Top You Asked: With the expiration of the Public Health Emergency (PHE) Quality, Safety & Oversight (QSO) memos, and with the flu season coming up, what guidance should nursing homes follow related to vaccinations?
We Answered: Vaccination requirements for nursing homes are outlined in the State Operations Manual Appendix PP under F883 and F887:
- §483.80(d)(1) – Influenza: Facilities must offer the influenza vaccine annually (October 1–March 31), provide education on risks/benefits, allow refusal, and document education, administration, or contraindication/refusal in the medical record.
- §483.80(d)(2) – Pneumococcal: Residents must be offered pneumococcal vaccination with education provided, refusal permitted, and medical record documentation required.
- §483.80(d)(3) – COVID-19: When available, facilities must offer the vaccine to all residents and staff, provide education on risks/benefits and side effects, document each dose or refusal/contraindication, and maintain staff vaccination records consistent with CDC/NHSN reporting requirements.
CMS notes that facilities should follow the CDC and ACIP recommendations for vaccines. The information related to current vaccine recommendations, including scheduling and contraindications, may be found on the CDC’s Advisory Committee on Immunization Practices webpage or the “Epidemiology and Prevention of Vaccine-Preventable Diseases,” otherwise known as “The Pink Book”.
For up-to-date information on indications and timing of pneumococcal vaccines, CMS recommends referring to the following websites:
Top As workforce shortages persist across the aging services sector, immigration policy—both current and proposed—continues to influence the availability and stability of care teams.
To better understand the experiences of members, LeadingAge Ohio has launched a short, two-minute survey aimed at capturing how immigration-related issues are affecting providers statewide. Your feedback will help inform advocacy priorities, guide educational offerings, and shape workforce development strategies. Questions? Contact Randi Hamill, Director of Workforce Development and Initiatives, at rhamill@leadingageohio.org. Monday’s Advocacy in Action call provided an overview of housing-related policy and legislation currently under consideration before the state legislature, the potential impact and status of the property tax provisions that were passed in the state operating budget, and a preview of what potentially lies ahead for the remainder of the general assembly, and how LeadingAge Ohio plans to develop a policy platform to advocate for the issues that matter most to our members.
Members can watch a full recording of the August 18 session on the LeadingAge Ohio Learning Center, and are encouraged to register for the next Advocacy in Action call, scheduled for September 15. Are Medicaid cuts going to lead to nursing home closures, or is the story more complicated? Join Susan Wallace in conversation with renowned researcher Bob Applebaum of Miami University’s Scripps Gerontology Center as they unpack a recent Brown University study that predicted the closure of hundreds of nursing homes nationwide.
In the latest episode of the LeadingAge Ohio podcast, Another Word for Living, Bob also sheds light on broader long-term care trends and clears up some of the biggest misconceptions surrounding nursing homes. Listen here! There's always something happening at LeadingAge Ohio, and we don’t want you to miss a moment. From educational opportunities to networking events, our calendar is packed with ways for members to stay informed, engaged, and connected.
Explore what's ahead and make plans to join us—whether you're looking to expand your knowledge, connect with peers, or get involved in shaping the future of aging services in Ohio.
View all upcoming events here and mark your calendar today!
September 10, 11 AM - Survey Tips & Tactics: Enhanced Barrier Precautions Top LeadingAge is gathering member feedback to strengthen national advocacy efforts on issues that directly affect providers across the aging services continuum. Two current priorities highlight why member engagement is critical:
Medicare Advantage
LeadingAge seeks input from members on a range of challenges, including payment, contract terms, and provider incentives. This work will support advocacy for the bipartisan Prompt and Fair Pay Act (HR 4059). To continue the conversation, LeadingAge Ohio members are encouraged to join our Managed Care Solutions Network meeting on September 11, 2025, at 1:00 p.m. ET.
Inpatient to Outpatient Shift of Surgical Procedures
The proposed 2026 Hospital Outpatient Prospective Payment System (OPPS) rule would move certain surgical procedures currently classified as inpatient to outpatient under Medicare Fee-for-Service. This shift could significantly impact both skilled nursing facilities (SNFs) and home health agencies (HHAs). Public comments on the proposed rule are due September 15, 2025. LeadingAge Ohio members are invited to discuss these potential impacts during the Nursing Home Network Meeting on August 26, 2025, at 1:00 p.m. ET.
Your participation ensures Ohio providers’ experiences and concerns are represented in national advocacy efforts. The next meeting of the LeadingAge Managed Care Solutions Network will take place on Wednesday, September 11, at 1 p.m. ET. Please note that this is a schedule change from the Network’s usual 3 p.m. start time.
This session will focus on provider payments under Medicare Advantage (MA), with discussion topics including current MA payment rates and incentives, timeframes for achieving a “clean claim” and receiving payment, and trends in accounts receivable.
LeadingAge encourages skilled nursing facility and home health agency members to participate, and especially to invite billing and MA payment experts from their organizations to join the call.
To help guide discussion, LeadingAge has developed a set of prompting questions for members to respond to. Feedback can be shared either during the meeting or directly with Nicole Fallon to inform our ongoing advocacy efforts.
If you are not yet a member of the LeadingAge Managed Care Solutions Network, we invite you to take one minute to register here so your name is added to the distribution list.
We hope you will join us for this important conversation! Top This week, the Ohio Department of Medicaid posted a new Private Room Compliance Fact Sheet describing the method by which the Department would monitor compliance with ORC 5165.158, and in particular those requirements for nursing homes receiving private room payments to 1. Have a policy in place to prioritize placement in a private room based on the medical and psychosocial needs of the resident, and 2. Participate in the Oho resident or family satisfaction survey.
Per the Fact Sheet, providers will receive an email notification from ODM NF_PrivateRoom@medicaid.ohio.gov notifying them that a portal link is active. Once active, this link will be available for thirty (30) days from September 2 through October 2, 2025. During that time period, nursing homes will need to attest online to the fact that:
-
The policy was in place July 1, 2025; 2.
-
The facility plans to participate in the 2025 resident or family satisfaction survey; and
-
That the information is complete and accurate.
Upon submission, the NF will receive an email notification confirming receipt from ODMNF_PrivateRoom@medicaid.ohio.gov. More detail is included in the fact sheet, which can be found on the Ohio Medicaid Nursing Facility page. Last month, LeadingAge Ohio posted a sample private room policy to assist providers in complying with the requirement. This is available on the LeadingAge Ohio Toolkits page. The Joint Committee on Agency Rule Review (JCARR) heard testimony last week opposing proposed rules for certified medication aides (CMAs), filed by the Ohio Board of Nursing (OBN) following passage of SB 144 (Romanchuk).
The CMA rules, which have already drawn concerns in public hearings earlier this month, were added to JCARR’s agenda at the last minute and sparked further debate. Licensed practical nurse Paul Dohse of Xenia and licensed nursing home administrator and registered nurse Sherri Gunasekera of Beavercreek both argued that the rules conflict with state and federal law and place residents at risk.
Dohse criticized the reduction of CMA training to just one and a half days, warning that the change would allow individuals with minimal instruction to administer medications, including opioids. He said the new rules conflict with the Nurse Practice Act and the federal Nursing Home Reform Act by eliminating standardized training and testing requirements. Gunasekera also questioned the safety of allowing CMAs to administer dangerous medications with such limited preparation.
Rep. Brennan (D-Parma) suggested opponents’ issues might be with SB144 itself, not the rules.
OBN staff responded that the proposed rules align with the intent of SB 144 and were crafted to comply with the Ohio Revised Code. However, legislators on the panel, including Sen. Bill DeMora (D-Columbus), echoed concerns about CMAs’ limited training hours and the potential risks of medication administration without direct nurse notification.
JCARR did not take action on the rule at the meeting.
Read the full report from The Hannah Report here. Top The new Minimum Data Set (MDS) 3.0 Item Sets (v)1.20.1v3 and accompanying Item Matrix are now finalized and available in the Downloads section of the MDS 3.0 Resident Assessment Instrument (RAI) Manual page on the CMS site. This version contains changes finalized in the Fiscal Year 2026 Skilled Nursing Facilities (SNF) Prospective Payment System (PPS) rule and will be effective beginning October 1, 2025. Some House Republicans are preparing a second budget reconciliation push this fall—often dubbed another “big, beautiful bill”—but prospects appear uncertain without the kind of deadline pressure that moved the first package. Even within the GOP, senators have voiced reservations about using reconciliation again, noting both the political lift and the potential strain on bipartisan cooperation. For a concise look at the Capitol Hill dynamics, see this overview of congressional sentiment.
Parallel staff briefings have begun to sketch health policy options that could be incorporated into a follow-on package. Discussion items include site-neutral hospital payments, a scaled-back renewal of ACA marketplace tax credits, Medicare Advantage changes targeting overpayments, and scrutiny of PBM and 340B policies. For context on the topics circulating in those meetings, see a summary of the policy areas under discussion. The Congressional Budget Office (CBO) has warned that the One Big Beautiful Bill will likely trigger automatic spending cuts under the Statutory Pay-As-You-Go Act (PAYGO). Unless Congress intervenes, sequestration would take effect in January 2026, with Medicare facing an estimated $45 billion reduction in that year alone, according to the CBO PAYGO letter.
Senior GOP leaders have signaled that Congress will likely waive PAYGO requirements before the end of the year, as it has done several times since the law’s enactment in 2010.
A separate CBO distributional analysis found that households in the lowest 10 percent of earners would see about a $1,200 annual loss in resources, largely from Medicaid and SNAP cuts. Middle-income households would see annual gains of $800 to $1,200, while the top 10 percent of earners would see increases averaging $13,600 per year, driven by tax cuts.
Meanwhile, House Energy and Commerce Committee Chairman Brett Guthrie (R-KY) highlighted a CBO coverage update showing that about 10 million people will lose Medicaid coverage, not the 17 million previously reported, with most either ineligible or voluntarily leaving the program. The Institute for Healthcare Improvement (IHI) is inviting LeadingAge members and aging services providers to join the Age-Friendly Health Systems movement.
Through the Age-Friendly Health Systems Online Course with Coaching, participants will build a strong foundation in the 4Ms Framework and learn how to implement age-friendly care across diverse settings, including hospitals, ambulatory clinics, nursing homes, and home health agencies. This interactive program equips teams to take the first steps toward delivering age-friendly care while preparing participants to serve as champions within their organizations.
The course offers 10 continuing education credits for physicians, nurses, pharmacists, social workers, and CPPS recertification. Registration is $549 per person.
A limited number of scholarships are available to offset costs. Applications are due September 3, 2025, and will be reviewed individually using standardized criteria.
Learn more and register for the course. Questions may be directed to Program Manager Lauren Cameron at afhsocc@ihi.org. The Centers for Medicare & Medicaid Services (CMS) has released its proposed rule for the 2026 Physician Fee Schedule (PFS), which outlines Medicare payment policies and related Part B issues for the coming year.
LeadingAge is closely reviewing the proposal and preparing comments on behalf of members. Key provisions under review include payment updates with Physician Fee and related Part B policy issues, telehealth flexibilities, and the Medicare Shared Savings Program.
The proposed rule is open for public comment through September 12, 2025. Aging services providers are encouraged to review the provisions and consider submitting comments.
View the CMS Fact Sheet here and LeadingAge’s article here.
LeadingAge will continue to analyze the rule and provide updates on issues most relevant to members. Top In recent months, the Ohio Department of Health (ODH) has cited facilities under F908 for failing to maintain kitchen equipment in safe operating condition. According to the State Operations Manual Appendix PP, §483.90(d)(2), facilities must maintain all mechanical, electrical, and patient care equipment in safe operating condition.
Recent ODH citations include:
- Kitchen steamer leaking and not safely operable
- Improperly configured or maintained drain lines, not in accordance with the FDA Food Code
Surveyors are instructed to determine compliance by evaluating:
- How does the facility assure all mechanical, electrical and patient care equipment is maintained in safe operating condition?
- Is essential equipment (e.g., boiler room equipment, nursing unit/medication room refrigerators, kitchen refrigerator/freezer and laundry equipment) in safe operating condition?
- Does the bed control panel covering have signs of damage where liquids could leak in?
- Does the electronically powered bed’s power cord, cord plug, and wall plug in have damage?
- Is equipment maintained according to the manufacturer’s recommendations?
Facilities should implement and document a preventive maintenance program that includes routine checks of dietary, laundry, and resident care equipment. Timely repair or replacement of equipment is essential to ensure safety, avoid F908 citations, and support compliance with CMS requirements. Facilities should also routinely monitor compliance using the surveyor guidance outlined in the State Operations Manual Appendix PP. LeadingAge has received questions about the use of off-site staff in nursing homes, such as Minimum Data Set (MDS) coordinators. In a recent update to the Payroll-Based Journal (PBJ) Policy Manual and FAQs, the Centers for Medicare and Medicaid Services (CMS) clarified that only hours worked on-site may be recorded in PBJ. Hours worked off-site, even for licensed nurses performing administrative duties, may not be counted.
While nursing homes may engage off-site staff for certain administrative tasks, facilities must continue to meet MDS assessment requirements. These include direct observation of and communication with residents, as well as collaboration with the interdisciplinary team. Off-site nurses may perform coding and transmission of MDS data, but all staff completing this work must hold licensure in the state where the nursing home is located. For MDS coordinators serving multiple facilities across state lines, this means securing licensure in each applicable state.
CMS also emphasized that questions regarding MDS responsibilities and scope of practice should be directed to the state Resident Assessment Instrument (RAI) coordinator. A full list of state RAI contacts is available in CMS Appendix B. On August 15, the Centers for Medicare & Medicaid Services (CMS) announced that Nursing Home Care Compare will be frozen until October 2025. This freeze includes star ratings and monthly updates to health inspections.
The pause follows the successful transition of all nursing home survey and certification data to the Internet Quality Improvement and Evaluation System (iQIES). CMS is implementing the temporary freeze to validate data integrity and ensure that publicly reported information meets quality standards moving forward.
During this period, nursing homes must continue to display their most recent survey findings in a publicly accessible area of the facility. In addition, members of the public may request federal agency records, including CMS inspection documents and related compliance materials.
Updates to Nursing Home Care Compare are scheduled to resume with the quarterly refresh on October 29, 2025. Read the full alert from CMS. Top Has your organization recently celebrated a major milestone? Opened a new building? Been featured in the news? Whether it’s a groundbreaking, an award, or a great story from your community, we want to help spread the word.
LeadingAge Ohio members are doing incredible work across the state, and we’re proud to highlight those efforts. Share your press releases, social media posts, or media coverage with us and we’ll feature them in the Member News section of The Source. We may also help amplify your story on LeadingAge Ohio’s social media channels.
To submit a news item, simply email Laurinda Johnson at ljohnson@leadingageohio.org. We can’t wait to celebrate your success! Top LeadingAge Ohio holds valuable education webinars and in-person events throughout the year. Opportunities are added weekly. See the complete Schedule of Events. Top
|
