Since the passage of the SFY 2027-2028 biennial budget last summer, LeadingAge Ohio has heard from members and residents alike who are frustrated with the budget’s omission of assisted living residents from the important increase to the personal needs allowance. Now, we are asking members to engage their residents in advocacy to increase visibility and demand action.
The personal needs allowance, which is the amount of income that a resident is able to keep to pay for small purchases like haircuts, cellular service, or a meal out with friends, became a priority for the DeWine Administration in the months leading up to the budget process, when a resident council wrote to the administration requesting that the amount be increased. The purchasing power of the monthly amount had diminished over time and had not been increased in many years. Once the bill was passed, however, it became clear that the Administration only intended to increase the amount for individuals residing in nursing facilities and not those who are part of the assisted living waiver program.
This is particularly challenging because individuals in assisted living often have higher personal expenses than those in nursing facilities, and it also serves to discourage moving to a lower-cost care setting.
LeadingAge Ohio has drafted talking points for members explaining the solution, as well as a draft letter for residents. We strongly encourage members to make these tools available to their resident advocates, including sharing them with their assisted living resident councils. While member advocacy is welcome, we believe that residents will have the strongest voice and impact on the Administration to address this issue.
Additionally, this week, Representative Click (R-Tiffin) introduced HB 822, which would increase the personal needs allowance for all long-term care settings to $100 per month. Top LeadingAge Ohio will convene providers, plans, and policymakers for its annual Palliative Care Summit on May 21 at the OCLC Conference Center in Columbus. The one-day event focuses on expanding access to palliative care across Ohio, with continuing education offered and a program shaped by feedback from last year’s summit.
The agenda includes a keynote on reframing palliative care messaging to support earlier referrals and reduce stigma, followed by a moderated discussion with health plans on network adequacy, telehealth, and partnership expectations. Additional sessions will examine scalable care models, statewide infrastructure, and data-informed approaches to access, along with an update on state policy priorities, grant opportunities, and momentum advancing palliative care across Ohio. Register for the Palliative Care Summit here. LeadingAge’s 16 Member Networks and 13 Peer Groups, covering a wide range of job, care setting, and community-specific categories, as well as interest areas like technology, workforce and quality and risk management, provide valuable access to knowledge and insights from colleagues at mission-driven organizations nationwide. Explore them and sign up—here’s how. We kicked off our regional networking events in Cleveland this week. We gathered nearly 50 members from across the Northeast region to connect at Great Lakes Brewing. Big thank you to our partner Link-age Solutions for sponsoring these meaningful events.
LeadingAge Ohio’s Regional Network Gatherings return this spring, offering members the opportunity to connect with peers from across the state. These in-person gatherings center on conversation and relationship-building among mission-driven aging services organizations.
Join us at one of the networking events from 4 p.m. to 6 p.m.:
Attendance is free for LeadingAge Ohio member communities. Associate firms and partners are welcome to attend for a fee. Contact Corey Markham at cmarkham@leadingageohio.org for details. Stay Connected Snapshot
There's always something happening at LeadingAge Ohio, view all upcoming events here and mark your calendar today!
- April 16, 2:30 p.m. - Survey Success Collaborative: Building Strong Foundations for 5-Star Outcomes
- April 20, 10 a.m. - Advocacy in Action - CANCELED
- April 23, 9 a.m. - Hospice Clinical Bootcamp
- April 23, 2:30 p.m. - DON Network Meeting
- April 28, 9:30 a.m. - SNF/AL Clinical/Operations Subcommittee
- April 29, 1 p.m. - Palmetto GBA Jurisdiction M, 2026 Medicare Home Health Workshop - Navigating the Essentials of Medicare
- April 30, 9 a.m. - Advanced Principles of Hospice Management
- April 30, 10 a.m. - Philanthropy Network
- April 30, 12:30 p.m. - Central/Southeast STARS Awards
Top As the midterm election cycle accelerates, nonprofit leaders are weighing how to support civic participation while maintaining a nonpartisan approach. A national coalition—including Independent Sector, Nonprofit VOTE, the Alliance for Justice’s Bolder Advocacy program, and the League of Women Voters—has launched Voices in Action, an initiative designed to help organizations connect their daily community work to informed voter engagement.
The effort centers on practical guidance for nonprofit providers, including those serving older adults, who play a trusted role in their communities. A kickoff webinar is scheduled for May 5, 2026, at 2 p.m. ET, with additional tools available through the National Council of Nonprofits’ voter engagement resources. Together, these materials outline how organizations can encourage participation, share information, and support access to the democratic process while remaining firmly nonpartisan. Top Newly introduced legislation in the Ohio House would increase the Medicaid personal needs allowance (PNA) and extend it to assisted living residents, addressing a gap left in the most recent state operating budget.
House Bill 822, introduced this week, proposes raising the monthly PNA to at least $100 for individuals and $200 for couples across nursing facilities, ICFs/IID, and the Medicaid-funded assisted living program. The bill also explicitly includes assisted living waiver participants—who were not part of the recent budget increase.
As advocates will recall, the SFY 2026–2027 operating budget increased the PNA for nursing facility residents from $50 to $75 per month. However, the Ohio Department of Medicaid did not apply that increase to individuals enrolled in the assisted living waiver, leaving those residents at the prior level.
HB 822 seeks to correct that disparity by both aligning assisted living with other long-term care settings and establishing a higher statutory minimum going forward.
For providers and stakeholders, the change could help ensure greater equity across care settings while giving residents more resources to cover personal expenses not included in their care. The proposal may also support ongoing advocacy efforts to ensure consistent treatment of assisted living residents within Medicaid policy. A group of Ohio lawmakers are advancing a proposal to significantly restructure the state’s Medicaid system, replacing managed care organizations (MCOs) with a simplified administrative model they say could reduce costs and improve transparency.
Sens. Louis Blessing (R-Cincinnati) and Beth Liston (D-Dublin) this week introduced Senate Bill 386, the “Medicaid Savings Act,” which would shift the program to an administrative services only (ASO) model. Under this approach, vendors would be paid a set fee to administer Medicaid, rather than taking on financial risk as MCOs do today.o’s recent pharmacy benefit manager (PBM) reforms—and similar changes in Connecticut—as evidence that streamlining Medicaid can generate savings while increasing provider participation and directing more dollars to care.
Liston, a physician, emphasized that Ohio’s current system is highly complex, with multiple plans, varying requirements, and administrative hurdles that can burden providers and limit access for patients. She argued that past efforts to simplify Medicaid, such as adopting a single PBM, have made the system work better for both providers and beneficiaries.
Lawmakers on the Senate Medicaid Committee raised issues including federal approval requirements, how savings would be used, and how patient outcomes would be measured. The bill would establish a working group to address transition details.
A companion bill, House Bill 780, has been introduced in the House by Rep. Karen Brownlee (D-Cincinnati), and sponsors plan to continue discussions on the proposal in the coming weeks. Enrollment for the 2026 Senior Farmers Market Nutrition Program opens April 22 at noon, offering eligible Ohioans age 60 and older $50 to purchase fresh, locally grown produce, herbs, and honey. Applications are available through the state’s SFMNP portal and close May 22. Participants must meet income guidelines and reapply each year. Digital benefits remain the primary option, with funds available starting May 15, while physical cards continue for those who prefer them.
The program supports both nutrition access and local agriculture, with added flexibility for participants to choose digital or physical redemption. Providers serving older adults may want to share timelines and eligibility details now, particularly for communities that rely on mailed cards, which can take several weeks to arrive.
Read the full announcement from the Ohio Department of Aging. Top The President released the fiscal year budget request on April 3, outlining funding priorities for federal agencies, including the Centers for Medicare & Medicaid Services and the Centers for Disease Control and Prevention. LeadingAge has provided a high-level overview of the proposals most relevant to aging services providers, along with a more detailed analysis of the Department of Health and Human Services budget and its potential impact on care delivery and public health programs.
LeadingAge will continue tracking the federal appropriations process and share updates as legislative decisions are made. Federal advisors are taking a closer look at how the Program of All-Inclusive Care for the Elderly (PACE) is monitored across states. At its April meeting, the Medicaid and CHIP Payment and Access Commission signaled support for changes that would improve transparency, streamline oversight, and reduce duplication for providers—areas that have long created administrative strain.
MACPAC’s recommendations focus on aligning audits across agencies, making PACE performance data easier to access and compare, and establishing a standardized national quality measure set. Together, these steps aim to give providers clearer expectations while offering policymakers and the public more consistent information about program performance. For more details, review the MACPAC presentation on PACE oversight and recommendations. Top CMS clarified in the April 3, 2026, QSO-26-03-NH memo that facilities may demonstrate a return to substantial compliance even if noncompliance is identified at the time of a revisit. To avoid a determination of continued noncompliance, the facility must provide evidence acceptable to CMS or the State that there was a period of substantial compliance between the time prior deficiencies were corrected and when the new noncompliance began.
Determining the date of substantial compliance is not limited to the alleged correction date on the facility’s Plan of Correction (PoC). Surveyors first evaluate whether credible written evidence supports the facility’s claim that all deficiencies were corrected and that the facility is capable of remaining in substantial compliance. The date of substantial compliance may not always be the date specified by the facility in the approved PoC; it is also not necessarily the date of the revisit (onsite or paper-review). In some cases, a revisit may determine that a facility was able to correct all deficiencies and return to substantial compliance with the requirements before the alleged correction date on the approved POC. While the plan of correction serves as the facility’s allegation of compliance in non-immediate jeopardy cases, substantial compliance cannot be certified, and any remedies imposed cannot be lifted until facility compliance has been verified.
Facilities are responsible for ensuring that documentation clearly establishes when compliance was achieved. Evidence must include the timing of corrective actions, how those actions resolved the deficient practice, and how the facility implemented systems to prevent recurrence. This applies whether the review is conducted onsite or through an offsite (desk) review. If sufficient evidence is not provided, surveyors will default to the PoC date, or a later date supported by findings during the revisit. If a facility can demonstrate that it achieved and maintained substantial compliance before the revisit, any newly identified noncompliance may begin a new enforcement cycle rather than being cited as continued noncompliance. CMS has issued additional clarifications to complaint survey and enforcement guidance for nursing facilities, building on updates released earlier this year. While the changes do not introduce new policy, they tighten expectations for survey timing and provide more direction on how penalties are applied—both of which have direct implications for survey readiness and public reporting.
What You Need To Know
- CMS issued April 3, 2026, clarifications to survey and enforcement guidance for nursing facilities.
- Abbreviated complaint surveys must now be completed over two consecutive calendar days, starting at entrance.
- CMS clarified how per-day and per-instance civil money penalties (CMPs) are applied, noting examples in the memo are illustrative only.
- Actual CMP amounts will be determined using the CMP Analytic Tool, which is available to surveyors and providers.
- Changes apply to enforcement cycles beginning on or after March 31, 2026.
What Happens Next
- CMS will begin displaying per-instance CMPs on Nursing Home Care Compare starting June 24, 2026.
- Surveyors will continue using updated State Operations Manual guidance aligned with current practices.
- Providers should expect greater visibility into enforcement actions and more standardized CMP calculations.
What to Do
- Review internal survey readiness processes to ensure teams can support two-day abbreviated surveys without gaps.
- Familiarize leadership and compliance staff with the CMP Analytic Tool methodology.
- Monitor publicly reported data on Nursing Home Care Compare ahead of the June rollout.
- Share updates with clinical and operations teams to ensure consistent understanding of survey expectations.
For full details, review the CMS memo with April clarifications. On April 13, CMS updated the Nursing Home Five Star Rating Technical Users Guide. In the April revisions, the long-stay antipsychotic medication quality measure calculation will be updated to ensure that all residents with a history of schizophrenia are excluded, consistent with established specifications. A subset of these residents was not appropriately excluded from the measure data released in January 2026. CMS notes that this change did not have a significant impact on scores for this measure or quality measure ratings. However, the scoring cut points for this measure will be reset to place providers into deciles using data from 2024Q4-2025Q3. LeadingAge Ohio reminds members that they are able to access their LeadingAge Five Star Report directly from the LeadingAge Report Portal. Top LeadingAge Ohio holds valuable education webinars and in-person events throughout the year. Opportunities are added weekly. See the complete Schedule of Events. While Parkinson's Disease (PD) is traditionally considered a motor system disorder based on the hallmark features of tremor, rigidity, and bradykinesia, PD is now recognized to be a complex disorder involving a wide range of nonmotor manifestations that contribute to disability. Psychosis, not motor dysfunction, is the single greatest risk factor for nursing home placement in patients with Parkinson's Disease.
Parkinson's Disease Psychosis (PDP), characterized most often by visual hallucinations and paranoid delusional ideations, can be one of the most debilitating nonmotor symptoms of PD as disease progresses.
This month's DYK from LeadingAge Ohio Partner, HealthDirect Pharmacy Services, covers early clinical manifestation and causes of PD psychosis in these patients with recommendations for reducing episode frequency and severity of psychosis symptoms through medication management and intervention when indicated. Top Last week, House Bill 809 was introduced as companion legislation to Substitute Senate Bill 154. Both bills seek to expand Esther’s Law, which allows electronic monitoring devices in resident rooms, to assisted living facilities.
LeadingAge Ohio spoke with the media about our concerns with resident privacy, specifically around strengthening consent forms to allow roommates to fully consent to the possibility of the recording of private health information. As LeadingAge Ohio President/CEO, Susan Wallace, told McKnights, “For residents, we believe that the use of the camera functions as a de-facto waiving of HIPAA privacy rules in the inevitable situation when protected health information is shared via audio feed,” Wallace said. “If the resident has a roommate, we believe that the roommate should explicitly consent to the transmission of their healthcare information via the camera. This ensures that all residents’ rights to privacy are honored.”
LeadingAge Ohio is working with legislators to address this issue.
View media coverage from NBC4 and McKnights. Top
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