LeadingAge Ohio will meet with the Ohio Department of Medicaid next Tuesday, July 28, to discuss implementation of the court-ordered Quality Incentive Payment (QIP) back payments authorized in House Bill 479.
The meeting represents the first time the nursing home associations plan will meet formally with Medicaid on the topic quality incentive payments since the September Supreme Court decision; the meeting is expected to include details on both timeline and mechanisms for issuing back payments to Ohio nursing homes. Other points of clarification may include:
- Steps Medicaid has taken to ensure payments will qualify for federal matching funds,
- How and whether managed care organizations will be involved in issuing payments,
- How providers that experienced ownership changes will be handled,
- Implications for hospices and pass-through room & board payments, and
- Communication and guidance providers can expect as the process moves forward.
LeadingAge Ohio welcomes member questions regarding the payment process, to ensure next week’s meeting will be as productive as possible. Questions or comments may be directed to Eli Faes at efaes@leadingageohio.org. LeadingAge Ohio will continue advocating for a transparent, efficient payment process and will share updates with members as additional information becomes available. Top You Asked: Can a facility be cited if meals are not served at the time they are posted to be served?
We Answered: Yes. While CMS does not require meals to be served at an exact clock time, surveyors evaluate whether meals and nutritional supplements are provided at regular times comparable to normal mealtimes in the community or in accordance with each resident's needs, preferences, requests, and plan of care.
Under F809, surveyors observe meal schedules and determine whether residents are receiving meals at appropriate and consistent times. In addition, CMS instructs surveyors to evaluate whether meals or nutritional supplements are provided within 45 minutes of a resident's request, or sooner if consistent with the facility's scheduled meal service.
Surveyors also assess whether the facility has sufficient dietary staffing to safely and effectively prepare and serve meals. Under F802, facilities must employ enough qualified food and nutrition services staff to meet the needs of the resident population, taking into consideration resident acuity, assessments, plans of care, and the Facility Assessment. If meal delays, cold food, or untimely nutritional supplements are observed, surveyors may determine that insufficient dietary staffing contributed to the concern. Top The LeadingAge Ohio Annual Conference is more than an educational event - it is an opportunity to connect with colleagues, gain valuable insights, engage with policymakers, and help shape the future of aging services.
Professionals from across the continuum of care come together to build relationships, share best practices, and learn from one another. With interdisciplinary education focused on the clinical, operational, regulatory, workforce, and leadership challenges facing providers today, attendees leave with practical strategies they can bring back to their organizations.
The conference also provides critical advocacy updates, including legislative and regulatory developments impacting aging services. Attendees have the opportunity to hear directly from legislators and agency representatives, participate in question-and-answer sessions, and better understand how their voices can influence the future of care in Ohio.
From networking with peers to discovering innovative solutions, the LeadingAge Ohio Annual Conference equips professionals with the knowledge, connections, and resources needed to advance their mission and serve older adults.
Join your colleagues for an experience designed to connect, educate, and inspire action across Ohio’s aging services community. This week’s Advocacy in Action webinar featured Katy Barnett with LeadingAge National for an update on CMS's proposed Calendar Year 2027 Home Health Prospective Payment System rule, which threatens sweeping changes affecting all Medicare providers. In response to the Administration’s heightened focus on Medicare fraud, CMS proposed in its recent rule significant changes that will make it easier for CMS to revoke provider certification that may have far-reaching and unintentional impacts. Examples of providers that could be impacted included:
- Providers that happen to be colocated. For example, if one physician from a practice serves as the medical director for an agency that has significant Medicare debt, other physicians from that practice may have their Medicare provider status revoked;
- Provider organizations that hire clinical leadership that have previously worked for a provider that has been convicted of a misdemeanor of financial misconduct;
- Revocations may now be retroactive to the date of misconduct, dramatically increasing risk to providers.
Members across the care continuum should be informed about these potential changes.
To listen to this week’s Advocacy in Action webinar, click here.
On July 20, Secretary Kennedy announced the delegation of his agency’s authority to effectuate exclusions from federal health programs to CMS. With both OIG and CMS now having the authority to exclude providers, LeadingAge is concerned about the consolidation of power and will continue to monitor the intersection with other policy proposals. In collaboration with Oppenheimer & Co. and Ascensus, LeadingAge Ohio is excited to announce the launch of a retirement plan solution created exclusively for our members. Designed for organizations sponsoring either a 401(k) or 403(b) retirement plan—as well as those exploring the addition of a retirement plan for the first time—this new solution provides access to the advantages of a pooled employer plan, helping organizations simplify retirement plan administration, reduce fiduciary responsibilities, leverage economies of scale that can help reduce retirement plan costs, and support employees in preparing for retirement.
Whether you’re evaluating your current retirement plan, considering a change, or looking to establish a retirement plan for the first time, this solution offers a modern, streamlined approach designed to meet the unique needs of our members.
Join us for an informational webinar on August 4, where we’ll introduce the program, explain how it works, and highlight the benefits available to LeadingAge Ohio members. Members attending the LeadingAge Ohio Annual Conference at the end of August will also have the opportunity to schedule one-on-one meetings to discuss their organization’s retirement plan needs and determine whether this new solution is the right fit. There’s always something happening at LeadingAge Ohio. View upcoming events and mark your calendar today.
- July 28, 9:30 a.m. - SNF/AL Clinical Operations Subcommittee Meeting
- August 4, 10 a.m. - Discover LeadingAge Ohio’s New Retirement Plan Solution
- August 4, 1 p.m. - Membership Committee
- August 6, 9 a.m. - Budget and Finance Committee Meeting
- August 6, 10 a.m. - Advocacy Committee Meeting
- August 13, 10 a.m. - Board of Directors Meeting
- August 14, 1 p.m. - Foundation Board Meeting
- August 17, 10 a.m. - Advocacy in Action
- August 20, 1 p.m. - 2026 Reimbursement Collaborative: Maximizing Opportunity in a Changing Environment - The High-Performance Playbook
- August 24, 9 a.m. - Hospice Pre-Conference Sessions
- August 25-27, 2026 - Annual Conference & Trade Show
Top Join over 6,000 changemakers from across the aging services sector at the 2026 LeadingAge Annual Meeting, October 25–27, to connect, collaborate, and advance meaningful change for older adults and the communities we serve. Bring the changemakers on your team and in your network to join the conversation and help shape what's next for aging services. Bring changemakers from your team as our sector comes together at the LeadingAge Annual Meeting. Register prior to July 24 for the early bird discount! Top The Buckeye Institute released a new policy report, The Cost of Aging, outlining challenges facing Ohio’s long-term care system and offering recommendations to address the growing needs of an aging population. The report highlights workforce shortages, Medicaid sustainability concerns, and the need to modernize care delivery and financing. Recommendations include strengthening community-based services, simplifying Medicaid reimbursement, reducing unnecessary regulatory barriers, expanding the direct care workforce, encouraging private long-term care planning, and leveraging technology to support caregivers. This information is placed on behalf of the Ohio Department of Health:
Now that you are receiving your nursing home surveys under your federal nursing home profile in your Enhanced Information Dissemination & Collection (EIDC) account, we would like to remind you to also submit your Self Reported Incidents (SRIs) under your federal profile in EIDC. After clicking on the Self Reported Incident menu item in EIDC on the light blue column located on the left of your screen, please select your federal nursing home profile designated by the Federal ID number that starts with 36, to create a new incident. Any SRI already submitted or started under the licensure nursing home profile can be completed under the licensure nursing home profile and are still being received and processed by ODH. For continuity and consistency in managing SRIs going forward, please resume submitting your SRIs under the federal nursing home profile, if you have not already. We appreciate your cooperation. For any questions on SRI submission, please contact your assigned regional office. Top CMS has released the July 2026 OASIS Q&As, which are updated quarterly to address questions submitted to CMS help desks. Because these responses may be time-limited, they can be superseded by future CMS guidance.
This update includes an important clarification that non-Medicare/non-Medicaid OASIS data will be used to calculate a home health agency's Home Health Quality Reporting Program (HHQRP) Annual Payment Update (APU) compliance for patients with an OASIS Start of Care (SOC) M0090 date on or after January 1, 2027.
CMS also issued revised guidance for coding M1060 (Height and Weight) and M1311 (Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage). The responses provided in the July 2026 Q&As supersede the guidance in the OASIS-E2 Guidance Manual. Home health agencies should review these updates carefully and ensure clinical staff are informed of the revised coding guidance. CMS has published a proposed rule, Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care Related Taxes (CMS-2452-P), outlining how the agency intends to implement Section 71115 of H.R. 1.
The proposal would reduce the indirect hold harmless threshold for certain provider taxes, establish new definitions that differ from previous CMS guidance, strengthen compliance requirements, and create new state reporting obligations. CMS estimates the rule would reduce federal Medicaid spending by approximately $246 billion between 2026 and 2035.
While the proposal leaves provider taxes on nursing homes and intermediate care facilities largely unchanged, Ohio's hospital and managed care organization provider taxes could be affected. As a Medicaid expansion state, Ohio would be required to gradually reduce affected provider taxes to comply with the new 3.5% hold harmless threshold by 2032, if the rule is finalized.
The proposed rule is open for public comment for 60 days, with comments due on or around September 19. CMS has also released a fact sheet summarizing the proposal. The U.S. Department of Education has updated its interim list of professional degree programs subject to a recent court order affecting the RISE rule. The update clarifies that certain Master of Science in Nursing (MSN) and Doctor of Nursing Practice (DNP) programs remain eligible for higher federal student loan limits and adds the Ph.D. in Clinical Psychology to the list. LeadingAge continues to monitor the litigation and legislative proposals, citing concerns that the RISE rule could negatively impact workforce pipelines for nursing and rehabilitation professions. LeadingAge submitted comments to CMS on its proposed rule governing Medicaid State Directed Payments (CMS-2449-P), urging the agency to align the regulation with the statutory language in H.R. 1 and withdraw provisions that expand beyond congressional intent. The comments also raise concerns that the proposal would create significant administrative burdens for states and providers and could have unintended consequences for PACE reimbursement and provider contracting arrangements. Read LeadingAge’s comments here. The U.S. Department of Health and Human Services Office of Inspector General (OIG) found that Medicare Administrative Contractor Novitas Solutions improperly paid an estimated $19.5 million for certain Part B services provided to beneficiaries residing in nursing homes. The audit reviewed evaluation and management, psychotherapy, and podiatry claims from 2018–2019 and found documentation or coverage issues in a significant portion of sampled claims.
While the findings focused on Medicare contractor oversight rather than nursing homes themselves, the report highlights continued federal scrutiny of Medicare Part B billing and documentation practices in post-acute and long-term care settings. OIG recommended strengthened claims review processes and additional provider education to help prevent future improper payments. Top CMS has expanded expectations for the medical director's oversight of schizophrenia diagnoses and the appropriate use of psychotropic medications.
Under F841 of the State Operations Manual, the medical director is responsible for coordinating medical care and ensuring resident care policies reflect current professional standards of practice. This includes discussing concerns with, and intervening as appropriate, when a physician or other practitioner provides care that is inconsistent with accepted standards—for example, assigning a new schizophrenia diagnosis or prescribing psychotropic medications without adequate clinical justification or adherence to professional standards.
Medical director’s responsibilities include:
- Implementation of resident care policies, such as ensuring physicians and other practitioners adhere to facility policies on diagnosing and prescribing medications and intervening with a health care practitioner regarding medical care that is inconsistent with current professional standards of care.
- Participation in the Quality Assessment and Assurance (QAA) committee or assign a designee to represent him/her. (Refer to F868).
- Addressing issues related to the coordination of medical care and implementation of resident care policies identified through the facility’s quality assessment and assurance committee and other activities.
- Active involvement in the process of conducting the Facility Assessment.
If a deficiency has been identified regarding a resident’s care, the Long-Term Care Survey Process (LTCSP) instructs surveyors to also determine if the medical director had knowledge or should have had knowledge of a problem with care, or physician services, or lack of resident care policies and practices that meet current professional standards of practice and failed to get involved or to intercede with other physicians or practitioners to facilitate and/or coordinate medical care; and/or provide guidance for resident care policies. Top Join LeadingAge for the next LPC Member Network meeting on Thursday, July 30 at 2 p.m. for a fascinating discussion on some of the disparate and emerging research studies that focus on LPCs. The panel will feature Tom Akins, LeadingAge North Carolina’s President and CEO, as well as Karan Shah, Data Analyst from the National Investment Center, among others. All LeadingAge provider members are welcome. To receive the invitation, email Dee at dpekruhn@leadingage.org. 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
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