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November 26, 2025
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A budget amendment keeping nursing home reimbursement rates at current levels was adopted by the state legislature last week, a move that surprised few in the aging services field but leaves unresolved how the state will repay more than two years of court-ordered underpayments. Speaking to Gongwer News Service, LeadingAge Ohio President and CEO Susan Wallace said the decision avoids reductions but falls short of the increase required by the Ohio Supreme Court. LeadingAge Ohio and other provider groups will be working with the Ohio Department of Medicaid to address outstanding back payments.
Read more here. Top This season offers a meaningful opportunity to express our gratitude to the LeadingAge Ohio community. Your dedication, compassion, and steady commitment to those you serve strengthen aging services across our state. Each day, you provide comfort, stability, and support for older adults and families who rely on your care.
We are thankful for your leadership, your partnership in our mission, and the trust you place in us as we work beside you to advance the priorities that matter to your organizations. It is a privilege to serve such a deeply rooted, mission-driven community.
Wishing you and your communities a warm and restorative Thanksgiving. LeadingAge Ohio has partnered with E&M Consulting, Inc. to produce a Membership Directory and Resource Guide for LeadingAge Ohio members. The publication will be available in both print and digital formats. E&M will manage the entire project, including advertising sales and layout/graphic design.
LeadingAge sent a new membership list to E&M Consulting this week, and they will be reaching out to provider and partner members regarding advertising opportunities that are available.
Questions may be sent directly to E&M Consulting at advertising@eandmsales.com. Top The Ohio Department of Health has released draft revisions to Chapter 3701-18, which governs the Nurse Aide Training and Competency Evaluation Program. The proposal includes updates to the state-administered testing process and introduces new requirements for facility-based programs that proctor examinations. The changes are designed to align Ohio’s rules with recent statutory updates and to remove older regulatory language. Key implications include:
- Training program operations: Facilities that operate their own Nurse Aide Training and Competency Evaluation Program may need to adjust curricula, administrative processes, and testing procedures to meet revised state requirements.
- Testing oversight responsibilities: The proposal introduces defined expectations for facilities that proctor the state competency exam. Because the department can rescind proctoring privileges if irregularities occur, providers will need strong internal controls and documentation practices.
- Impact on onboarding timelines: Changes to testing procedures—especially clarifications on successful test completion and substantially similar examinations—may affect how quickly candidates can complete certification and begin working.
- Coordination with education partners: Providers that rely on local schools or community-based programs for nurse aide training may see updates in reporting, communication, and testing workflows driven by the rule changes.
- Regulatory compliance readiness: Updated rules replace outdated language and incorporate recent statutory changes, which may require providers to review and revise policies, training manuals, and oversight protocols.
The full draft package, including new rules 3701-18-27 and 3701-18-27.1, is available in the department’s posted materials.
Members may submit comments by December 1 through the draft rule portal. Top The Centers for Medicare & Medicaid Services has released updated skilled nursing quality data, including the first public reporting of new Transition of Health measures within the Quality Reporting Program. These measures capture whether a reconciled medication list is shared during transfers or at discharge and reflect CMS’s continued emphasis on safe, well-coordinated transitions. Early national averages indicate that most providers already follow strong communication practices.
The refresh also introduces public reporting on whether residents are considered “up to date” on COVID-19 vaccination, though shifting federal guidance has created uncertainty about coding expectations. Until CMS provides additional direction, providers are encouraged to rely on clinical judgment and maintain clear communication with residents. More detail on the updated measures is available through McKnight’s coverage. The Centers for Medicare & Medicaid Services has released a memo dated November 24 that responds to questions about survey and certification recovery following the federal government shutdown, which concluded November 12. Key points include:
- Survey and certification activities have fully resumed.
CMS confirmed that all survey functions are back to normal without limitation.
- State survey agency funding is restored.
Agencies will receive funding for the first quarter of FY 2026 and the first 30 days of the second quarter, aligned with FY 2024 levels.
- Additional funding supports hospice recertification surveys.
The Continuing Resolution provides an extra $2 million for hospice recertification surveys required under the IMPACT Act through January 30, 2026.
- State licensure surveys conducted during the shutdown will not count as federal certification surveys.
Federal certification surveys must still be completed, along with any lower-level complaint investigations handled under state authority during the lapse.
- Surveys that were underway when the shutdown began will resume.
CMS clarified that providers do not need a new survey; however, survey teams may need to update samples and certain tasks.
- CMS-2567 deadlines apply for surveys with completed exits.
If a survey team exited before the shutdown but had not issued the CMS-2567, the state survey agency must issue it by December 12.
- Exit dates may be adjusted.
States may align the exit date with either:
• the date the CMS-2567 is issued, or
• the provider’s alleged compliance date,
as long as compliance can be validated.
- Enforcement cycles may begin based on the adjusted exit date. This includes timelines for civil money penalties and Denials of Payment for New Admissions.
Top The Centers for Medicare & Medicaid Services has resumed updates to Nursing Home Care Compare after delays caused by the federal shutdown, acting on LeadingAge’s November 13 letter urging an off-cycle refresh. The Health Inspection domain had been frozen since August, and the October 29 quarterly update could not occur during the shutdown, leaving the Staffing, Quality Measures and overall Five-Star ratings temporarily outdated. CMS provided LeadingAge with the refreshed data on Nov. 20, bringing all three domains and the overall rating current again.
The next quarterly refresh is planned for January and will introduce a revised long-stay antipsychotics measure using claims data. Providers who identify discrepancies in their ratings may contact CMS at bettercare@cms.hhs.gov. LeadingAge will continue working with CMS as additional verification and reporting functions come back online. CMS has finalized a 2026 rule that removes 285 procedures from the inpatient-only list, allowing many surgeries historically performed in hospitals to shift to outpatient settings. While CMS emphasized that clinicians should continue admitting frail or medically complex older adults as inpatients when appropriate, the agency did not pair this change with any broad protection of skilled nursing coverage for individuals whose procedures occur on an outpatient basis. The agency’s overview is available in the 2026 OPPS/ASC fact sheet.
For nonprofit aging services providers, the implications are significant. Many of the affected procedures have long driven a substantial share of skilled nursing admissions; if completed on an outpatient basis, those same individuals would not meet Medicare’s three-day inpatient stay requirement for SNF coverage. This could lead to gaps in access for older adults who still need rehabilitative or transitional care and may shift hospital discharge patterns that members rely on to stabilize census. LeadingAge has cautioned that surgeons may not always recognize the post-acute consequences of selecting an outpatient setting, potentially leaving some older adults without needed support. Members may wish to monitor discharge planning trends closely and continue advocating for modernization of the three-day rule so that changing hospital practices do not limit appropriate access to skilled care. A recent Nonprofit Quarterly analysis highlights longstanding systemic challenges across long-term care, including the widening divide between well-resourced organizations and those operating with thin margins, particularly providers serving large numbers of Medicaid-funded residents. The piece points to persistent workforce instability, rising operating costs and the influence of complex financial arrangements across the sector as contributors to uneven performance and ongoing strain. It also reflects the shared understanding that the current system leaves many older adults, workers and providers without the stability they need. The full analysis is available through Nonprofit Quarterly’s feature on long-term care and economic justice. Top Shrivers Hospice has brought back a long-standing Coshocton holiday tradition: the Remembrance Tree in Court Square. The tree was lit on November 21 and features handcrafted, metallic-gold, heart-shaped ornaments personalized in honor of loved ones.
“This is Shrivers Hospice’s gift to the community,” said team leader Marge Donley. “The holidays bring back a lot of memories, and it can bring some peace to see a loved one’s ornament.” Kudos to Shrivers for bringing back this tradition. Read more here. Top Enrollment is now open for the Winter 2026 session of the Core of Knowledge, a program designed for Administrators-in-Residence that fulfills the academic requirement set by the Board of Executives of Long-Term Services and Supports (BELTSS) for qualifying to sit for the state licensure board examination to become a Licensed Nursing Home Administrator (LNHA).
The three-week course will be held January 12–30, 2026, Monday through Thursday, at the OCLC Conference Center. This is one of only two opportunities to complete the required coursework in 2026.
The deadline to register is December 5, 2025. Learn more and register for the 2026 Winter Core of Knowledge. For additional information, contact Corey Markham at cmarkham@leadingageohio.org. 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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Upcoming Events
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December 10, 2025
11:00AM - 12:00PM | Webinar Series |
| December 18, 2025
1:00PM - 2:00PM | Webinar Series |
| December 18, 2025
2:30PM - 3:30PM | Virtual
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