You Asked: How are we expected to report for staff who perform different roles or duties throughout their day?
We Answered: Reporting is to be based on the employee’s primary role. It is understood that most roles have a variety of non-primary duties that are conducted throughout the day (e.g., helping when needed). Facilities shall still report just the total hours of that employee based on their primary role. However, CMS recognizes that staff may completely shift their primary role in a given day. For example, a nurse who spends the first four hours of a shift as the unit manager and the last four hours of a shift as a floor nurse. In these cases, facilities can change the designated job title and report four hours as a nurse with administrative duties and four hours as a nurse (without administrative duties).
For facilities that use the universal care workers, facilities must use a reasonable methodology to separate the time that the universal care worker spends performing their primary role, from their time that is spent performing other activities. For example, assume a universal care worker is paid to work 7.5 hours each day (excluding a 30-minute mealtime). Of the 7.5 hours, 5.5 hours are spent performing CNA-related duties, one hour is spent providing cooking services, and one hour is spent providing cleaning services. In this situation, the facility shall only report 5.5 hours of CNA time. Additionally, the facility may report one hour of housekeeping time, and one hour of “other services” time as reporting of these categories is optional (see Table 1 of the PBJ Policy Manual).
LeadingAge Ohio reminds providers that November 14th is the reporting deadline for 4th quarter. Additional guidance can be found in the PBJ Policy Manual and FAQ document. Top What do the midterm election results mean for Ohio’s aging services providers? Join LeadingAge Ohio’s policy team for Advocacy in Action on Nov. 24 at 11:30 a.m. to discuss changes in Ohio and Washington and the potential implications for aging services, Medicaid, and policy priorities heading into 2027.
The team will also provide an update on House Bill 945 and other legislation being monitored during Ohio’s lame-duck session, including what could move before the end of the year. Stay informed on the issues affecting nonprofit aging services providers and what lies ahead in the new legislative session.
Register for Advocacy in Action on Nov. 24. LeadingAge Ohio hospice members Greg Vaughn of Shrivers Hospice and Cheryl Lampkowski-Sowle of Otterbein SeniorLife testified before the Ohio House Health Committee on Nov. 10 in support of House Bill 945, which seeks to strengthen hospice oversight, patient protections and accountability. Amendments to the bill are expected as lawmakers continue their work during the lame-duck session.
Members can show their support for strengthening hospice integrity in Ohio with the HB 945 Social Media Toolkit. Featuring ready-to-use graphics and captions focused on hospice quality, access, and accountability, members can easily tag their legislator on social media in support of advocacy efforts and bring awareness to why strengthening Ohio’s hospice program is needed. Additional resources are available on LeadingAge Ohio's Hospice Quality page. On Nov. 18 from 9 a.m. to 4:30 p.m., LeadingAge Ohio will host AI for Senior Living: Practical Tools, Compliance, and Competitive Advantage at Quest Conference Center in Westerville with Hartman Executive Advisors. The full-day program will cover AI use cases, implementation, data and predictive analytics, cybersecurity, governance, privacy and compliance, followed by a panel of Ohio providers discussing how their organizations are using AI, where they remain cautious, and what they have learned. View the full agenda and register for Technology Day. Reimbursement is revenue. Every missed clinical detail can mean dollars left unclaimed, while coding that is not fully supported by documentation can put already-earned reimbursement at risk. LeadingAge Ohio’s 2026 Reimbursement Day will focus on both sides of the equation: capturing the full clinical picture through accurate MDS and PDPM coding and building the documentation needed to protect those dollars when Medicare, Medicaid or a contractor starts asking questions.
Set for Nov. 16 from 9 a.m. to 4 p.m. at the Quest Conference Center in Westerville, this full-day program will follow the money from the factors that drive reimbursement through coding, documentation, medical review and audit response. Attendees will work through real-world scenarios and common vulnerabilities, including what happens when reimbursement opportunities are missed and what providers need when CGS comes calling.
Review the agenda and details for 2026 Reimbursement Day: Maximizing Reimbursement — Coding, Documentation and Audit Readiness and plan to bring the team members responsible for capturing, supporting, and defending reimbursement. LeadingAge Ohio is accepting applications for the 2027 Leadership Academy, a seven-month program designed to develop leaders across aging services. Open to employees of provider and associate member organizations, the Academy has graduated more than 150 leaders since 2013.
Two competitive tuition scholarships are available for fellows from member organizations new to the Academy or those that have not participated in recent years. Applications are due Nov. 30, 2026. Review the Leadership Academy program details and apply for the 2027 cohort. Are you taking advantage of all your LeadingAge Ohio membership benefits? Our Preferred Service Providers (PSP) program connects members with trusted partners offering exclusive discounts and services to help reduce costs and support daily operations. Participating providers include Instrumentl, offering 20% off its grant discovery and management platform; Herzing University, providing tuition discounts of 10% to 35% on eligible programs; and Hondros College of Nursing, offering tuition savings for nursing education.
Members can also access preferred pricing through LeaderStat for executive recruitment and interim leadership services, explore managed care contracting support through the Ohio Aging Services Network, and learn about retirement plan options offered in partnership with Oppenheimer & Co. and Ascensus. Visit the Preferred Service Providers program page to explore participating organizations, available discounts and eligibility requirements. LeadingAge Ohio's Regional Network Gatherings return this December, offering three opportunities to reconnect with colleagues across Ohio's aging services community. Made possible by Link-age Solutions, these informal gatherings offer members an opportunity to enjoy free brews and food while catching up with colleagues and meeting fellow aging services professionals. President and CEO Susan Wallace will provide a brief statewide update, followed by remarks from Link-age Solutions.
Join us in Cleveland on Dec. 1 at Great Lakes Brewing Company, Toledo on Dec. 3 at Maumee Bay Brewing Company, or Cincinnati on Dec. 8 at Firehouse Grill. Each gathering runs from 4 to 6 p.m. Registration is free for LeadingAge Ohio members, with associate firms and partners welcome for a fee. There’s always something happening at LeadingAge Ohio. View upcoming events and mark your calendar today.
- November 16, 9 a.m. - 2026 Reimbursement Day - Maximizing Reimbursement: Coding, Documentation, and Audit Readiness
- November 17, 10 a.m. - Professional Development Committee
- November 17, 11:30 a.m. - Shop Talk: Affordable Senior Housing
- November 18, 9 a.m. - AI for Senior Living: Practical Tools, Compliance, and Competitive Advantage
- November 24, 11:30 a.m. - Advocacy in Action
- December 1, 4-6 p.m. - Cleveland Regional Network Gathering
- December 3, 4-6 p.m. - Toledo Regional Network Gathering
- December 8, 4-6 p.m. - Cincinnati Regional Network Gathering
Top LeadingAge will host an interactive workshop on Dec. 10 at 2 p.m. focused on using generative artificial intelligence (AI) responsibly in aging services. Led by Travis Gleinig, vice president for innovation and chief information officer at United Methodist Communities, the session will feature hands-on exercises and real-world examples covering AI applications, human oversight, accuracy and compliance.
Space is limited. Register for the AI literacy workshop. Scott Code, vice president of LeadingAge's Center for Aging Services Technologies (CAST), shares lessons from a recent Technology First Foundation session with SHIFT. His latest article encourages aging services providers to consider how technology can support individual preferences, independence and personal goals rather than focusing solely on technology purchases.
Read Code's article on the Technology First approach. Join LeadingAge for the next Managed Care Solutions Network meeting on November 12. Topics will include an update on congressional action and the election’s implications for policy priorities, a discussion of LeadingAge’s 2027 Policy Priorities, and an opportunity to provide input on a Senate Finance Committee long-term care Request for Information (RFI). We’ll also review the CY 2028 Medicare Advantage proposed rules and preview several Center for Medicare & Medicaid Innovation (CMMI) models expected to roll out in the coming months.
Not yet part of the network but interested in participating? Contact Nicole Fallon for meeting details and information on joining the network. Top The Ohio House passed House Bill 530 on Nov. 10, legislation sponsored by state Rep. Jodi Salvo (R-Bolivar) to establish a Long-Term Care Workforce Study Commission. The commission would examine direct care workforce shortages, recruitment and retention challenges, and future staffing needs across Ohio, including rural and underserved communities.
The commission would be required to submit findings and policy recommendations to the General Assembly by Oct. 31, 2027. Its review would include workforce vacancies, turnover rates, projected demand, and gaps in available data. HB 530 now moves to the Ohio Senate for consideration.
Read the original Ohio House press release. Applications for the 2027 Ohio Scholars in Aging program close tomorrow, Friday, Nov. 13, at 11:59 p.m. A collaboration between the Ohio Department of Aging and the Ohio Association of Gerontology and Education, the program gives students opportunities to learn about aging-related policymaking, build professional relationships and explore careers in aging services.
The program is open to undergraduate and graduate students enrolled at accredited Ohio institutions across a variety of academic fields, including nursing, social work, gerontology, nutrition and health services. Students participating in administrator-in-training programs may also be considered. LeadingAge Ohio members are encouraged to share this opportunity with eligible students and emerging professionals.
Apply for the 2027 Ohio Scholars in Aging program or visit the Ohio Department of Aging's program page for additional details. Gov.-elect Amy Acton has named John Haseley, former chief of staff to Gov. Ted Strickland, to lead her transition team ahead of taking office Jan. 11. Acton also launched a transition website where Ohioans can express interest in joining her administration. Her team faces a busy transition, including cabinet appointments and preparation of the state's next executive budget proposal, due March 15.
Meanwhile, Gov. Mike DeWine has expressed opposition to legislation that would significantly restrict the incoming governor's authority. Two proposals, House Bill 775 and House Bill 1024, would revise state agency rulemaking authority and oversight. Republican legislative leaders have not committed to advancing the measures during the lame-duck session, while DeWine has emphasized cooperation and continuity between administrations. Read additional coverage of Acton's transition and the debate over executive authority. Top The Centers for Medicare & Medicaid Services (CMS) announced $10 billion in 2027 funding through the Rural Health Transformation Program on Nov. 9, including $201.9 million for Ohio. The funding is part of a five-year, $50 billion federal initiative supporting rural health care access, workforce development, technology and new care delivery models. Second-year awards are based in part on states' progress implementing their approved plans.
LeadingAge will discuss the funding and its implications for rural aging services providers during its Rural Provider Member Network Call on Dec. 16. Members can also follow LeadingAge's ongoing coverage for program developments.
Read the CMS announcement and state funding details. Top Residents residing in secured or locked units, including memory care units, have the right to be free from involuntary seclusion. Under F603 (§483.12(a)(1)), facilities must ensure that placement in a secured unit is clinically justified, individualized, and not based solely on a diagnosis, family request, or staff convenience.
Involuntary seclusion is defined as separation of a resident from other residents or from her/his room or confinement to her/his room (with or without roommates) against the resident’s will, or the will of the resident representative. Involuntary seclusion could mean a resident placed in a secured area of the facility, but does not meet the criteria for the unit and is not provided with access codes or other information for independent egress.
CMS identifies specific considerations for determining whether placement in a secured unit constitutes involuntary seclusion. Facilities should ensure the following are in place:
- Established clinical criteria: The facility has identified clinical criteria for placement in the secured unit. Placement decisions are individualized and not based on a diagnosis alone.
- Clinical justification: The medical record includes documentation from the resident's physician, along with information from the interdisciplinary team, supporting how the resident meets the criteria for placement.
- Resident/representative involvement: Documentation reflects the resident's and/or representative's involvement in the decision to place the resident in the secured unit and in developing the care plan.
- Least restrictive approach: Documentation supports that placement in the secured unit is the least restrictive reasonable approach to protect the resident's health and safety.
- Resident response: The interdisciplinary team documents the resident's reaction or response to placement, including any concerns or objections.
- Ongoing evaluation: The interdisciplinary team periodically reviews whether the resident continues to meet the criteria for secured placement and revises the care plan as necessary.
- Access and visitation: Family members, representatives, and other visitors have immediate access, subject to reasonable clinical and safety restrictions and the resident's right to refuse visitation.
A resident who chooses to live in the secured/locked unit (e.g., the spouse of a resident who resides in the area), and does not meet the criteria for placement, must have access to the method of opening doors independently. The chosen method for opening doors (e.g., distribution of access code information) is not specified by CMS. Staff should be aware of which residents have access to opening doors and monitor their use of the access to ensure other residents’ safety. The Ohio Department of Health's November Question of the Month addresses three Minimum Data Set (MDS) coding questions involving the Brief Interview for Mental Status (BIMS), pressure injuries and alarm systems.
- C0200-C0500: Brief Interview for Mental Status
- Question: Can a provider alter the questions of the Brief Interview for Mental Status (BIMS)? For example, for data item C0200 Repetition of Three Words, could the assessor say shirt, green, and chair instead of sock, blue, and bed?
- Answer: No, the BIMS questions cannot be altered. Interviewers need to use the words and related category cues as specified for each item. The assessor should administer each interview in the Minimum Data Set (MDS) as instructed on the MDS and in the RAI 3.0 User's Manual.
- Guidance regarding interview strategies is provided in Appendix D of the RAI 3.0 User's Manual. Page Appendix D-2 states, "Ask the questions as they appear in the questionnaire." The guidance in Appendix D continues with approaches such as unfolding, disentangling, and echoing that can increase the accuracy of the resident's response.
- M0300: Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage
- Question: I have a resident who had a deep tissue injury (DTI) coded on their Admission MDS as unstageable and as present on admission. The same wound then evolved into an unstageable due to slough after admission. Would this wound continue to be coded "present on admission" or is it now considered facility acquired?
- Answer: Because this pressure ulcer/injury has not been numerically stageable at any point in the resident's stay (i.e., the resident was admitted with an unstageable ulcer due to deep tissue injury that evolved to a pressure ulcer/injury that was unstageable due to slough or eschar), the unstageable pressure ulcer/injury due to slough continues to be considered present on admission.
- P0200: Alarms
- Question: I have a question regarding a technologically advanced contactless monitoring system. This is not a device that is attached to the resident but rather is part of the resident's bed. The audible alarm rings at the nursing station, not in the resident's room. Should this be considered an alarm when coding P0200 Alarms?
- Answer: The device that you described meets the definition of an alarm. Per page P-9 in the RAI 3.0 User's Manual, "An alarm is any physical or electronic device that monitors resident movement and alerts the staff, by either audible or inaudible means, when movement is detected, and may include bed, chair and floor sensor pads, cords that clip to the resident's clothing, motion sensors, door alarms, or elopement/wandering devices."
Nursing home staff involved in MDS coding, including MDS coordinators, social service directors and dietary managers, can subscribe by emailing Cheryl.Moya@odh.ohio.gov with "Question of the Month" in the subject line. Include your name, title, email address and facility name in the body of the email. Staff may also submit MDS coding questions to the same address for consideration in future editions. Top Have news to share with fellow LeadingAge Ohio members? We want to hear about your organization's accomplishments, from new projects and developments to special events, staff recognition and challenges overcome. Share your news with Laurinda Johnson at ljohnson@leadingageohio.org for consideration in an upcoming member newsletter. Top Enrollment is now open for the Winter 2027 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 11–28, 2027, Monday through Thursday, at the OCLC Conference Center. This is one of only two opportunities to complete the required coursework in 2027.
The deadline to register is December 11, 2025. Learn more and register for the 2027 Winter Core of Knowledge. For additional information, contact Corey Markham at cmarkham@leadingageohio.org. The first round of three communities winning $10K each was announced at the LeadingAge Annual Meeting in Philadelphia during the General Session on Monday, October 26th.
But don’t worry, there are still three more chances to win!
If your community isn't using Value First as the primary GPO, you can enter the sweepstakes by clicking here and completing a short form for a chance to win. Your community will receive a free, no-obligation cost analysis - a line-item comparison of your current monthly food spend with Value First's cost-saving contracts.
One month of food data is required before December 6th to be eligible. LeadingAge Ohio holds valuable education webinars and in-person events throughout the year. Opportunities are added weekly. See the complete Schedule of Events. Top Join LeadingAge Wednesday, November 18, at 2 p.m. ET for the next Assisted Living Member Network call. To make participation easier, the call has been shortened to 30 minutes.
This month’s discussion will focus on the Quality in Assisted Living Collaborative’s (QALC) Emergency Operations Guidelines, scheduled for release on Thursday, November 12, on the LeadingAge Assisted Living topic page.
The Assisted Living Member Network meets on the third Wednesday of each month and is open to all interested LeadingAge members, state partners, and staff.
Have a question or a topic you’d like to see discussed? Email Jodi Eyigor at jeyigor@leadingage.org.
Not yet part of the network? Register here. Top
|
