Yesterday, LeadingAge Ohio sent an alert about The Centers for Medicare & Medicaid Services’s (CMS) announcement of sweeping new nationwide enforcement actions targeting fraud, waste, and abuse within the hospice and home health sectors, including a six-month nationwide moratorium on new Medicare enrollments for hospices and home health agencies (HHAs). The moratorium took effect yesterday, May 13, 2026.
CMS stated the action is part of a broader federal anti-fraud initiative and reflects growing concerns regarding systemic fraud, questionable ownership activity, inappropriate billing practices, and rapid provider growth patterns in portions of the hospice and home health industries.
Importantly, existing Medicare-certified providers may continue operating and serving beneficiaries without interruption.
LeadingAge has developed an analysis of what members can expect here, and their press release can be found here.
After the announcement, CMS Administrator Dr. Oz and Vice President JD Vance held a press conference urging states to detail how they will combat Medicaid fraud after citing complications working with California, which is resulting in the administration withholding $1.3 billion in Medicaid funds from that state. Learn more from this LeadingAge article.
In accordance with this request, the DeWine administration announced yesterday several new Medicaid fraud prevention initiatives aimed at strengthening oversight of home health and hospice providers participating in Ohio Medicaid. Governor DeWine stated that Ohio is partnering closely with the federal government and CMS to accelerate implementation of these reforms and expand existing program integrity efforts. View a summary of the initiatives here.
LeadingAge Ohio was invited to a meeting today with key members of the DeWine Administration to learn more about these initiatives. LeadingAge Ohio will send more information after this meeting.
LeadingAge Ohio is in full support of measures to prevent fraud, waste, and abuse in our sector. LeadingAge Ohio members have been sounding the alarm, particularly around red flags with hospice programs in Ohio, and have been working with policymakers to strengthen regulations and increase transparency for consumers.
LeadingAge Ohio will continue to keep members updated on these emerging issues. Top You Asked: Is there a resource available to help develop elopement protocols?
We Answered: Yes, Ohio’s Quality Improvement Organization, Superior Health, has developed the Ohio Skilled Nursing Facility Elopement Compliance Toolkit. According to Superior Health, the toolkit provides Ohio nursing homes with practical, survey-ready resources to prevent elopement, ensure resident safety, and demonstrate compliance with Ohio Administrative Code (OAC) 3701-17, Centers for Medicare & Medicaid Services (CMS) F689 (Accidents/Supervision), and related reporting and Quality Assurance and Performance Improvement (QAPI) expectations. Materials are designed for front line staff, leadership, and interdisciplinary teams. Top The final 2026 STARS ceremony took place yesterday at Tiffin University, where nearly 200 guests gathered to recognize the people who keep aging services running with skill, grit, and heart. We’re grateful to St. Francis Ministries for offering the invocation, welcome, and prayer. This was the largest STARS ceremony yet in Tiffin, and the energy in the room made clear just how much these team members mean to the organizations and communities they serve.
Across five ceremonies statewide, 329 STARS from 82 member organizations were recognized. These are the team members who repair, clean, coordinate, problem-solve, deliver clinical care, assist with activities of daily living, and handle the thousand details that make excellent care possible. Nurses, social workers, maintenance teams, dietary staff, information technology professionals, housekeeping, groundskeeping, and many more were honored for the work they do every day to support older Ohioans. They may not always be the most visible people in the building, but they are often the ones holding it all together.
Photos from each event are available on LeadingAge Ohio’s LinkedIn page. Organizations interested in receiving photos of their group of STARS can email Laurinda Johnson at ljohnson@leadingageohio.org. The LeadingAge Ohio Technology & Innovation Network will hold its next meeting on Wednesday, June 10, from 9:30–10:30 a.m., bringing members together for an open forum discussion focused on the technology questions, operational challenges, and emerging trends organizations are navigating across aging services.
This interactive roundtable conversation will give participants the opportunity to discuss the technology platforms, software systems, and operational tools their organizations are currently using and how those systems are being applied in day-to-day operations. Discussion topics may include clinical technology platforms, workflow frustrations, cybersecurity, IT inventory and governance, staff training, operational inefficiencies, budgeting for technology investments, and the growing complexity of managing integrated systems across organizations.
Members will also receive an overview of technology and AI-related resources available through LeadingAge Ohio and LeadingAge, including the LeadingAge Ohio AI Toolkit and LeadingAge CAST resources designed to support providers as organizations continue navigating rapidly changing technology environments.
Join the meeting on June 10. Mark your calendars for the LeadingAge Ohio Annual Conference and Trade Show, August 25-27, with a special hospice pre-conference on August 24. Themed Celebrating the Changemakers, the conference will feature over 60 education sessions, celebrations of impactful individuals, and time for fun and networking.
In addition to our awards program, the conference will feature the Hall of Changemakers! The Hall of Changemakers is your opportunity to recognize colleagues, mentors, residents, or their families who have made an impact on your life. Share their name, photo (if available), and a short narrative about how they have been a changemaker in your life or for your organization, and we will feature them alongside other changemakers in a special display. These recognitions can be from an organization or from individuals submitting their personal changemakers. Learn more about this and our awards program here. 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. Missed an Advocacy in Action, All Member Webinar, or STAT: Survey Tips and Tactics? Check out our on-demand webinar library on the Learning Center here. Top As workforce shortages persist across aging services, providers are looking to foreign-born workers as one potential source for filling open positions. Immigrants already are significant contributors to the long-term care workforce: over 30% of all home care aides, over 20% of all nursing assistants, 20% of RNs in nursing homes and over 15% of licensed practical nurses (LPNs) in nursing homes are foreign-born. LeadingAge is supporting policies, programs, and innovations that expand pathways for foreign-born workers to enter the U.S. to join the aging services sector.
Follow this serial post from LeadingAge for updates and ideas. Top The Ohio House Medicaid Committee this week examined concerns surrounding “waste, fraud and abuse” within Ohio Medicaid, with significant attention focused on home- and community-based services (HCBS), provider oversight, and managed care accountability. During invited testimony, Niklas Kleinworth, State Health Reform Director with Paragon Health Institute, argued that gaps in oversight, verification, and reimbursement structures have contributed to vulnerabilities within Medicaid-funded services both nationally and in Ohio.
Discussion centered heavily on HCBS programs, including personal care, transportation, and other community-based supports. Testimony raised concerns about electronic visit verification systems, provider enrollment practices, managed care organization transparency, and reimbursement rates tied to certain Medicaid services. Lawmakers also discussed proposals aimed at increasing oversight, including additional eligibility verification requirements, reassessment standards, auditing practices, and stronger tracking mechanisms for service delivery.
Several committee members pushed back on portions of the testimony, noting the importance of distinguishing between intentional fraud and operational realities facing providers and families. Rep. Crystal Lett specifically raised concerns about workforce shortages and the role family caregivers often play in helping individuals remain safely in community settings. Other lawmakers questioned how proposed reforms could affect Medicaid recipients and whether additional restrictions could unintentionally reduce access to needed supports.
The hearing also included discussion around Ohio’s Medicaid spending growth, the role of managed care organizations in overseeing services, and the effectiveness of the state’s current electronic visit verification system. The committee later heard testimony from members of the Ohio Occupational Therapy Association, who emphasized the role occupational therapy services play in helping Medicaid recipients maintain independence and improve quality of life.
A recording of the committee hearing can be found here. Paragon’s presentation slides can be found here. Gov. Mike DeWine has appointed Andy Wilson to serve as Ohio’s next attorney general following the resignation of Dave Yost. Wilson will complete the remainder of Yost’s term through January 2027, with Ohio voters set to elect the state’s next attorney general this November.
Wilson currently serves as director of the Ohio Department of Public Safety and previously worked as DeWine’s senior adviser for criminal justice policy. Before joining the governor’s administration, Wilson served as a Clark County prosecutor and has been closely involved in statewide public safety, law enforcement, and criminal justice initiatives.
Yost announced earlier this month that he will step down June 7 to accept a position with the conservative legal organization Alliance Defending Freedom. Yost endorsed Wilson’s appointment, calling him a strong choice to continue the work of the attorney general’s office. Top The Department of Health and Human Services (HHS) has launched a new initiative focused on reducing unnecessary psychiatric medication use. In a May 4 announcement, HHS Secretary Robert F. Kennedy Jr. outlined an action plan aimed at preventing inappropriate initiation of psychiatric medications while supporting safe tapering or discontinuation when individuals are not experiencing clinical benefit. The initiative centers on education and outreach, policy and program changes, and research-to-practice efforts. In a related Dear Colleague letter, HHS encouraged providers to prioritize informed consent, shared decision-making, and ongoing review of medication risks and benefits. The agency also highlighted nonpharmacological interventions and identified billing codes that may support evidence-based nonmedication treatment approaches.
While much of the announcement focused on children and adolescents, the initiative is also relevant for nursing homes and other aging services providers given heightened federal attention on psychotropic medication use. CMS updated nursing home guidance in November 2024 to classify unnecessary psychotropic medications as chemical restraints while continuing efforts to reduce antipsychotic use in long-term care settings. As HHS advances this initiative, providers should continue focusing on core compliance areas including informed consent, appropriate clinical indications, documentation, and gradual dose reductions when indicated.
LeadingAge resources on psychotropic medications and prevention of chemical restraints may also help organizations review current practices. The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) is holding the first Healthcare Advisory Committee meeting on May 18 at 2 p.m. The public meeting will focus on introducing Committee members, outlining the vision of the Committee and establishing Committee bylaws.
The Healthcare Advisory Committee, was established earlier this year as a federal advisory body comprised of leaders from across the healthcare system to provide expert advice on improving, strengthening and modernizing U.S. healthcare.
The Committee will advise HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz on ways to improve how care is financed and delivered across Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace.
The meeting will be held via a virtual webinar only and pre-registration is not required. Webinar details and full agenda will be made available here.
View the Federal Register Notice on the upcoming Healthcare Advisory Committee meeting. Top Hospice services in the nursing home setting continue to be an area of surveyor focus, particularly related to coordination of care, communication between the nursing home and hospice provider, and maintaining current hospice documentation within the resident record. CMS guidance under F849 emphasizes that the nursing home and hospice must work together to ensure the resident’s care plan is coordinated, current, internally consistent, and reflective of the resident’s changing needs.
Surveyors are reviewing whether facilities maintain the most current hospice documentation in the resident record and whether staff can demonstrate ongoing communication and coordination with the hospice provider. Deficiencies are often identified when facilities are unable to produce updated hospice plans of care.
Under §483.70(n)(3)(iv), the facility’s designated interdisciplinary team member is responsible for obtaining and maintaining hospice documentation, including:
- The most recent hospice plan of care
- Hospice election forms
- Physician certification and recertification of terminal illness
- Hospice contact information
- Instructions on accessing hospice’s 24-hour on-call system
- Hospice medication information
- Hospice physician and attending physician orders.
Surveyors are instructed to use the Hospice and End of Life Care and Services Critical Element (CE) Pathway along with the interpretive guidelines to determine compliance. Surveyors may review the record to determine whether the coordinated plan of care remains current and accurately reflects both the hospice services and the services being provided by the nursing home. Guidance specifically states that the coordinated plan of care must be current and internally consistent to ensure resident needs are met at all times. Top Twenty-three years ago, when Lynne Giacobbe launched Kendal at Home, a program of LeadingAge member Kendal Corporation, the idea of aging in place “without walls” with the support of a Community Care Retirement Community (CCRC) was new. Now, says Giacobbe–recognized by Kendal’s COO Doug Helman as “an innovator in the CCaH field”–"Things have changed where there is much more awareness of the ability to be able to successfully age at home.” Learn why–and more on Giacobbe’s contributions. 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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