You Asked... We Answered

You Asked: Where can the current scope and severity grid for nursing homes be found?  

We Answered: CMS provides this scope and severity grid in the State Operations Manual (SOM), Chapter 7 Survey and Enforcement Process for Skilled Nursing Facilities and Nursing Facilities, specifically under Section 7400.3.1 Matrix for Scope & Severity. This matrix outlines how surveyors determine the level of deficiency based on the scope (isolated, pattern, widespread) and severity (potential for minimal harm through immediate jeopardy). 

The CMS Five-Star Technical User Guide also includes the scope and severity grid, along with the points assigned to each level, which directly impact a facility’s Five-Star rating on Care Compare.

Palliative Care Summit Returns May 21

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.

Maximize Your Membership: Preferred Service Providers

LeadingAge Ohio is introducing preferred service providers to give members easier access to trusted tools, services, and cost-saving opportunities. These providers offer discounted rates, special offers, and exclusive benefits designed specifically for LeadingAge Ohio. We will be introducing these preferred service providers throughout the year and the benefits they will be offering our members.

Register for our special all-member webinar held April 8 and learn about the program, what you can expect throughout the year, and about our first PSP, Instrumentl - the all-in-one grant software offered at a discounted rate for LeadingAge Ohio members.

Stay Connected Snapshot

There's always something happening at LeadingAge Ohio, view all upcoming events here and mark your calendar today!

• April 7, 9 a.m. - Southwest STARS Awards Breakfast
• April 7, 12:30 p.m. - Southwest STARS Awards Luncheon
• April 8, 9:30 a.m. - Technology Network Meeting: AI Risk and Governance
• April 8, 11 a.m. - Survey Tips & Tactics: Medication Storage, Labeling, & Controlled Substance Oversight
• April 8, 12:30 p.m. - New LeadingAge Ohio Program + Instrumentl Information
• April 14, 4 p.m. - Cleveland Spring Regional Networking Event
• April 15, 2 p.m. - Home Health and Hospice Subcommittee
• April 16, 2:30 p.m. - Survey Success Collaborative: Building Strong Foundations for 5-Star Outcomes
• April 20, 10 a.m. - Advocacy in Action
• 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

Mark Your Calendar: Special April 6 National Policy Pulse Call

Join LeadingAge’s national policy team on Monday, April 6, for a National Policy Pulse call focused on the 2026 outlook for federal aging services policy and our assessment of how aging services providers will fare under President Donald Trump’s fiscal year 2027 budget request to Congress. Finally, we’ll also discuss LeadingAge’s priorities for Lobby Day, April 22, when hundreds of providers will visit House and Senate offices. LeadingAge members can sign up for the calls using the link on our National Policy Pulse webpage.

Housing and Immigration: Upcoming Policy-Focused Live Events

As the Department of Housing and Urban Development’s (HUD) policies, procedures, and staffing continue to evolve, affordable housing providers can get needed insights on current regulations and apply them to daily operations at our two-part Fair Housing in Focus: From Policy to Practice live event. Mark your calendars now: Thursday, April 30 and Thursday, May 14.

Seeking guidance on ways to maintain workforce stability while preparing for immigration enforcement activity? Join us on June 4 for Immigration Compliance for Aging Services Employers. LeadingAge will be joined by workforce and immigration expert Jacob Monty for an afternoon live event.

LeadingAge Ohio Submits Comments on Pre-Clearance Vent Rule

This week, LeadingAge Ohio continued its advocacy on Ohio’s Medicaid nursing facility ventilator program, renewing requests made in February in an earlier request for information made by the Department of Medicaid. LeadingAge Ohio affirmed the Department’s proposal to require facilities employ respiratory therapy on a full-time basis, but allowing staffing to be on-call 24/7, rather than staffed 24/7 as originally suggested by LeadingAge Ohio. 

LeadingAge Ohio praised changes to the program including maintaining a separate rate for ventilatory weaning services, requiring prior authorization for 100 percent of non-invasive / tier 2 residents, and discontinuing ventilator programs that have not billed nor served individuals in the past 12 months. 

LeadingAge Ohio again encouraged the Department to align its coverage requirements with Medicare guidelines for ventilator care, which defines ventilatory dependence by blood gas levels as well as dependency on the ventilator for at least four hours per day (nonconsecutive), for at least 70 percent of days. 

To review LeadingAge Ohio’s full comments click here. If your organization offers ventilator care, please reach out to swallace@leadingageohio.org.

Ohio Expands Next Generation MyCare Program to Additional Counties

Ohio continues to move forward with a major overhaul of how care is delivered to people eligible for both Medicaid and Medicare. The Next Generation MyCare Ohio program is central to that shift, bringing services under a single, coordinated model intended to simplify access and improve continuity of care. As Phase 2 launches April 1, providers in newly added counties will begin seeing operational and enrollment changes tied to this transition.

What You Need To Know

• The Ohio Department of Medicaid is launching Phase 2 of the Next Generation MyCare program on April 1.
• The program will expand into 10 additional counties: Ashtabula, Defiance, Erie, Fairfield, Fayette, Henry, Licking, Paulding, Sandusky, and Williams.
• MyCare coordinates Medicare and Medicaid benefits for more than 250,000 Ohioans who are dually eligible.
• The updated model includes expanded behavioral health services, transportation supports, and stronger access to long-term services and community-based care.
• Three statewide plans—Anthem Blue Cross and Blue Shield, CareSource, and Molina Healthcare of Ohio—will serve members; Buckeye Health Plan will not accept new members in 2026.

What Happens Next

• Additional counties will continue to phase in throughout 2026 as Ohio moves toward a fully statewide model.
• Members in newly added counties will begin enrollment and transition into participating health plans.
• Providers should expect continued alignment of Medicare and Medicaid services under single managed care plans.

What to Do

• Review the Next Generation MyCare Program Overview One-Pager, Next Generation MyCare Member Frequently Asked Questions, and Next Generation MyCare Member Help Desk One-Pager to understand plan changes and supports.
• Identify which of the three statewide plans your organization contracts with—and where gaps may exist.
• Prepare staff to answer questions from individuals and families about enrollment, services, and care coordination.
• Monitor the Ohio Department of Medicaid’s MyCare webpage for updates on additional county rollouts and operational guidance.

MAHA Elevate to Fund Wellness, Prevention in 3-year Grants

Last month, the Centers for Medicare & Medicaid Services announced new grant opportunities through a new program, Make America Healthy Again: Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence (MAHA ELEVATE).  MAHA ELEVATE is part of the Administration’s plan to reform America’s health systems to address the chronic disease epidemic. 

The model will provide approximately $100 million to fund 3-year cooperative agreements for up to 30 proposals that promote health and prevention for Original Medicare beneficiaries. The proposals will utilize evidence-based, whole-person care approaches — including functional or lifestyle medicine interventions — currently not covered by Original Medicare. These approaches are intended to support, not replace, the medical care received by people with Medicare. MAHA ELEVATE will also gather and evaluate new data on cost and quality to inform future interventions promoting healthy lifestyle behaviors and ultimately reduce spending in Original Medicare. The first cohort of this voluntary model will launch October 2026, and initial letters of intent are due no later than April 10. 

Senior living operators are uniquely positioned to demonstrate the value they already provide through wellness supports to individuals already residing on their campuses. If you plan to apply for MAHA ELEVATE, please let our team know by emailing swallace@leadingageohio.org. 

CMS Signals New Expectations for Food and Nutrition Services

The Centers for Medicare & Medicaid Services (CMS) issued a Quality and Safety Special Alert Memo on March 30, reminding hospitals of their obligations for patient food and nutrition services, including alignment with the Dietary Guidelines for Americans, 2025–2030, released in January. Though nothing has been directed at nursing homes, members should still be prepared for survey enforcement based on national guidelines. 

What You Need To Know

• The Centers for Medicare & Medicaid Services issued a Quality and Safety Special Alert Memo on March 30 focused on patient food and nutrition services.
• CMS expects alignment with the Dietary Guidelines for Americans, 2025–2030, including limiting ultra-processed foods, using 100% whole grains, and keeping added sugars at or below 10 grams.
• The memo outlines practical changes, such as replacing processed meats with freshly prepared proteins and avoiding sugar-sweetened beverages.
• While directed at hospitals, these expectations apply to nursing homes through existing requirements to follow “established national guidelines.”

What Happens Next

• CMS has not released nursing home-specific guidance.
• Surveyors can still assess compliance under current federal regulations without additional direction.
• LeadingAge is monitoring for any nursing home-specific updates.

What to Do

• Review menus and food service practices against the updated dietary guidelines.
• Identify areas where ultra-processed foods, refined grains, or added sugars exceed recommendations.
• Begin aligning meal planning and purchasing practices with national dietary standards.
• Read the full CMS memo.

Survey Tip of the Week: Emergency Preparedness Deficiencies

Emergency preparedness continues to be an area of focus during surveys, with CMS identifying recurring deficiencies under Appendix Z. The Centers for Medicare and Medicaid Services (CMS) has developed a Frequently Cited Emergency Preparedness (EP) Citation & Potential Impact resource to help providers better understand how these requirements are evaluated and commonly cited. This resource highlights key compliance gaps and offers insight into surveyor expectations.  

To further support providers, ASPR TRACIE has created the CMS Emergency Preparedness Rule webpage, which includes provider-specific checklists aligned with Appendix Z, as well as additional tools and resources to assist with compliance. This includes by-provider checklists, encompassing CMS’ Appendix Z guidance, and also provides various other resources and tools. CMS has identified the following as the top five most commonly cited emergency preparedness deficiencies in nursing homes:  

• Emergency preparedness testing requirement 
• Development, review and updating of the emergency preparedness plan 
• Long-Term Care emergency power 
• Subsistence Needs 
• Emergency preparedness training 

Surveyors are evaluating not only whether required elements are in place, but also whether they are current, implemented, and reflective of the facility’s operations and risks. Deficiencies often occur when plans are not updated, drills are not conducted or documented appropriately, or staff are unable to demonstrate knowledge of their roles during an emergency. 

CMS also offers free on demand emergency preparedness training through the QSEP portal. This course is the same training used for surveyors and provides a helpful overview of regulatory requirements and the survey process. CMS notes that facilities may benefit from completing this training to better understand expectations and identify potential gaps in their programs. 

Check out the LeadingAge Ohio Education Calendar!

LeadingAge Ohio holds valuable education webinars and in-person events throughout the year. Opportunities are added weekly. See the complete Schedule of Events.

Wallace Joins Five States in Waiver Discussion

At this week’s National Investment Center (NIC) conference in Nashville, LeadingAge Ohio president / CEO Susan Wallace joined state association leaders from California, Minnesota, Georgia, and Oregon to discuss their states’ disparate approaches to offering assisted living to low-income older adults. Minnesota and Oregon lead the country in prioritizing home- and community-based care options, while Wallace highlighted recent gains for Ohio’s assisted living waiver, with both increased rates in 2023 as well as policy changes that enable assisted living to be paired with 4 percent low-income housing tax credits to finance development. 

“Opportunity abounds… for now” Wallace reflected, noting challenges on the horizon, including Medicaid cuts via HR1 as well as a gubernatorial election later this year.