The November 3 election results will bring significant changes to the political landscape in Ohio and Washington, with potential implications for aging services and the providers, older adults and families we represent.
Key takeaways include:
- A change in Ohio's administration: Democrat Amy Acton defeated Republican Vivek Ramaswamy, marking 20 years since the last Democratic gubernatorial win in Ohio. Acton will take office in January 2027, bringing a new administration and potentially different policy priorities. Acton has stated previously her support of aging in place, potentially signaling an emphasis on home- and community-based services, and property tax relief for seniors. According to an AARP questionnaire, Acton also mentioned her desire for investments in senior centers, telehealth, and education for older adults.
- A shift in the Ohio House: Democrats broke the Republican supermajority in the House, while Republicans retained their supermajority in the Senate. The new balance could mean more gridlock, but may also create greater opportunities for compromise and more moderate policymaking. The election results could also contribute to a busy lame-duck session as lawmakers work to advance priorities before the new General Assembly takes office.
- A change in Washington: Democrats won control of both the U.S. House and Senate. This shift could put significant federal policy decisions back on the table, including budget and Medicaid cuts enacted in recent years, with the possibility that some could be revised or rolled back. The shift in party control also paves the way for Democrat-backed policies like nursing home staffing mandates and hospice benefit reform.
Stay Engaged
Join us for our November Shop Talks and Advocacy in Action on November 24. These sessions will provide opportunities to hear more about the election results, discuss potential implications for our members and consider what may lie ahead for aging services in 2027.
Top You Asked: Are physicians required to sign their progress notes on the same day they conduct a physician visit?
We Answered: No. The Ohio Department of Health (ODH) has confirmed that F711 does not require physicians to sign or close their progress notes on the same day as the visit. ODH has also clarified that there is no regulatory expectation for immediate signature or closure of physician progress notes to demonstrate compliance with F711.
Facilities are not required to establish or revise policies to mandate same-day physician signatures. Rather, medical directors and administrators should work collaboratively to establish policies and procedures that support timely completion of physician documentation, consistent with professional standards and the intent of the regulation.
Additionally, ODH also confirmed that F712 includes guidance outlining required physician visit frequencies and the circumstances under which nurse practitioners may conduct visits. When evaluating compliance with physician visit requirements, surveyors are instructed to consider visits conducted by nurse practitioners where permitted by regulation. Top LeadingAge Ohio members are reminded of the Pooled Employer Plan (PEP), a retirement savings solution introduced earlier this year in partnership with Oppenheimer & Co. and Ascensus. The program offers organizations an opportunity to simplify retirement plan administration, reduce fiduciary responsibilities and potentially lower costs through shared purchasing power.
Designed for organizations with existing 401(k) or 403(b) plans, as well as those considering retirement benefits for the first time, the PEP provides another option for supporting employees' long-term financial security. Members interested in evaluating their current retirement offerings can explore the program's features and available resources.
Read LeadingAge Ohio's Pooled Employer Plan announcement for additional details. 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. 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 6, 10 a.m. - Marketing Roundtable
- November 10, 10 a.m. - Awards Committee
- November 10, 11:30 a.m. - Shop Talk: Home Health & Hospice
- November 10, 11:30 a.m. - Uniform Grant Regulations’ Changes: How You can Prepare for What’s Next
- November 11, 11 a.m. - STAT: Survey Tips and Tactics - Abuse Investigation Pitfalls
- November 12, 10 a.m. - LeadingAge Ohio Board of Directors Meeting
- November 13, 1 p.m. - LeadingAge Ohio Foundation Board Meeting
- 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 Nearly 6,000 aging services professionals gathered in Philadelphia Oct. 25-28 for the 2026 LeadingAge Annual Meeting & EXPO. The event featured more than 140 education sessions addressing workforce challenges, technology, leadership and care delivery. Ohio members received national recognition, including Jill Wilson, president and CEO of Otterbein SeniorLife, who received the 2026 LeadingAge Award of Honor. Susan DiMickele, president and CEO of National Church Residences, was named to the 2027 LeadingAge Board of Directors.
Looking ahead, the 2027 LeadingAge Annual Meeting & EXPO will take place Nov. 7-10 in Minneapolis, Minnesota. The 2027 Call for Sessions is now open, inviting aging services providers to share successful programs, tested approaches and lessons learned with colleagues nationwide. Proposals are due Monday, Dec. 7, at 8 p.m. ET.
Read LeadingAge's 2026 Annual Meeting coverage for conference highlights and organizational updates. LeadingAge is offering A Practical Introduction to Dementia Inclusion, a three-part webinar series examining how aging services organizations can create more inclusive communities for people living with dementia. The series focuses on person-centered approaches that support autonomy, belonging and meaningful participation in community life beyond traditional memory care settings.
Sessions will be held Nov. 5, 12 and 19, from 2 to 3:30 p.m. ET. Topics include the foundations of dementia inclusion, incorporating the lived experiences of people with dementia into care practices, and approaches providers are using to support inclusion in residential settings. Participants will hear from organizations implementing these practices and learn about challenges, lessons and opportunities relevant to their own communities.
View the webinar details and registration information through the LeadingAge Learning Hub. LeadingAge's Rethinking Dining in Senior Living: Lessons from the Field examines how member organization ThriveMore in Winston-Salem, North Carolina, improved its dining program by incorporating resident feedback, expanding menu variety and creating more opportunities for social engagement. Executive Chef Eric Nooe and President and CEO Reed VanderSlik share how the changes made mealtimes a more meaningful part of community life.
The video resource, available free to LeadingAge members, offers senior living providers an example of using resident preferences to guide dining services while supporting nutrition and social engagement. Top Ohio's Program of All-Inclusive Care for the Elderly (PACE) continues to expand, with BoldAge PACE opening a new center Nov. 1 in Moraine, serving Montgomery County. PACE coordinates medical care, personal assistance and social services for adults 55 and older who meet nursing facility-level care requirements, supporting their ability to remain in their homes and communities.
PACE is now available in nine Ohio counties, with expansion into Lucas County planned for early 2027. The Ohio Department of Aging estimates more than 220,000 Ohioans could qualify for PACE services statewide. The expansion increases access to coordinated, community-based long-term care for older Ohioans and their families.
Read the Ohio Department of Aging's Nov. 4 announcement. State Sen. Mark Romanchuk (R-Ontario) received the Outstanding Public Service Award from the Ohio Association of Area Agencies on Aging (o4a) during its annual conference Oct. 21-22 in Columbus. The award recognizes his work supporting older Ohioans and Ohio's aging and disability services network.
The association highlighted Romanchuk's support for including Area Agencies on Aging in the Next Generation MyCare Ohio program and his engagement on policies affecting community-based care. Duana Patton, o4a board president and CEO of the Ohio District 5 Area Agency on Aging, recognized his commitment to preserving access to services that help older adults remain independent in their communities.
Read the original announcement from the Ohio Association of Area Agencies on Aging. Top Democrats won control of both the U.S. House and Senate in the Nov. 3 midterm elections, bringing changes to congressional leadership, committee assignments and legislative priorities when the new Congress convenes in January 2027. The transition will affect how federal policies are considered, including those related to aging services, health care and affordable senior housing. President Donald Trump will retain veto authority over legislation.
Before the transition, Congress must address unfinished business during its lame-duck session, including fiscal year 2027 appropriations that affect affordable senior housing and other aging services programs. LeadingAge continues its federal advocacy efforts and is seeking member participation in developing its 2027 policy priorities through member networks and weekly National Policy Pulse calls.
Read LeadingAge's analysis of the 2026 midterm elections. A federal judge in Massachusetts ruled Oct. 29 that the Centers for Medicare & Medicaid Services (CMS) exceeded its authority by narrowing exemptions from Medicaid work requirements for people with qualifying medical conditions. The court struck down a provision requiring individuals to demonstrate that their medical conditions significantly impair their ability to meet work requirements, finding that the additional restriction went beyond federal law.
The ruling removes the restriction nationwide but does not delay implementation of Medicaid work requirements on Jan. 1, 2027. The court upheld limitations on self-attestation and a 12-month review period for medical claims data. Ohio was not among the 25 states challenging the rule and is not covered by the six-month enforcement relief granted to those states.
Read the federal court's Oct. 29 ruling. Top CMS has recently identified choking prevention as a significant area of concern in nursing homes. Survey citations under F689, Accidents, have included residents receiving food inconsistent with their prescribed diets, residents accessing food from other residents' trays, and residents requiring supervision while eating being left unattended. This includes residents who require supervision but are left to eat alone in their rooms.
Under F689, §483.25(d), facilities must ensure that each resident receives adequate supervision to prevent avoidable accidents. The State Operations Manual (SOM) Appendix PP directs facilities to identify and evaluate accident risks, implement individualized interventions to reduce those risks, and monitor their effectiveness. Residents with dysphagia, cognitive impairments, impulsive eating behaviors, or a history of choking may require additional precautions, including modified diets, assistance with eating, or supervision during meals and snacks.
Choking prevention extends beyond ensuring the correct diet is delivered. Facilities must consider whether residents can access food that is unsafe for them, whether staff understand and implement required supervision, and whether appropriate precautions are maintained when residents choose to eat in their rooms. Surveyors may observe residents during meals, interview staff regarding individualized precautions, and review assessments, physician orders, and care plans to determine whether identified choking risks are being appropriately addressed.
Facilities should review residents identified as being at risk for choking and verify that diet orders, care plans, and supervision requirements are accurate, communicated to staff, and consistently implemented. Consider conducting observations during meals and snacks, including in resident rooms, to identify potential gaps in supervision, food access, and adherence to prescribed diets. Refer to the Accidents Critical Element Pathway and SOM Appendix PP, F689, for additional guidance surveyor observation, interview, and record review investigations. Four Senate Finance Committee Democrats released an Oct. 29 report examining how private equity investment, complex ownership structures and related-party transactions affect nursing home finances and resident care. The report raises concerns about operators transferring funds through affiliated businesses rather than directing resources toward staffing and services. It cites a federal audit finding that 7 will of 14 nursing homes reviewed improperly reported related-party costs, resulting in more than $1.7 million in overstated costs.
The findings add to congressional scrutiny of nursing home financial transparency, ownership disclosures and oversight. LeadingAge President and CEO Katie Smith Sloan expressed support for greater ownership transparency, emphasizing that misconduct by individual operators undermines public trust across the sector. Senate Finance Committee Democrats are also seeking feedback on proposed long-term care reforms, including related-party transactions and nursing home accountability, through Dec. 18.
Read the full Senate Finance Committee minority report and LeadingAge's coverage. The Ohio Department of Health (ODH) is offering two live webinars on misappropriation and exploitation in long-term care facilities, scheduled for Nov. 17 at 2 p.m. and Nov. 18 at 10 a.m. The sessions will cover federal regulations, common abuse citations, prevention practices and how ODH's Bureau of Regulatory Operations investigates allegations of abuse, neglect and misappropriation.
Registration is limited, and continuing education credits will not be offered. Providers should review the Nov. 5 EIDC bulletin from the Ohio Department of Health for registration instructions and additional details. The registration link is intended for bulletin recipients and should not be forwarded. Top LeadingAge Ohio member The Ohio Masonic Communities is closing out 2026 with an impressive collection of national and local honors across its three campuses. Browning Masonic Community in Waterville, Springfield Masonic Community and Western Reserve Masonic Community in Medina all ranked among the top 15% in the Activated Insights Customer Experience Awards, based on resident and family feedback. Western Reserve also earned a five-star overall rating from the Centers for Medicare & Medicaid Services (CMS), while Springfield received a four-star overall rating and five stars for staffing.
The recognition extends beyond resident satisfaction and federal quality ratings. Western Reserve and Springfield were named to Newsweek's 2027 America's Best Nursing Homes list for the third consecutive year, ranking 17th and 23rd, respectively, in Ohio. Western Reserve also earned Best Nursing Home and Best Assisted Living honors in the Medina Gazette's Best of the Best awards, while Springfield was voted Best Assisted Living/Retirement/Rehab Facility in the Best of Springfield awards for the third consecutive year. Together, these honors recognize the organization's commitment to quality care and resident experience across its communities.
Read The Ohio Masonic Communities' full announcement and list of 2026 honors. 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. 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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