01/15/2026

Nursing Home Leaders Still Bracing for Regulatory Pressure

Skilled nursing leaders continue to see regulation as a day-to-day operational strain rather than a policy problem on the horizon, according to McKnight’s 2026 Outlook survey. Nearly half of respondents ranked tighter compliance and regulatory standards among their top concerns for the year, trailing only staffing shortages and Medicaid cuts. Respondents pointed to frequent rule changes, inconsistent federal messaging, inexperienced surveyors, and growing documentation demands as factors that continue to weigh on clinical operations and administrative capacity, even after the repeal of the federal staffing mandate and a pause on certain ownership reporting requirements.

Concerns are especially pronounced around survey processes and quality measurement. Respondents cited the growing number of inexperienced surveyors, expanded antipsychotic quality measure calculations by the Centers for Medicare & Medicaid Services, and new Minimum Data Set reporting requirements as high-risk areas for 2026. Many leaders also flagged uncertainty tied to Medicaid policy changes and potential state-level funding cuts, noting that even flat Medicaid funding would further strain providers already operating on thin margins. While some respondents remain hopeful that additional regulatory relief may still emerge, the prevailing sentiment reflects caution and fatigue rather than confidence.

Read more in McKnight’s Long-Term Care News.