February 4 Newsletter

 

 

 

 

 

February 4, 2026

 

President Signs Funding Bill to Fully Reopen Government
Yesterday, February 3, President Trump ended a partial government shutdown by signing a spending deal into law, funding the government through September 30, 2026 — the deal includes several elements that are specific to long-term care.

What’s Included
The spending package includes five funding bills, which cover the departments of Defense, Transportation, Housing and Urban Development, Health and Human Services, and Labor and Education. It also includes a stopgap measure funding the Department of Homeland Security for two weeks. Specific to long term care, the funding extends several telehealth policies through December 31, 2027, including:

  • Geographic Limit Waivers: These preserve telehealth access nationwide whether in a facility or in a beneficiary home such as assisted living and ID/DD settings.
  • Expanded list of telehealth providers: This preserves the ability for PT/OT/SLP services via telehealth.   
  • Delay of in-person requirements for mental health services furnished via telehealth and telecommunications technology: This preserves access to mental health care especially in provider shortage areas.
  • Extending the waiver to permit audio-only telehealth services: This preserves access to distant site care providers when telehealth is not available or per patient preference.
  • Extended use of telehealth for hospice recertifications.

Also included is an extension of the work geographic floor index multiplier of 0.0 through January 1, 2027, preventing rate cuts for Part B services in certain rural locations.

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Let’s Celebrate Careers in Aging 2026!
Once again, HCAM will spotlight individuals who have chosen a career in long-term care — join us in celebrating Careers in Aging this spring! The Gerontological Society of America initiated this celebration to recognize individuals with LTC careers and help raise awareness about the many fulfilling opportunities available. Last year, we recognized over 100 employees who have made long-term care their calling in our skilled nursing and assisted living member facilities.

We Need Your Help: Please consider spotlighting an employee this year. Any position is eligible including administrators/executive directors, nurses, CNAs, medication aides, housekeepers, maintenance staff, therapy services providers, dining staffers, life enrichment directors, etc. The process is simple and quick. To participate, please send an email telling us about a team member with a strong history in long-term care by sharing:

  • Their name, job title and length of time in LTC.
  • A few sentences about what makes them special and why they love their career.
  • A photo or two of them in action, if possible.

Please email HCAM’s Lisa Reibsome by February 18. Throughout the spring, HCAM will share their stories in our publications, communications with the legislature and on social media to spread the word about the wide-ranging LTC career opportunities as well as celebrate current caregivers in the profession.

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Congratulations to HCAM’s Jenny Post!

Michigan’s Adult Foster Care Licensing Advisory Council elected HCAM VP of Assisted Living Jenny Post as Chair earlier today, February 4. She has served on the council since 2023. The council was established by Public Act 218 of 1979 and consists of individuals from AFC providers, associations, state departments and other stakeholders — meeting quarterly to advise the Michigan Department of Licensing and Regulatory Affairs on the content of the rules and their enforcement.

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Apply for HCA/NCAL Diversity Executive Leadership Program by February 13
Be sure to apply for the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) Diversity Executive Leadership Program (DELP) by Friday, February 13, 2026.DELP, with its competitive selection process, offers 15 outstanding candidates a chance to participate in a two-year program focused on leadership development. This opportunity includes comprehensive education, mentoring, networking and active participation in the AHCA/NCAL community. The program is dedicated to empowering individuals from underrepresented groups, including those distinguished by race, ethnicity, gender, sexual orientation, disability and religion. The program also values diversity in geographic location and organizational affiliation, understanding the importance of different perspectives.

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Save the Date! 2026 HCAM Capitol Day & Legislative Reception 
Last year’s Capitol Day & Legislative Reception was a highly successful and meaningful gathering of members and legislators. Mark your calendars for this year’s event — June 23, Michigan State Capitol, Lansing — to help shape long-term care policy with Michigan legislators.

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HCAM 2026 Skilled Nursing Facility Wage Survey is Now Open (SNF)
HCAM tracks staff wage compensation to share with you to help with workforce strategies and advocate on your behalf with the Legislature, administration and state department officials. This data is critical as we work to help shape Medicaid reimbursement policy and the SFY 2027 budget. 

Please complete the wage survey. We are asking for data on your facilities’ expenses over the last three years, primarily related to staffing wages. We appreciate you taking the time to complete the survey spreadsheet. HCAM will share aggregate data results with those who complete the survey. If your building is part of a multi-facility organization, please coordinate survey completion with your corporate leadership.

Survey Instructions

  1. Fill out one survey per facility.
  2. After opening, save the excel document to your computer, rename as (Your Location) Wage Survey.
  3. Please answer all questions, if possible, in the space given.
  4. For wage information, give hourly rates only. Assume a standard year at 2080 hours. 
  5. Hourly rates are meant to be an average starting wage per position, without DCW.

Email Michael Batts your completed survey or if you have any questions.

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CMS Releases Update on Medicare Advantage RADV Audit Plans (SNF)
​CMS released an update on the status of Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) audits, reaffirming that strengthening oversight and improving payment accuracy remain top priorities. With federal estimates indicating roughly $17 billion in annual MA overpayments due to unsupported diagnoses, CMS is moving quickly to address its backlog and accelerate audits across several payment years.

CMS expected Payment Year 2020 RADV audits to begin as early this month, following its broader effort announced in May 2025 to speed completion of audits for payment years 2018–2024. Recoveries tied to earlier audits (2011–2013) are also expected soon.

What Providers Should Know: ​In response to industry concerns about burden, timing and transparency, CMS refined several components:

  • Longer time for plans to submit records – That means the five-month medical record submission window has been restored. This should result in fewer urgent chart requests and longer record request turnaround timeframes.
  • More predictable audit timing – every three months – which should help to reduce overlapping requests. CMS is planning to publish a formal calendar to help organizations anticipate activity. 
  • Smaller, more tailored samples from 35-200 enrollees based on plan size. Smaller plans are unlikely to face the largest samples.
  • Fewer document requirements reducing repetitive documentation demands. For each audited condition, plans may submit up to two medical records – but CMS only needs one valid record to support the diagnosis and thereby payment. However, providers should be aware that identifying the appropriate supporting record may still require reviewing multiple charts before locating the one or two that meet audit criteria. 
  • AI enabled coder support tools will be introduced to streamline reviews, though all overpayment decisions will remain with certified human coders.
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MDHHS Pauses LOCD Passive Redeterminations (SNF)
Passive redeterminations generated from the MDS 3.0 assessment are on hold because of issues found during implementation. That means no LOCD passive redetermination records will be generated by the MDS 3.0 assessment until further notice. The Michigan Department of Health and Human Services (MDHHS) will notify providers when they have corrected the issues. This update negates the department’s December 10 alert, which had advised that the LOCD Passive Redetermination process would be reinstated.

References for additional information on LOCD Passive Redeterminations:

  • Visit the Medicaid Provider Alerts & Resources Institutional Providers section, scroll down to the Skilled Nursing Facility section. Within that section, find the March 2020 LOCD Passive Redetermination Recording, PDF and Q&A document.
  • The Medicaid Provider Manual, Nursing Facility Level of Care Determination Chapter, Sections 3.8 Passive Redetermination of Functional Eligibility, 3.8.A. LOCD Doors Addressed by Passive Assessment, 3.8.B. Passive Redetermination Process, 3.8.C. Passive Redetermination Decisions and 3.8.D. Need to Conduct a New LOCD.
  • Email Provider Support or call them at (800) 292-2550.  
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CMS Releases Online Provider Complaint Form for MA Plans (SNF)
The Centers for Medicare and Medicaid Services (CMS) released an online form for providers to submit complaints about Medicare Advantage (MA) plans. It is important to note that any submitted complaints must be beneficiary-focused for CMS to review. The form requires information about the complainant, beneficiary, provider, MA plan, a complaint summary, date(s) of service and claim number. Once submitted, the complaint will be sent to the Health Plan Management System Complaints Tracking Module. Complaints will enter a queue, where CMS will review and triage before assigning a contract number. As the information is submitted directly online, MA plans will not receive the original provider complaint form. 

Why the Change? The new provider‑initiated complaint process will help ensure that beneficiary access issues are addressed. It will also provide CMS with valuable data to identify patterns and oversee plan performance. Providers should consider using this form to highlight ongoing MA access and care-delivery issues in skilled nursing and post-acute care settings, thereby strengthening CMS’ ability to identify systemic problems and support meaningful improvements.

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Deadline Reminder: Upcoming PBJ Data Due February 14 (SNF)
Providers must submit Payroll Based Journal (PBJ) data for October 1 – December 31, 2025, by February 14, 2026.  The Centers for Medicare and Medicaid Services (CMS) released an updated Errata V4.00.2 in December 2025. Previously, the optional hire and termination dates could not exceed December 31, 2025. The CMS update removed this restriction, extending the date to December 31, 2050. Providers are encouraged to review additional details here.  

As a reminder, when submitting XML files, please ensure that the file has been accepted via the Final File Validation Report. This report is created and stored in the CASPER reporting system within 24 hours of submission. Remember to submit your data early to review this and other PBJ CASPER reports. Also note that support will only be available through 8 pm ET February 13, 2026. All files for this deadline must be submitted by February 14, 2026, at 11:59 pm ET. Direct any policy questions to NHStaffing@cms.hhs.gov.

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Update to the Special Focus Facility Program (SNF)
A January 28 Centers for Medicare and Medicaid Services (CMS) memo (QSO-23-01-NH Revised), “Revisions to the Special Focus Facility (SFF) Program” updates the current selection criteria for Special Focus Facility candidates. The criteria will now emphasize the prevalence of resident falls as the focus area of selection. Previously, CMS considered a facility’s staffing to determine if a facility is an SFF candidate. The change comes following the Office of Inspector General’s recent report highlighting the need for improved fall safety.

In the memo, CMS outlines the goal to reduce survey predictability by changing the survey frequency to no less than twice annually, rather than the previous schedule of once every six months. Life Safety Code and Emergency Preparedness surveys will be conducted annually, unless state or CMS determines that more frequent surveys are necessary. Providers will be selected based on their last two standard surveys rather than the last three. Those who are included on the SFF candidate list will be notified via iQIES Five-Star Preview Report.

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CDC Revises Definition of Up to Date for COVID Vaccine (SNF)
The Centers for Disease Prevention and Control (CDC) revised the definition for what is now considered an up-to-date COVID-19 vaccine for residents and healthcare personnel via the National Health Safety Network (NHSN). Nursing facilities should immediately begin to use the new definition for reporting vaccination status in NHSN. Individuals are considered up to date with COVID-19 vaccines during the surveillance period of December 29, 2025 – March 29, 2026, for the purpose of NHSN surveillance, if they meet the following criteria:

  • Individuals aged 65 and older are up to date when they have:
    • Received 2 doses of the 2025-2026 COVID-19 vaccine, or
    • Received 1 dose of the 2025-2026 COVID-19 vaccine within the past 6 months.
  • Individuals younger than age 65 are up to date when they have received 1 dose of the 2025-2026 COVID-19 vaccine.

For additional information, including examples, refer to the document COVID-19 Vaccination Modules: Key Terms.

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Care Compare January Refresh Will Be February 5 (SNF)
The Centers for Medicare and Medicaid Services (CMS) postponed the January refresh of Nursing Home Care Compare to February 5, 2026.  The refresh was postponed because pf issues with the data files that were scheduled for the January 28 refresh. CMS is working on reprocessing the data to ensure accuracy.

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Important OSHA Deadlines (SNF/AL)
Please note these two Occupational Safety and Health Administration (OSHA) compliance deadlines and requirements:

  • The OSHA Form 300A (Summary of Work-Related Injuries and Illnesses) must be posted in a conspicuous location at each establishment from February 1 through April 30, 2026. This form summarizes data from the previous calendar year and must be certified by a company executive, even if there are no recorded incidents.
  • Injury and Illness data must be submitted electronically by March 2, 2026, through OSHA’s Injury Tracking Application (ITA). Depending on your establishment’s size and industry (most long- term care is covered), you may need to submit Form 300A data, and potentially detailed information from Forms 300 and 301 if in a designated industry with 100-plus employees.  

To access the ITA directly and begin or complete your submission: Injury Tracking Application (ITA) | Occupational Safety and Health Administration 

These American Health Care Association resources offer practical, LTC-focused guidance to help you navigate recordkeeping, determinations, and ITA submissions effectively: 

  1. Basic OSHA Recordkeeping Requirements 
  2. Determining Work-Relatedness (Including COVID-19 and Other Illnesses) 
  3. OSHA Injury Tracking Application (ITA) and Electronic Submission 
  4. Webinar Resource – OSHA Recordkeeping and New Reporting Requirements Webinar (includes details on expanded requirements, best practices, and common pitfalls) 
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HFA Administrative Rule Changes Continue Though the Promulgation Process
The Homes for the Aged (HFA) ruleset continues to move through the rule promulgation process. On December 12, 2025, the new ruleset was sent to Joint Committee on Administrative Rules (JCAR). The timeline requires 15 legislative days to allow JCAR to review and approve the rule changes. HCAM expects the rules will take effect withing the next month. The final rules modify requirements for communicable disease screening to comport with today’s practice standards; allow HFAs to reduce how frequently primary care providers are contacted each time residents refuse medication; provide regulatory requirements: (a) for a corrective action plan for identified violations, (b) for criteria for dismissing complaint allegations, and (c) to update physical plant requirements to nationally recognized models in congregate settings. Questions? Email HCAM’s Jenny Post.

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Free Webinar for AL Members: Leveraging Data for Excellence
This one-hour webinar on February 18 at 1 p.m. EST will provide a practical roadmap for how AL providers can leverage data to drive meaningful change and achieve excellence. Participants will gain a clear understanding of the AHCA/NCAL National Quality Award Program and learn how data platforms — LTC Trend Tracker and the LTC Data Cooperative — can support quality improvement initiatives and strengthen Quality Award applications. The webinar will also outline actionable strategies for integrating data into decision-making and building a culture of continuous improvement. 

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