The Lead August 7, 2025 - LeadingAge Illinois

From the Desk of Angela Schnepf, President and CEO

Nursing and Rehabilitation:

HFS Proposes Rules on Incentive Payments
Center of Excellence for Behavioral Health Support Ending
Upcoming COE-NF Free Training
Requesting ePOC Administrator Access in iQIES
LeadingAge Comments on Medicaid Provider Tax Proposed Rule
McKnight’s Indicates SNF Revalidation Postponement
Top Cited Deficiencies in Illinois Nursing Homes
CMS Releases FAQ Document on MDS Validation Audit Program

Housing:
Greencastle of Kenwood Hosts House Speaker Pro Tempore
HUD Posts Updated HOTMA Forms for Public Comment
LeadingAge RAD for PRAC Webinar Series: Preserving Your Aging HUD Property
HUD Announces Office Hours Designed for RAD 202 Project Rental Assistance Contract (PRAC) Owners

HCBS:

Home Health October 2025 Preview Reports Available
Home Health Advocacy Resources
July Home Health Provider Trend Reports Now Available
New LeadingAge Resource: Preparing Your Hospice for the iQIES Transition

From the Desk of Angela Schnepf, President and CEO

The Illinois Department of Public Health (IDPH) issued a SIREN notice on June 24, reminding nursing home providers of the upcoming census report quarterly due date. The third quarter report (April 1 – June 30, 2025) is due no later than September 1, 2025 and must be submitted to IDPH by emailing it to DPH.LTCDailyCensus@illinois.gov. If you have any questions or technical difficulties, please email the same email address.

Kindest Regards,

Angela

HFS Shared Figures in OBBB Briefing

The Illinois Department of Healthcare and Family Services (HFS) and the Medicaid Advisory Committee recently held a briefing on the impact of the “One Big Beautiful Bill.”

There is potential for $4.8 billion lost from provider taxes. Only the MCO and hospital tax look to have problems. Directed payment losses are estimated at $3.4 billion. It is estimated that 270,000- 500,000 enrollees will lose coverage due to the work requirements.

Legislative Visits Held at Park Place of Elmhurst and Central Baptist Village

The most recent duo of visits was held at Park Place of Elmhurst and Central Baptist Village in Norridge.

For two hours the residents and staff at Park Place of Elmhurst held an outstanding visit with State Representative Martha Deuter recently.

Park Place is the newest of the Providence Life Services communities. At 13 years old, it sits next door to a hospital and a private high school, where residents can look out their windows and see youth coming to and from school and playing sports.

Jason Speaks, director of government relations, represented LeadingaAge Illinois at the visit. full tour was provided to the representative, which included seeing the construction of a new outdoor dining area. Providence raised $500,000 to build the dining area which will have a number of amenities that include fire pits.

Scott Studebaker, vice president of advancement represented Providence Life Services during the

visit. He is now in his 40^th year with the organization and has spent his entire career in the field. He started working at a nursing home owned by his father at 13 years old. Scott has been a major piece of LeadingAge Illinois’ grassroots advocacy, annually hosting state and federal legislators at Providence communities and reenergized the LeadingAge Illinois PAC by founding the Chair’s Circle.

U.S. Representative Mike Quigley visited Central Baptist Village this week. The community has been serving seniors for over 129 years. Rep. Quigley addressed a gathering of residents and staff talking about his life and career and discussing important issues in the current times. He grew up in Carol Stream and lives across from Wrigley Field in Chicago and talks with city residents frequently in addition to meeting with groups of constituents throughout his district. He represents 750,000 people in a disctrict that spans from Navy Per in Chicago to Barrington.

Quigley’s first elected position was a Cook County Commissioner, where he served for 10 years. Since then he has served in U.S. Congress since 2008. His first election, he defeated 23 opponents to take the seat left vacant by Rahm Emanuel who had left to become Chief of Staff to President Obama.

Quigley discussed the impact Medicaid cuts will have on Illinois and the current stressful times in Congress. He encouraged residents to advocate while also finding ways to reduce stress. He mentioned that his stress releif is playing hockey on Saturdays.

Jason Speaks represented LeadingAge Illinois during the visit to the three-story community. The Village is also the workplace of 2025 LeadingAge Illinois Rising Star Award recipient, Maggie Dickerson.

We have several other visits coming up and would like to add your community to the schedule. If you are interested, contact Jason Speaks.

CMS Removes Focused Infection Control Surveys from the Survey Process

The Centers for Medicare & Medicaid Services (CMS) revised a QSO memo on Guidance for the Expiration of the COVID-19 Public Health Emergency, now listed as QSO-25-23-ALL. This memo was initially released May 1, 2023, and outlined steps upon the termination of the public health emergency and 1135 waivers. In the revised memo dated July 30, 2025, CMS added that focused infection control (FIC) surveys are no longer part of the standard survey process and that any COVID-19 or infection control concerns should be investigated through complaint investigations outside of the long-term care survey process.

CMS Seeks Input on PACE Audit Protocol and Information Collection Activities

On July 14, the Centers for Medicare & Medicaid Services (CMS) posted a request for comment on Agency Information Collection Activities in the PACE Audit Process. The posting references an updated use of data and seeks comment on an unchanged previously approved information collection request. Comments are due August 13. If members have suggestions for this solicitation, please email Georgia Goodman at LeadingAge.

Potential Medicare Claims Adjustments Due to CBSA Errors

The Centers for Medicare & Medicaid Services (CMS) announced in a MLN Connects Newsletter on July 17, that errors were identified in the Core-Based Statistical Area (CBSA) zip code files for January, April, and July 2025. The CBSAs are used to classify providers as rural or urban when determining wage indices for payment rates. CMS made corrections to files and providers may see an adjustment as the Medicare Administrative Contractors (MAC) reprocesses affected claims.

QRP Non-Compliance Letters in CASPER Folders

The Centers for Medicare & Medicaid Services (CMS) is providing notification to providers that were determined to be out of compliance with Quality Reporting Program (QRP) requirements for the Calendar Year (CY) 2024, which impacts the Fiscal Year (FY) 2026 Annual Payment Update (APU). Non-compliance notifications are distributed by the Medicare Administrative Contractors (MACs) and were placed into providers CASPER folders in QIES (Hospice) and iQIES (SNF) on July 21. If you receive a letter of non-compliance, you may submit a request for reconsideration to CMS via email no later than 10:59 p.m. CT on August 26, 2025. You can find instructions on requesting a reconsideration on the appropriate QRP webpage:

QIO Programs Begin 13^th Scope of Work

The Quality Improvement Organizations (QIO) Program’s 13^th Scope of Work (SoW) has been approved and QIOs are once again authorized to provide training, resources, and technical support to nursing homes, hospitals, and physician’s offices. The SoW includes reassignment of QIOs into seven regions with both new state groupings and new contracts. Superior Health Quality Alliance was appointed as the QIO for Illinois and you can request assistance by visiting their website – www.superiorhealthqa.org

LeadingAge Illinois Bi-Weekly Member Call

We are excited to invite you to our biweekly member meeting, open to all members! This is a great opportunity to stay informed on the latest legislative developments and education updates, as well as engage with our featured guest speakers.

Mark your calendars!

Every other Friday from 9:00 – 10:00 AM

Next Zoom is August 15

Meeting Highlights:

Legislative Updates: Learn about the most recent legislative changes that may impact our community from our Public Policy Team.
Education Updates: Stay up-to-date with the latest education offerings.
Featured Guests: Special guests will join us to share their expertise and insights on key topics.

This event is free and open to all members—we encourage you to join, participate, and connect with fellow members and LeadingAge Illinois staff.

RSVP Here.

We look forward to seeing you on Zoom!

Best Practices – Pressure Ulcer Prevention & Repositioning

Numerous older adults are at risk of developing pressure ulcers and long-term care providers must identify this risk and implement interventions to reduce this risk in those they serve. Repositioning is an intervention that is frequently used as a prevention strategy. However, is there a best practice to determine the frequency and methods used for repositioning? When researching pressure ulcers, I found a robust guide on several topics on patient repositioning including determining the frequency that someone should be repositioned given their overall condition as well as how individuals should be repositioned.

The National Pressure Injury Advisory Panel (NPIAP) offers a free online guidance document(s) on the multiple facets of pressure ulcer prevention, identification, and treatment. To prevent information overload, lets focus on one area at a time.

The NPIAP information outlines that pressure injuries cannot form without mechanical loading acting on the tissue which includes extended periods of lying or sitting on a particular part of the body without redistributing the pressure leads to tissue deformation and ultimately damages the tissue in the form of a pressure injury. Repositioning is an essential preventative measure to reduce the occurrence of pressure injuries. To reduce your burden in researching these, I’ve outlined some key considerations to implementing best practice in your community.

General Repositioning:

It is good practice to reposition patients at risk for pressure ulcers, regardless of the pressure redistribution support surface being used. However, you may consider the frequency of repositioning based on the support surface. It is good practice to reposition patients in a way that offloads pressure points and maximizes redistribution of the individual’s weight. Implementation considerations include:

The person’s goals of care and priorities. For example, someone at the end of life may forego reducing the risk of pressure injury to not be disrupted by repositioning or to cause pain by repositioning. While pressure ulcers cause pain in and of themselves, the individual’s goals may outline that a repositioning at a less frequent schedule is sufficient to both meet their preferences and not develop pressure ulcers.
Look at the individual’s repositioning needs over a 24-hour period. Are there times when the person will always be at meals that can be counted as a repositioning time? Additionally, there may be considerations to their preference of repositioning location (such as a bed compared to a recliner). An interdisciplinary approach should be used when developing a schedule for the patient.
Check all pressure points when you are redistributing their weight. Areas such as the gluteal cleft, elbows, malleolus, and wrist are vulnerable areas that are frequently overlooked.
Assess the patient’s pain before, during, and after repositioning. Consider the use of pain medication before repositioning occurs if the act of repositioning causes pain.
Assess the patient’s full body when repositioning. Evaluating the person’s body alignment and posture to maximize comfort and offload pressure is necessary to pressure ulcer prevention. The use of additional repositioning supports or devices may be necessary to ensure proper alignment and pressure reduction.
Use of positioning devices can be used to maintain position, elevate and support pressure injury prone areas, promote body symmetry, posture and comfort Ensure that the patient and/or staff are well educated on positioning devices intended anatomical areas for pressure relief (for example do not position a pillow directly against the sacrum when in a lateral position). Consider using specialized repositioning devices to support specific needs or body shape such as a Z-Flo or similar device that can be molded or conformed to the patient’s position and won’t flatten over time like towels or blankets.
Ensure that objects and medical devices are moved out from underneath patients to prevent device-related pressure and friction.
If a patient can self-reposition, encourage them to do so as often as possible and staff may need to remind them to regularly do so. Assess and monitor these individuals to ensure that their self-repositioning techniques are effectively offloading pressure points and they are avoiding friction and sheer as they reposition themselves.

When repositioning patients, it is good practice to use specialized equipment designed to reduce friction and shear. If manual handling is necessary, techniques that minimize the friction and shear should be applied. Implementation considerations include:

Identifying individual’s experiences with manual handling. Fear, pain and/or discomfort may lead to difficult transfers and repositioning.
Specialized manual handling equipment shall be easily available and in good working order. Ensure that this equipment is also safe based on age, weight, and dimensions of the individual.
Establish procedures to support safe and appropriate transfers such as lifting rather than dragging and consider use of assistive devices such as low friction fabric transfer sheets. Also pay close attention to patient’s heels during repositioning and/or transfers.
Minimize shear once repositioning by ensuring that surface materials are not pulling on skin. Examples of this can include loosening sheets.
Manual handling equipment should not be left under the resident unless the equipment is specifically designed for this purpose.
Consider implementing a dedicated repositioning team who are experts in manual handling to promote optimal repositioning, adherence to schedules, and reduction of staff injuries such as ComfortGlide Turning and Repositioning System by Medline.

When positioning in bed it is not necessary to use a 30-degree lateral positioning or maintaining a 30-degree head of bed elevation as there is low certainty of evidence supporting these recommendations.

Avoiding laying in positions that increase pressure is recommended such as a 90-degree lateral position.
When repositioning in a lateral position, offload the sacrococcygeal area without placing pressure on the trochanter. This can be possible by positioning the upper leg forward of the lower leg with support from a pillow to promote comfort and stability.
Ensure bony prominences such as heels, knees, and ankles are offloaded.
Consider use of a Leaf Sensor or similar device that the patient can wear and will tell the staff if the individual needs repositioned or if they are correctly positioned with offloading of pressure injury prone areas.
The head of the bed should be as flat as possible considering the individual’s clinical needs and preferences. When possible, maintain elevation at 30 degrees or lower.
When elevating the head of the bed, ensure that the thighs are elevated to minimize shear by sliding.
Investigate alternatives to sitting in bed such as sitting out of bed during meals.
Avoid slouched positions which increase pressure and shear on the sacrum and coccyx.

Upcoming IDPH Webinars

The Illinois Department of Public Health announced the following upcoming webinars. Registration is required and attendance is limited. If you’re unable to attend, email Michael.moore@illinois.gov as the webinar will be recorded and can be distributed following the event.

Hot Topics in Public Health on August 8 from 1 – 2 p.m.
Identified Offender Program pt 2 on August 20 from 1-3 p.m.
Contractor Toolkit on August 22 from 1 – 2 p.m.
Multidrug- Resistant Organism (MDRO) and Denial of Admission on September 17 from 1-2 p.m.

HFS Proposes Rules on Incentive Payments

The Illinois Department of Healthcare and Family Services (HFS) recently proposed rules for Medical Payments concerning HFS’ rate determination appeal process in cases where a nursing facility does not receive staffing incentive payments intended to help them hire more Certified Nursing Assistants (CNAs) and/or increase their pay.

If the facility failed to timely submit federally required quarterly Payroll Based Journal (PBJ) staffing data, the facility will not receive incentive payments for the applicable quarter. If the facility timely submitted PBJ data that was not accepted by the federal Centers for Medicare and Medicaid Services (CMMS), it will receive 90% of the incentive payment made for the most recent quarter prior to the CMMS rejection.

The facility must inform HFS of the reason for the rejection (e.g., reporting errors, federal audit). If CMS rejects the facility’s data in subsequent quarters, an additional 10% reduction (to 80%, 70%, etc.) will be applied to its incentive payments for each applicable quarter.

Center of Excellence for Behavioral Health Support Ending

The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) will reach the end of its three-year funding period on September 29, 2025. After that date, technical assistance consultations and live training events will no longer be available for nursing homes. Recorded education and resources will remain accessible on the Centers for Medicare & Medicaid Services (CMS) website after the grant concludes with additional details soon. Additionally, Alliant Health Solutions will also post the recorded training and resources for at least one year after the grant funding terminates (September 2026). You can access Alliant Health Solutions website here.

LeadingAge is interested in hearing feedback on the impact terminating this funding may have on nursing homes. Have you used their 1:1 technical support or accessed resources and training? Please email Jodi Eyigor at LeadingAge with specific information.

Upcoming COE-NF Free Training

The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) is offering the following free training opportunities in August:

Question, Persuade, Refer (QPR) Suicide Prevention on August 7 from 1 – 2:30 p.m. CT
An Introduction to Trauma-Informed Care on August 12 from 1-2 p.m. CT
Beyond Consults: Embedding Behavioral Health in Post-Acute Care Teams on August 14 from 5-6 p.m. CT
Empowering Nursing Facility Care with CLAS! Culturally and Linguistically Appropriate Services on August 19 from 1-2 p.m. CT
Empathy and Compassion: Foundations for Person-Centered, Staff-Sustaining Care on August 26 from 12:30 – 1:30 p.m. CT
Opioid Stewardship in Skilled Nursing Facilities: Preventing Opioid Use Disorder (OUD) Before it Starts on August 28 from 1-2 p.m. CT
Mental Health First Aid (MHFA) on August 29 from 10 a.m. to 3:30 p.m. CT

Requesting ePOC Administrator Access in iQIES

CMS announced on July 23, that you were able to request ePOC access in iQIES. To request this access:

Enroll in HCQIS Access Roles & Profile (HARP) by registering at https://harm.cms.gov/register.
Complete the identity verification through Experian. (HARP uses Experian to remotely verify the user’s identity by applying the data that a user provides such as date of birth and social security number to generate a list of personal questions for the user to answer.)
Set up two-factor authentication. If you receive an error message stating that your email address already exists, this most likely means that you have completed some level of identity proofing in the past. You will need to login to HARP using your Enterprise Identity Management (EIDM) information. If you don’t remember your login information, you will need to contact the QualityNet Help Desk at qnetsupport@cms.hhs.gov or call 866-288-8912. Once you login, you will be directed to set up the two-factor authentication.

How to request provider ePOC administrator role:

Login to iQIES (https://iqies.cms.gov) using your HARP User ID and Password (EIDM login information if you are a EIDM user).
Verify your account using the two-factor authentication.
On the “Welcome to iQIES” page, click the “Request User Role” Button.
Select a “User Category” – “Provider”, then click “Next”.
Select a “User Role” – “ePOC Administrator”, then click “Next”.
Add your organization using the CCN or Facility ID, click Add and then “Submit Request”. A “Role Request Submitted” message will be displayed on the My Profile Page. The approval status will be emailed to you after your request is reviewed. In order for your request to be approved, your organization must have at least one Provider Security Official (PSO) assigned to approve this request.

IDPH granted a grace period for Plan of Corrections that were due during the outage period. We reached out to them to identify when this grace period will end and will follow up with this information. However, in the event that they are not allowing much time, please complete the request as soon as possible to ensure you receive access to submit ePOCs.

LeadingAge Comments on Medicaid Provider Tax Proposed Rule

On May 15, the Centers for Medicare & Medicaid Services (CMS) posted Medicaid Program; Preserving Medicaid Funding for Vulnerable Populations – Closing a Health Care-Related Tax Loophole proposed rule. CMS cites concern with Medicaid Provider Taxes that fail to comply with “generally redistributive principles” codified in the Social Security Act. The proposed rule aims to curb these practices by introducing additional criteria to which states must adhere when structuring their provider taxes to ensure the fiscal burden is not unduly borne upon Medicaid providers or units of service.

In the LeadingAge comments, they stress the unique nature of nursing home payer mixes and urge CMS to consider carving nursing homes out of the new provisions. For taxes that CMS has deemed out of compliance, they urge a five-year transition to increase states’ opportunities for compliance and allow for alternative plans to back fill revenues these taxes were anticipated to generate. An article on the proposed rule is available here, along with comments here.

McKnight’s Indicates SNF Revalidation Postponement

On July 17, McKnight’s Long-Term Care News released an article indicating that the Centers for Medicare and Medicaid Services (CMS) is again delaying the skilled nursing facility (SNF) off-cycle revalidation deadline. Originally due earlier this year, CMS has postponed the deadline more than once due to the onerous additional disclosable party’s requirement. While CMS has not officially announced the postponement, McKnight’s indicated the new compliance deadline will be January 1, 2026.

Top Cited Deficiencies in Illinois Nursing Homes

In June, LeadingAge Illinois began introducing top cited deficiencies in nursing homes based on the Centers for Medicare & Medicaid Services (CMS) Quality, Certification & Oversight Reports (QCOR) website. Based on the latest report for the calendar year 2025, the top five deficiencies include F689 (38%); F600 (21%); F880 (27%); F684 (24%), and F686 (18%). (The percentages denote the providers cited for each respective tag in Illinois.)

F689 (see previous article for falls and elopements) while it is not commonly cited, the interpretative guidance includes required practices when a resident smokes. If the nursing home allows residents to smoke, and the resident desires to smoke, a smoking assessment must be completed to identify if the resident is safe to smoke independently or if appropriate interventions need implemented to protect the resident. If interventions are identified in the assessment, they must be included in the resident’s care plan and carried out appropriately by the staff. Additionally, the best practice is for staff to store cigarettes and lighters for the residents. If the resident desires to keep their supplies in their room, a lock box would be recommended for safety. Common citations related to resident smoking include:

A smoking assessment was not completed.
The interventions identified in the smoking assessment were not care planned.
During observations the resident did not have the identified interventions in place.

F600 continues to be cited for abuse and relates to both staff to residents and resident to resident abuse.

F880 (see previous article for hand hygiene and enhanced barrier precautions) Another commonly cited concern which can be cited under F880 for infection prevention or the regulation that the type of care being provided or the task performed is included in, is glove use. For example, if gloves are not used appropriately during pressure ulcer care it may be cited under F686 or F880.

Gloves must be used whenever the task the staff is completing may result in contact with blood or body fluids or when there is potential to contaminate the resident or their items.
Prior to donning (or applying) gloves, staff must ensure they complete hand hygiene.
When wearing gloves, the staff must make sure that they don’t touch anything that is potentially contaminated without changing their gloves. For example, in the wound care identified above, the staff member would gather supplies for a dressing change and place them on a barrier before they apply their gloves. If the staff member applies gloves and then touches the treatment cart drawer, they have contaminated their gloves and must change them.
Gloves must be changed when transitioning from a dirty task to a clean task. Continuing with the wound care example, the staff would be required to change their gloves after removing the dressing that is currently placed on the wound. Reminder that hand hygiene must be completed whenever gloves are changed.
Gloves must be removed when the task is finished and before touching other items. In the wound care example, once the dressing has been secured on the wound the staff must remove their gloves otherwise, they risk contaminating other items in the resident’s room if there is any bacterial on their gloves from completing the treatment. As a reminder, hand hygiene must be completed whenever gloves are removed.
Gloves should not be placed in the pockets of staff members uniforms as this is considered a potentially contaminated area. The staff could place enough changes of gloves for the procedures on the clean barrier if the glove dispenser is not close to the treatment location.

F684 continues to be cited frequently for lack of assessments and interventions. You can read more about this in previous articles.

F686 relates to pressure ulcer prevention, detection, and treatment. Nursing home residents are expected to remain free of avoidable pressure ulcers if they are admitted without a pressure ulcer. If they have a pressure ulcer, the expectation is that the pressure ulcer will not worsen unless it is unavoidable. What does avoidable mean? The nursing home should identify based on a risk assessment, residents who are at risk for developing pressure ulcers. Based on this risk assessment, interventions should be implemented to prevent pressure ulcer development. For example, if the resident is identified as being at risk for pressure ulcer development, the nursing home may place a cushion in the resident’s chair that they normally sit in to reduce the pressure being placed on the resident’s coccyx. If a pressure ulcer is identified, the nursing home should make all efforts to prevent worsening. For example, the treatments should be provided as ordered by the physician. If items are not available to complete the treatment or they are simply not being done, and the ulcer worsens it could be seen as avoidable.

Additionally, the nurse must complete ongoing skin assessments on the pressure ulcer. These skin assessments must include actual measurements of the wound including depth. Frequently the measurements state length and width but lack depth. If it is not possible to measure the depth (such as a deep tissue injury) then this should be identified in the narrative description. Items that should also be included in the routine assessment are the appearance of the wound which may include the wound bed, surrounding tissue, if any odor is present, what the edges of the wound look like, if there is drainage, etc. These items help identify a potential infection or worsening wound. It is expected that if these are noted, the nurse promptly notifies the resident’s provider of additional recommendations such as a change in treatment or antibiotics.

If you have questions on these or any other regulations, please contact Kellie Van Ree, Director of Clinical Services

CMS Releases FAQ Document on MDS Validation Audit Program

In June, the Centers for Medicare & Medicaid Services (CMS) released an FAQ document on the Skilled Nursing Facility (SNF) Validation Program which includes audits to assess the accuracy of the Minimum Data Set (MDS) based quality measures. The SNF Validation Program is being developed based on Fiscal Year (FY) 2024 and FY 2025 SNF Prospective Payment System (PPS) final rules to ensure that accurate data is being collected for the Value Based Purchasing (VBP) and Quality Reporting Program (QRP). The SNF Validation Program is scheduled to begin this fall for measures in the FY 2027 program year.

What do you need to know?

Healthcare Management Solutions (HMS) is the validation program contract that will be conducting the audits on behalf of CMS through a Data Use Agreement (DUA). SNF providers are randomly selected based on submitting at least one MDS assessment in the calendar year (CY) and in the current FY. However, each SNF can only be selected once per FY. If selected, you will be notified of the audit via the iQIES system in the Provider Preview Reports Folder. This notification will also include how to submit documents and a list of sampled residents selected.

The SNF will need to identify a point of contact (POC) to receive audit-related email notifications. If you need to change the POC at any point, you can click on the original audit link and update the POC. You will have 45 calendar days from the date of the notification to upload the requested documentation.

Medical record documentation must be bundled with each resident’s information in a single PDF file. The file must include a specific formatted title that identifies your CCN number and the MDS Assessment ID (see example in question #17 of the FAQ document). The PDF will be uploaded to a secure website for review. The audit information will include a specific date range that must be included in the medical record documentation. Records that are outside of the established date range, the resident’s face sheet, or social security number must not be submitted. Once the individual records have been successfully uploaded as well as when all requested records have been submitted, an email notification will be sent to the POC.

At the conclusion of the audit, a Summary Audit Scoring Report will be uploaded to iQIES including the results for each measure along with detailed results from each sampled assessment and medical chart audited. The reports are for informational purposes only and SNFs will not be penalized for their audit results. These reports will be available within three months of the submission deadline. SNFs that don’t comply with the audit may have a 2% reduction in their SNF Annual Payment Update for the FY2027 SNF QRP program year. A noncompliance letter will be sent from the Medicare Administrative Contractor (MAC). If you disagree with the noncompliance letter, you may submit a request for reconsideration to CMS within 30 days from the noncompliance notification letter. Any requests submitted after 30 days will not accepted.

Any questions on the SNF Validation Program can be directed to the help desk at snfvalidation@hcmsllc.com.

Greencastle of Kenwood Hosts House Speaker Pro Tempore

Embrace Living continues to advocate for senior housing at the federal and state levels. In the last week weeks, they have hosted state and federal legislative visits at some of their communities. One of the most recent was a visit from State Representative Kam Buckner, Speaker Pro Tempore at Greencastle of Kenwood in Chicago. The visit included meeting with residents and taking a tour.

HUD Posts Updated HOTMA Forms for Public Comment

The Department of Housing and Urban Development (HUD) has posted draft materials needed for certain federally-assisted housing providers to comply with requirements under the Housing Opportunity and Modernization Act (HOTMA). HOTMA is a major rule change in affordable housing that impacts who is eligible for HUD-assisted housing and how much rent they pay, among other changes. After repeatedly delaying implementation, HUD has currently set the compliance date for multifamily housing providers on January 1, 2026. The materials include long-awaited forms, such as the new model lease for Section 202 and Section 8 housing communities, that HUD has updated to reflect tenant certification and rent procedure changes required by HOTMA. Posting the materials to the drafting table gives HUD’s multifamily housing stakeholders a chance to review the drafts; next, HUD will publish the draft forms to the Federal Register to formally request feedback within a 30-day window. You can review the draft documents here.

LeadingAge RAD for PRAC Webinar Series: Preserving Your Aging HUD Property

Join LeadingAge for a special mini-series on the Rental Assistance demonstration (RAD), a critical senior housing preservation tool administered by the Department of Housing and Urban Development (HUD). Many affordable senior housing providers are exploring preservation options for aging PRAC properties with limited opportunities to attract recapitalization and rehabilitation investment; the September webinar series, taught by affordable housing expert Gates Kellett, reviews the basics of RAD and then dives into best practices and pitfalls to avoid. Whether you are just beginning to explore RAD or seeking to refine your approach, this insightful two-part webinar will provide valuable knowledge and practical guidance for making informed decisions and ensuring the long-term success of your housing portfolio.

HUD Announces Office Hours Designed for RAD 202 Project Rental Assistance Contract (PRAC) Owners

The Department of Housing and Urban Development (HUD) is hosting additional office hours to help affordable senior housing providers understand their property preservation options through the Rental Assistance Demonstration (RAD). HUD’s Office of Recapitalization is hosting office hours for 202 PRAC owners and their partners who are contemplating RAD on Wednesday, July 23 at 12 p.m. CT. According to HUD, program experts will be available to engage with property owners and their partners on how to use RAD and Preservation Rent Increase tools to recapitalize and reposition your 202 PRAC properties. HUD previously hosted office hours in June that members found helpful. Stakeholders can join RAD office hours for PRAC owners and partners via Teams or dial in by phone at 509-904-9877,,636285916#. United States, Spokane Find a local number with Phone Conference ID: 636285946.

Home Health October 2025 Preview Reports Available

On August 6, the home health Provider Preview Reports were updated and posted to iQIES. These reports contain provider performance scores for quality measures, which will be published on Care Compare during the October 2025 refresh. Data contained within the Provider Preview Reports are based on quality assessment data submitted by HHAs from Quarter 1, 2024 through Quarter 4, 2024. The data for the claims-based measures will display data from Quarter 1, 2023 through Quarter 4, 2024 for the Discharge to Community and Medicare Spending Per Beneficiary measures, Quarter 1, 2022 through Quarter 4, 2024 for the Potentially Preventable 30-Day Post-Discharge Readmission measure, and Quarter 1, 2024 through Quarter 4, 2024 for the Home Health Within-Stay Potentially Preventable Hospitalization measure. Additionally, the data for the HHCAHPS measures will display data from Quarter 2, 2024 through Quarter 1, 2025. Providers have until August 8, 2025, to review their performance data.

Home Health Advocacy Resources

The proposed cut to Medicare Fee for Service (FFS) payment rates for home health services included in the Centers for Medicare & Medicaid Services (CMS) Calendar Year (CY) 2026 Home Health Payment System Rate Update is deep: 9%. When combined with the 8.8% payment reductions the agency has imposed since CY 2023, the impact will be significant to all providers of home health care – but nonprofit providers are particularly at risk.

You can learn more about LeadingAge’s multi-pronged advocacy strategy to fight against the cuts, including an initiative with the National Alliance for Care at Home, as well as LeadingAge’s members-only resource for nonprofit providers here.

You can also complete this survey which provides data to support the advocacy work being done. By completing the survey, it will help LeadingAge understand the impact of a 9% payment decrease and the financial realities you are navigating by answering a few questions. The information will inform the advocacy response.

July Home Health Provider Trend Reports Now Available

Provider Trend reports are now available in the LeadingAge Report Portal for Home Health members. You can access your report on the Report Portal linked here.

New LeadingAge Resource: Preparing Your Hospice for the iQIES Transition

As part of the transition from the Hospice Item Set to the Hospice Outcomes and Patient Evaluation (HOPE), hospices will be required to create an iQIES account for data submission to the Centers for Medicare & Medicaid Services (CMS). For agencies that include home health or skilled nursing as another business line, there is more than likely an existing iQIES account for your organization and your hospice can be added as another provider by searching for the CCN. For those agencies that do not have an existing iQIES account, you will need to create an account. To help members with this process, LeadingAge created a new resource guiding members through what to consider as new accounts are created.