| CMS Issues Memo to Outline Contingency Plans During Government Shutdown | https://www.ahcancal.org/News-and-Communications/Blog/Pages/CMS-Issues-Memo-to-Outline-Contingency-Plans-During-the-Government-Shutdown.aspx | CMS Issues Memo to Outline Contingency Plans During Government Shutdown | | | | | 10/2/2025 4:00:00 AM | | <span data-contrast="auto" lang="EN-US" style="font-size:11pt;">Recently, the Centers for Medicare & Medicaid Services (CMS) released a </span><a href="https://www.cms.gov/files/document/qso-26-01-all.pdf" target="_blank" rel="noreferrer noopener" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" style="font-size:11pt;"><span data-contrast="none" lang="EN-US"><span data-ccp-charstyle="Hyperlink">QSO memo</span></span></a><span data-contrast="auto" lang="EN-US" style="font-size:11pt;"> outlining the contingency plan for the Quality, Safety & Oversight Group (QSOG) and the Survey & Operations Group (SOG) during the federal government shutdown. The memo provided information on several areas that directly affect nursing home providers.</span><span data-ccp-props="{}" style="font-size:11pt;"> </span><div><br><div style="text-decoration:underline;"><span data-contrast="auto" lang="EN-US"><strong>Survey and Certification Activities Not Affected by the Federal Government Shutdown</strong></span><span data-ccp-props="{}"> </span></div><div><ol role="list" start="1"><li aria-setsize="-1" data-leveltext="%1." data-listid="1" data-list-defn-props="{"335552541":0,"335559685":720,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" data-aria-posinset="1" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US">CMS or State Vendor Contracts Awarded on or before September 30, 2025.</span><span data-ccp-props="{}"> </span></li></ol></div><div><ol role="list" start="2"><li aria-setsize="-1" data-leveltext="%1." data-listid="1" data-list-defn-props="{"335552541":0,"335559685":720,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" data-aria-posinset="2" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US">State Funded Surveys- these are surveys that occur in addition to any federally required surveys.</span><span data-ccp-props="{}"> </span></li></ol></div><div><ol role="list" start="3"><li aria-setsize="-1" data-leveltext="%1." data-listid="1" data-list-defn-props="{"335552541":0,"335559685":720,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" data-aria-posinset="3" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US">Surveys of Medicaid-only facilities.</span><span data-ccp-props="{}"> </span></li></ol></div><div style="text-decoration:underline;"><span data-contrast="auto" lang="EN-US"><strong>Expected Medicare Functions During the Shutdown</strong></span><span data-ccp-props="{}"> </span></div><div><ol role="list" start="1"><li aria-setsize="-1" data-leveltext="%1." data-listid="2" data-list-defn-props="{"335552541":0,"335559685":720,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" data-aria-posinset="1" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US"><strong>Complaint Investigations Alleging Harm</strong></span><span data-contrast="auto" lang="EN-US"><strong>:</strong> State Agencies are expected to conduct complaint investigations when the complaint was triaged as a credible allegation of immediate jeopardy (IJ) or harm to an individual. CMS notes, states should maintain the infrastructure to accept complaints, log, and triage the complaints, throughout the length of the Federal Government shutdown. </span><span data-ccp-props="{}"> </span></li></ol></div><div><ol role="list" start="2"><li aria-setsize="-1" data-leveltext="%1." data-listid="2" data-list-defn-props="{"335552541":0,"335559685":720,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" data-aria-posinset="2" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US"><strong>Certain Federal Enforcement Actions</strong></span><span data-contrast="auto" lang="EN-US"><strong>:</strong> If any enforcement actions are needed, as a result of a complaint investigation detailed in number one, state agencies must continue to process enforcement and transfer cases that meet the Immediate Imposition of Federal Remedies requirements, as these represent resident harm.</span><span data-ccp-props="{}"> </span></li></ol></div><div><ol role="list" start="3"><li aria-setsize="-1" data-leveltext="%1." data-listid="2" data-list-defn-props="{"335552541":0,"335559685":720,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" data-aria-posinset="3" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US"><strong>Revisit Surveys Approved By Exception and Necessary To Prevent Termination</strong></span><span data-contrast="auto" lang="EN-US"><strong>:</strong> State Agencies may request approval to conduct revisits when a provider has alleged compliance, </span><span data-contrast="auto" lang="EN-US">and </span><span data-contrast="auto" lang="EN-US">the revisit survey is needed to determine compliance and prevent the scheduled Medicare termination, </span><span data-contrast="auto" lang="EN-US">and </span><span data-contrast="auto" lang="EN-US">the Medicare termination is likely to occur due to timing or specific circumstances.</span><span data-ccp-props="{}"> </span></li></ol></div><div><ol role="list" start="4"><li aria-setsize="-1" data-leveltext="%1." data-listid="2" data-list-defn-props="{"335552541":0,"335559685":720,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" data-aria-posinset="4" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US"><strong>Immediate Threat To Life Or Safety (Emergencies Or Natural Disasters):</strong></span><span data-contrast="auto" lang="EN-US"> State Agencies are directed to take action to prevent or mitigate any other immediate threats to the life or safety of residents. This may be necessary during a public health emergency, for example.</span><span data-ccp-props="{}"> </span></li></ol></div><div><ol role="list" start="5"><li aria-setsize="-1" data-leveltext="%1." data-listid="2" data-list-defn-props="{"335552541":0,"335559685":720,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" data-aria-posinset="5" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US"><strong>Orderly Shutdown Of Other Tasks</strong></span><span data-contrast="auto" lang="EN-US"><strong>:</strong> The memo notes that if tasks were being conducted on September 30, 2025, those tasks should be completed, if they can be completed within four hours. An example of this includes uploading completed survey information into iQIES. </span><span data-ccp-props="{}"> </span></li></ol></div><div style="text-decoration:underline;"><span data-contrast="auto" lang="EN-US"><strong>Activities Not Supported During a Federal Government Shutdown</strong></span><span data-ccp-props="{"335559685":360}"> </span></div><div><ol role="list" start="1"><li aria-setsize="-1" data-leveltext="%1." data-listid="3" data-list-defn-props="{"335552541":0,"335559685":1080,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" data-aria-posinset="1" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US">Standard (Recertification) Surveys</span><span data-ccp-props="{}"> </span></li></ol></div><div><ol role="list" start="2"><li aria-setsize="-1" data-leveltext="%1." data-listid="3" data-list-defn-props="{"335552541":0,"335559685":1080,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" data-aria-posinset="2" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US">Revisit Surveys, which do not meet the requirements in the section above (number 3).</span><span data-ccp-props="{}"> </span></li></ol></div><div><ol role="list" start="3"><li aria-setsize="-1" data-leveltext="%1." data-listid="3" data-list-defn-props="{"335552541":0,"335559685":1080,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" data-aria-posinset="3" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US">Initial Surveys</span><span data-ccp-props="{}"> </span></li></ol></div><div><ol role="list" start="4"><li aria-setsize="-1" data-leveltext="%1." data-listid="3" data-list-defn-props="{"335552541":0,"335559685":1080,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" data-aria-posinset="4" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US">Complaint investigations that were not triaged at the immediate jeopardy or actual harm level.</span><span data-ccp-props="{}"> </span></li></ol></div><div><ol role="list" start="5"><li aria-setsize="-1" data-leveltext="%1." data-listid="3" data-list-defn-props="{"335552541":0,"335559685":1080,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" data-aria-posinset="5" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US"><strong>Informal Dispute Resolutions (IDRs):</strong> No IDRs or Independent IDRs should be completed.</span><span data-ccp-props="{}"> </span></li></ol></div><div><ol role="list" start="6"><li aria-setsize="-1" data-leveltext="%1." data-listid="3" data-list-defn-props="{"335552541":0,"335559685":1080,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" data-aria-posinset="6" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US"><strong>New approvals for CMP-funded projects:</strong> New projects will not be approved during the Federal Government Shutdown. However, if the project was already approved, facilities may proceed as planned.</span><span data-ccp-props="{}"> </span></li></ol></div><div><span data-contrast="auto" lang="EN-US">CMS notes that it will provide additional information if the shutdown continues longer than anticipated. Additional information on the Federal Government Shutdown may be found </span><a href="/News-and-Communications/Blog/Pages/Congress-Unable-to-Reach-Budget-.aspx" target="_blank" rel="noreferrer noopener" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083"><span data-contrast="none" lang="EN-US"><span data-ccp-charstyle="Hyperlink">here</span></span></a><span data-contrast="auto" lang="EN-US">. For any questions, please email </span><a href="mailto:regulatory@ahca.org" target="_blank" rel="noreferrer noopener" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083"><span data-contrast="none" lang="EN-US"><span data-ccp-charstyle="Hyperlink">regulatory@ahca.org</span></span></a><span data-contrast="auto" lang="EN-US">.</span><span data-ccp-props="{}"> </span></div></div> | | |
| HCS Home Care/Hospice Salary & Benefits Studies Underway | https://www.ahcancal.org/News-and-Communications/Blog/Pages/HCS-Home-CareHospice-Salary-&-Benefits-Studies-Underway-.aspx | HCS Home Care/Hospice Salary & Benefits Studies Underway | | | | | 6/17/2025 4:00:00 AM | | <p></p><div><strong>Hospital & Healthcare Compensation Service (HCS)</strong> has announced the 2025 <strong>Home Care</strong> and <strong>Hospice Salary & Benefits studies</strong> are now underway. The <strong>Reports </strong>are recognized as <em>the</em> authoritative source for comprehensive marketplace data for home health + hospice agencies. Last year’s <strong>Home Care Report</strong> contained data from 1,079 home health agencies. The <strong>Hospice Report</strong> had data from 797 hospice agencies. </div><div><br></div><div>Both studies include questions on staffing issues, nursing turnover/vacancy rates, and sign-on bonuses used by agencies to attract new employees. The results cover salaries/bonuses and hourly/per visit rates for 60 positions, with job data reported by auspice type, revenue size, region, state, and CBSA. Also included are 19 fringe benefits, planned salary increases, productivity/caseload, and data on visit and shift differentials. </div><div><br></div><div><strong>Directions to Participate in the HCS Home Care or Hospice Salary & Benefits Study: </strong></div><div><br></div><div><ol><li><span style="font-size:11pt;">D</span><span style="font-size:11pt;">ownload the questionnaire from the </span><a href="http://www.hhcsinc.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="font-size:11pt;"><strong>HCS website</strong></a><span style="font-size:11pt;"><strong>.</strong></span></li><li><span style="font-size:11pt;">Select either the single site or multi-site questionnaire for the Home Care or Hospice study. </span></li><li><span style="font-size:11pt;">E</span><span style="font-size:11pt;">mail </span><a href="mailto:surveys@hhcsinc.com" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="font-size:11pt;"><strong>surveys@hhcsinc.com</strong></a><span style="font-size:11pt;"> to confirm your planned participation. </span></li><li><span style="font-size:11pt;">Email your completed questionnaire to <strong>HCS</strong> by August 11th.</span></li></ol></div><div><br></div><div><span style="font-size:11pt;">There is no cost to participate. Participants save over 50% off the <strong>Report</strong> price. If you have any survey questions, or need a deadline extension, please call or email Rosanne Zabka, Director of Reports, <strong>HCS</strong>, </span><a href="mailto:rzabka@hhcsinc.com" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="font-size:11pt;">rzabka@hhcsinc.com</a><span style="font-size:11pt;"> or (201) 405-0075, ext. 11. </span></div><div><br></div><div style="text-align:center;"> <img src="/News-and-Communications/Blog/PublishingImages/Pages/HCS-Home-CareHospice-Salary-%26-Benefits-Studies-Underway-/Capture.PNG" alt="Capture.PNG" style="margin:5px;" /><br></div><div><em style="font-size:11pt;">As always, all individual data will be kept strictly confidential. Study results are reported as aggregated percentiles per job – No information will be released to any person or organization which will identify individual participants. </em></div><div><br></div><div><span style="font-size:11pt;">The Home Care results cover marketplace data for 59 jobs; the Hospice results cover 62 jobs. The 35th annual <strong>Home Care Report </strong>will be published in October; the 34th annual <strong>Hospice Report</strong> will be published in November. </span></div><div><br></div><div><span style="font-size:11pt;"><strong>HCS</strong>, founded in 1971, is recognized as the leader in national healthcare salary and benefits research. <strong>HCS</strong> conducts national and custom marketplace studies, publishing more than ten specialized <strong>Reports</strong> each year. </span></div><div><br></div><div> <br></div><p><br><br></p> | Hospital & Healthcare Compensation Service has announced the 2025 Home Care and Hospice Salary & Benefits studies are now underway. | |
| CMS Surveyors Begin Using Updated Guidance | https://www.ahcancal.org/News-and-Communications/Blog/Pages/CMS-Surveyors-Begin-Using-Updated-Guidance-.aspx | CMS Surveyors Begin Using Updated Guidance | | | | | 5/6/2025 4:00:00 AM | | <p></p><div>The Centers for Medicare and Medicaid Services (CMS) released <a href="https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos/policy-memos-states-and-cms-locations/revised-revised-long-term-care-ltc-surveyor-guidance-significant-revisions-enhance-quality-and-0" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">QSO-25-14-NH</a> in March, which included significant updates for surveyor guidance to several regulatory areas effective April 28, 2025. The memo updated the previously released memos from November 18, 2024, and January 15, 2025. <br></div><div><br></div><div>CMS has released additional updated resources, including updated Critical Element Pathways (CEP) within the <a href="https://www.cms.gov/files/zip/survey-resources.zip" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">surveyor resources folder</a>. CMS has not yet released a final version of Appendix PP, and providers should refer to the advanced copy from the <a href="https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos/policy-memos-states-and-cms-locations/revised-revised-long-term-care-ltc-surveyor-guidance-significant-revisions-enhance-quality-and-0" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">QSO memo</a>. </div><div><br></div><div>AHCA previously released a webinar titled, <em>Preparing for Upcoming CMS Guidance Changes: Key Updates and Action Items for Compliance</em>, which is available on <a href="https://educate.ahcancal.org/products/preparing-for-upcoming-cms-guidance-changes-key-updates-and-action-items-for-compliance" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">ahcancalED</a>. Additionally, action tools for reach regulation are available where guidance was updated on the <a href="/Survey-Regulatory-Legal/Pages/default.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">AHCA Survey Regulatory Page</a>. Please email <a href="mailto:regulatory@ahca.org" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">regulatory@ahca.org</a> with any questions. <br></div><p></p> | The Centers for Medicare and Medicaid Services released QSO-25-14-NH in March, which included significant updates for surveyor guidance to several regulatory areas effective April 28, 2025. | |