The CDC has launched its Sepsis Prevention Assessment Tool (SPAT) for Nursing Homes to help providers address the high risk of sepsis among residents by strengthening infection prevention and early recognition practices. The tool guides facilities in assessing policies, staff training and clinical workflows to identify gaps and prioritize improvements. Additional resources are included to support implementation and help nursing homes improve compliance, care quality and resident outcomes.
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CMS issued a comprehensive memo revising chapters 5 and 7 of the State Operations Manual, outlining updates to survey and enforcement processes that AHCA is currently reviewing. Initial highlights include improved timelines and transparency for Informal Dispute Resolutions and expanded use of offsite desk reviews for less serious deficiencies. While these changes offer some operational relief, concerns remain about the inclusion of expanded Civil Monetary Penalty enforcement, which AHCA plans to continue addressing through advocacy for solutions and new rulemaking.
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IHCA is monitoring the Jan. 21 and Feb. 4 Iowa Administrative Bulletin for items that may impact members, with several adopted rule updates from the Department of Inspections and Appeals tied to the state’s Red Tape Review (Executive Order 10). The updates include repromulgated chapters and new standards for health care facility audits, elder group homes, assisted living programs and adult day services, specifically addressing certification processes, incident investigations and medication handling.
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The CDC has updated the definition of “up to date” for COVID-19 vaccinations for residents and health care personnel, affecting National Healthcare Safety Network (NHSN) reporting beginning Quarter 1, 2026. The revised criteria varies by age and vaccine timing, with different requirements for individuals 65 years of age and above versus those under 65 years of age. Nursing homes should immediately apply this definition for reporting and may revise previously submitted NHSN data for the quarter, if needed.
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CMS has significantly increased its regulatory focus on falls in nursing homes through expanded MDS fall definitions, revised quality measures and new Special Focus Facility (SFF) selection criteria that now emphasize fall prevalence. These changes heighten the importance of accurate documentation, prevention programs and data use, positioning nurse leaders as key drivers of compliance and resident safety. Proactive fall investigation, prevention and transparent use of data are essential to improving outcomes and reducing regulatory risk.
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The SING system received an overdue upgrade, going live on Jan. 25, with the old platform set to sunset on Feb. 28. Members must use the new SING portal for results, which are only available for 30 days, and access requires setting up an OKTA account through their agency admin. The old system remains available only for retrieving past submissions, and organizations are advised to download all necessary results before the deadline.
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Nursing facility leaders face constant risk when incidents involve resident harm, making swift, well-coordinated action critical if immediate jeopardy (IJ) is identified. Because IJ is not always obvious, leaders must quickly assess compliance and implement corrective actions across the entire facility, not just for the affected resident. The Compliance Store provides customizable immediate jeopardy removal plan templates to support leaders before or during surveys and investigations. As a reminder, all IHCA skilled nursing facility members receive full access to The Compliance Store as part of their IHCA membership.
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CMS updated the Special Focus Facility (SFF) Program to emphasize the prevalence of falls among residents as the main selection criterion, replacing staffing considerations. Survey frequency is adjusted to at least twice annually, with Life Safety Code and Emergency Preparedness surveys conducted at least annually or as determined by CMS or the state. Providers can review falls data in iQIES, access AHCA/NCAL’s Fall Prevention Guide, and are encouraged to check the Preview Report folder about a week before Nursing Home Care Compare updates.
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The Iowa Department of Health and Human Services (DHHS) Healthcare Associated Infections (HAI) team hosts monthly open office hours to provide long-term care staff with an open forum to ask questions about infection prevention and control. Held on the first Tuesday of each month at noon CST, the 30-minute sessions include brief updates followed by the opportunity for questions. These sessions are open to all long-term care facility staff and are not limited to any specific disease or condition. The next office hours meeting will take place on March 3.
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All skilled nursing facilities, assisted living communities and ID/DD centers must comply with OSHA’s Respiratory Protection Standard, which requires a formal respiratory protection program for employees exposed to airborne hazards. To help providers meet these requirements and reduce compliance risk, AHCA/NCAL and MCA Consulting have developed a comprehensive Respiratory Protection Plan training and toolkit that includes templates, required forms, fit testing guidance and employee training. AHCA/NCAL members can access this all-in-one compliance resource through a deeply discounted three-year subscription.
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The Skilled Nursing Facility (SNF) Data Validation Process for the SNF Value-Based Purchasing (VBP) and Quality Reporting (QRP) programs is now in effect. Selected SNFs will be notified through their iQIES MDS 3.0 Provider Preview Report folder and must submit medical chart documentation for 10 MDS assessments within 45 days to avoid a 2% Medicare reimbursement penalty. Facilities are encouraged to begin checking their iQIES folders weekly and seek additional guidance from CMS, if needed.
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CMS has begun the Skilled Nursing Facility (SNF) Value-Based Purchasing data validation process and has started sending selection notifications to some facilities through their iQIES Provider Preview Report folders. The process checks the accuracy of MDS-based quality measures used in the SNF Value-Based Purchasing and Quality Reporting Program. Selected SNFs must regularly monitor iQIES, identify points of contact within five business days and submit required medical record documentation within 45 calendar days. Documentation must be submitted properly following CMS instructions.
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CMS has released updated SNF Provider Preview Reports in iQIES, showing quality measure scores that will appear on Nursing Home Care Compare in April 2026. The reports use data from multiple time periods, including MDS submissions from Quarter 3, 2024 through Quarter 2, 2025, claims data from Quarter 4, 2022 through Quarter 3, 2024 and infection and vaccination measures from late 2023 through 2025, including a new COVID-19 resident vaccination measure based on Quarter 4, 2024 data. Nursing homes must review and correct their data by Feb. 14, 2026, as only timely updates will be reflected on Nursing Home Care Compare.
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The January assisted living (AL) survey trend report is now available in the IHCA Member Resource Center. This member-only report highlights the most common regulatory insufficiencies and is intended to help AL programs improve survey quality and prepare for future surveys. Congratulations to the IHCA assisted living members that recently achieved an insufficiency-free survey.
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OSHA has two key injury and illness recordkeeping compliance deadlines for 2026. Employers must post the OSHA Form 300A (Summary of 2025 Work-Related Injuries and Illnesses) by Feb. 1, 2026, and keep it posted through April 30, 2026. Required data must also be submitted electronically through OSHA’s Injury Tracking Application by March 2, 2026, depending on establishment size and industry. OSHA and AHCA/NCAL resources are available to help long-term care providers determine coverage and complete recordkeeping and reporting requirements.
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The Compliance Store is now included with IHCA membership for skilled nursing facilities, offering unlimited, no-cost access to compliance tools, templates and regulatory resources. Facility administrators can log in using their email address, add staff accounts with no user limits and watch an on-demand demo to see how the platform works day to day. Support and login assistance are available through The Compliance Store’s dedicated account team.
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CMS is transitioning the CLIA program to a fully electronic system, meaning nursing homes that perform lab testing must switch to paperless notifications, fee coupons and certificates by March 1, 2026. After that date, paper CLIA fee coupons and paper certificates will no longer be issued (with exceptions for CLIA-exempt states or state licensure). Facilities can opt in by notifying their state agency in writing or by completing the CMS-116 form to receive electronic notifications and certificates via email.
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CDC Project Firstline is hosting a webinar next Tuesday, Jan. 27 at noon CST with CDC experts and the American Medical Association on preventing and responding to respiratory virus outbreaks in long-term care settings. The session will cover illness recognition, testing, treatment, vaccination, infection control and practical resources for staff, residents and families. Registration is open, and participants can submit questions in advance.
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The January 2026 skilled nursing facility (SNF) survey trend report is now available in the IHCA Member Resource Center and highlights the most frequently cited tags and regulatory outcomes from Iowa skilled nursing facilities. Sponsored by HPSI Purchasing Services, this member-only resource is a helpful tool for survey readiness and planning, with data largely reflecting surveys completed about two months prior to publication. The report also recognizes IHCA member facilities that achieved deficiency-free recertification surveys.
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IHCA and The Compliance Store hosted a live demo earlier today to introduce IHCA’s newest member benefit for skilled nursing facility (SNF) members: full access to The Compliance Store — now included with your IHCA membership dues at no additional cost. If you weren’t able to attend live or want to share the walkthrough with your team, a recorded, on-demand demo will be posted tomorrow, Jan. 22, on IHCA’s Compliance Store webpage and will be available for members to access anytime.
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The University of Iowa will host four-hour, discussion-based MDRO tabletop exercises this spring to help Iowa health care facilities strengthen emergency response plans and meet CMS emergency preparedness requirements. These sessions will focus on identifying and responding to multidrug-resistant organism threats, with special emphasis on Candida auris and CPO. Upcoming events will be held April 29 in Webster City, April 30 in Red Oak and May 13 in Pella.
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Iowa’s latest Respiratory Virus Surveillance Report shows increasing activity of influenza (both A and B), RSV and COVID-19 statewide as of mid-December 2025, with continued cases in long-term care settings. These trends signal a heightened risk of outbreaks in nursing homes, requiring prompt use of established infection prevention and control measures. Leaders are urged to strengthen vaccination programs, ensure adequate PPE and testing supplies, enhance surveillance and masking when community transmission rises, educate residents, staff and visitors and improve ventilation. Facilities must comply with updated CDC guidance and meet both Iowa HHS and federal CMS reporting requirements through NHSN. Proactive preparedness, vigilant monitoring and clear reporting are essential to protecting residents and staff during this period of elevated respiratory illness activity.
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IHCA is monitoring the Dec. 24 and Jan. 7 Iowa Administrative Bulletin for items that may impact members, with several newly noticed Iowa Medicaid and waiver-related rule updates tied to the state’s Red Tape Review (Executive Order 10). The updates include proposed changes to waiver services, payment methods, provider policies and conditions of participation, managed care and covered services, along with an adopted rule increasing the State Supplementary Assistance personal needs allowance from $50 to $55.
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Effective July 2025, CMS transitioned its survey and certification data infrastructure to the new cloud-based Internet Quality Improvement and Evaluation System (iQIES). During this transition, some data discrepancies were identified. As a result, some facilities may notice inconsistencies in their Nursing Home Care Compare data, including an apparent increase in complaint allegations due to the removal of the “substantiated” complaint filter. These figures do not necessarily reflect the actual number of validated quality concerns. CMS is actively working to address these issues and plans to remove the complaint allegation and facility-reported incident counts from Nursing Home Care Compare. Facilities are encouraged to review their Nursing Home Care Compare profiles, report any discrepancies and inform relevant staff of these updates.
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The first Payroll Based Journal (PBJ) deadline of the year is approaching, with providers required to submit PBJ data for Oct. 1–Dec. 31, 2025 by Feb. 14, 2026. Key reminders include using unique employee IDs, properly linking ID changes, deducting 30 minutes for every eight hours worked and submitting early to review PBJ CASPER reports and correct any errors before the deadline. To help members stay compliant and survey-ready, IHCA’s two-part virtual PBJ Compliance Workshop begins tomorrow, Jan. 15, and is approved for 2.0 contact hours for nurses and administrators.
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CMS will begin validating Minimum Data Set (MDS) data for the Skilled Nursing Facility (SNF) Value-Based Purchasing and Quality Reporting Programs on Jan. 1, 2026, with provider notifications starting mid-January 2026. SNF providers will be randomly selected, and selection notices will be posted in the MDS 3.0 Provider Preview Reports folders within iQIES. This data validation process is intended to ensure the accuracy of MDS-based quality measures, as required by federal law, and will apply beginning with the FY 2027 program year/FY 2025 performance period. Providers should monitor their iQIES folders for notifications and review available CMS training resources for additional guidance.
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IHCA is offering skilled nursing facility (SNF) members full, complimentary access to The Compliance Store, a comprehensive compliance platform designed for long-term care providers. The platform includes customizable policies, survey-preparation tools and up-to-date regulatory resources to support day-to-day compliance. Clinical staff may request access through their administrator, and a live demo will be held next Wednesday, Jan. 21 with an on-demand recording available afterward.
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IHCA nursing facility members now have complimentary access to The Compliance Store, a comprehensive compliance platform with customizable policies, regulatory tools and survey-prep resources. Facility administrators should have received an email last week from The Compliance Store with login instructions, and administrators can request additional staff accounts as needed. IHCA and The Compliance Store will also host a live demo webinar next Wednesday, Jan. 21, with an on-demand recording available afterward.
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IHCA has launched a major new member benefit for skilled nursing facility (SNF) members: full, complimentary access to The Compliance Store, a comprehensive compliance platform designed specifically for long-term care providers. Included with IHCA membership dues, the platform offers regulatory tools, customizable policies and survey-preparation resources to support compliance and survey readiness. A live demo will be held Wednesday, Jan. 21, with an on-demand recording available afterward.
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IHCA is offering skilled nursing facility (SNF) members full, complimentary access to The Compliance Store, a comprehensive compliance platform designed for long-term care providers. The platform includes customizable policies, survey-preparation tools and up-to-date regulatory resources to support day-to-day compliance. Clinical staff may request access through their administrator, and a live demo will be held Wednesday, Jan. 21 with an on-demand recording available afterward.
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CMS has announced that the Skilled Nursing Facility (SNF) Data Validation Process for the SNF Value-Based Purchasing (VBP) and Quality Reporting (QRP) programs will begin in January 2026, delayed from the original fall timeline. Selected SNFs will be notified through their iQIES MDS 3.0 Provider Preview Report folder and must submit medical chart documentation for 10 MDS assessments within 45 days to avoid a 2% Medicare reimbursement penalty. Facilities are encouraged to begin checking their iQIES folders weekly starting in January, with additional guidance and FAQs available on CMS’s SNF data validation webpage.
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All skilled nursing facilities, assisted living communities and ID/DD centers must comply with OSHA’s Respiratory Protection Standard, which requires a formal respiratory protection program for employees exposed to airborne hazards. To help providers meet these requirements and reduce compliance risk, AHCA/NCAL and MCA Consulting have developed a comprehensive Respiratory Protection Plan training and toolkit that includes templates, required forms, fit testing guidance and employee training. AHCA/NCAL members can access this all-in-one compliance resource through a deeply discounted three-year subscription.
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CMS has announced that the Skilled Nursing Facility (SNF) Data Validation Process for the SNF Value-Based Purchasing (VBP) and Quality Reporting (QRP) programs will begin in January 2026, delayed from the original fall timeline. Selected SNFs will be notified through their iQIES MDS 3.0 Provider Preview Report folder and must submit medical chart documentation for 10 MDS assessments within 45 days to avoid a 2% Medicare reimbursement penalty. Facilities are encouraged to begin checking their iQIES folders weekly starting in January, with additional guidance and FAQs available on CMS’s SNF data validation webpage.
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The December skilled nursing facility (SNF) survey trend report is now available on the IHCA website. This report is a member-only resource that provides listings of the most frequently cited tags and regulatory outcomes from Iowa facilities. Please share this report with the individuals at your facility involved with managing survey success, as it is a helpful resource when planning for future surveys. Congratulations to the IHCA SNF member facility that recently achieved a deficiency-free recertification survey!
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Iowa nursing home administrators are reminded that licenses must be renewed by Dec. 31, 2025, with all required continuing education completed to maintain active status. IHCA’s renewal guidance outlines the process, and administrators who still need CEUs can choose from more than 60 on-demand courses available anytime, including options focused on Medicare, reimbursement, survey readiness, leadership and staff onboarding.
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On Thursday, Dec. 11, IHCA hosted its monthly Home Care Provider Update Call to discuss the most recent changes for the home health and home care profession. The main discussion focused on CMS's final rule for home health payments, which included changes to rates, quality reporting and implementation of a new Outcome and Assessment Information Set (OASIS) E2 system. The conversation ended with updates on Low Utilization Payment Adjustment (LUPA) rates and survey delays.
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IHCA continues to track issues of importance to members, including the subjects mentioned in the Iowa Administrative Bulletin that is released every two weeks. The bi-weekly areas of note found in the Nov. 12, Nov. 26 and Dec. 10 issues of the Iowa Administrative Bulletin include regulatory analyses related to Medicaid waiver services, conditions of participation for providers of medical and remedial care, adopted and filed rule related to conditions of eligibility, newly noticed rules related to assisted living programs, health care facility audits, adult day care and more.
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The Iowa Department of Inspections, Appeals and Licensing (DIAL) has rescheduled the joint provider-surveyor training that was originally planned for November. The hybrid training will now be hosted on Monday, Dec. 8, at the State Historical Society of Iowa. From 9:00 a.m. until 1:00 p.m., nursing facility leaders are welcome to join the training session in-person or virtually.
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CMS released an interim final rule (IFR) that repeals parts of the Biden Administration’s staffing mandate. Specifically, the IFR rescinds implementation of the 24/7 on-site registered nurse requirement, as well as the specific minimum number of nursing hours per resident per day requirements. This rule takes effect 60 days after the date of publication in the Federal Register. There is a 60-day comment period, with all comments due by Feb. 2, 2026.
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CMS has released Version 18.0 of the MDS 3.0 Quality Measures User’s Manual, including key changes to the long-stay antipsychotic medication measure and updates to the Discharge Function Score risk adjustment due to retired therapy items and new discharge item O0425. The re-specified antipsychotic measure will begin public reporting on Care Compare in January 2026 using Q3 2025 data, with resident-level results available in iQIES. Providers are encouraged to monitor Five-Star Preview reports, keep ICD-10-CM codes current and review QM package reports in iQIES to validate data accuracy.
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The December 2025 Quarterly Confidential Feedback Reports for the FY 2027 Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program are now available to download via iQIES. SNFs may submit correction requests for their measure results up to 30 days following this report being made available, until Jan. 1, 2026.
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CMS has issued new guidance directing state survey agencies to immediately resume all survey, enforcement and certification activities following the Oct. 1–Nov. 12 federal shutdown, including repeating certain state-only licensure surveys federally and issuing any held CMS-2567s by Dec. 12, 2025. Providers who had survey activity during the shutdown should closely monitor communications from the Iowa Department of Inspections, Appeals and Licensing (DIAL) and CMS, carefully review all survey reports for accuracy and promptly request corrections or clarification as needed.
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In response to Governor Reynold’s Executive Order 10, the Iowa Department of Inspections, Appeals and Licensing’s Adult & Special Services Bureau has posted a regulatory analysis of proposed rule changes to both chapters of administrative code (IAC 481-67 and 481-69) that apply to assisted living (AL) programs in Iowa. As expected, the most significant shift in the proposed rules integrates new scope of practice standards for licensed practical nurses (LPNs), enacted by the Iowa Board of Nursing earlier this year. With the IBON’s revision of practice standards to allow LPNs to participate in initial and ongoing assessments, the proposed AL rules now fully address the ability of LPNs to practice as the top of their licensure scope in Iowa AL programs.
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Effective Nov. 20, 2025, the October 2025 refresh of the Skilled Nursing Facility Quality Reporting Program data is now available on the compare tool on Medicare.gov and Provider Data Catalog.
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The November skilled nursing facility (SNF) survey trend report is now available on the IHCA website. This report is a member-only resource that provides listings of the most frequently cited tags and regulatory outcomes from Iowa facilities. Please share this report with the individuals at your facility involved with managing survey success, as it is a helpful resource when planning for future surveys. Congratulations to the IHCA SNF member facilities that recently achieved a deficiency-free recertification survey!
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Join IHCA for its Home Health Final Rule 2026 - What You Need to Know webinar on Dec. 10, led by IHCA’s home health consultant, Annette Lee of Provider Insights. While CMS has not yet released the final rule, we expect it soon. Annette will break down the key provisions, highlight changes to reimbursement and quality reporting and explain what agencies need to know to prepare for implementation. This webinar is approved for 1.5 contact hours for administrators and nurses.
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IHCA's November Home Care Provider Update Call last week covered the government shutdown resolution and its impact on telehealth services, hospice surveys and payment rules. Discussion focused on the timing of payment rule releases and Low Utilization Payment Adjustment (LUPA) rate adjustments for home health providers in Iowa, including implementation challenges and concerns about claim processing. The group also addressed the acuity add-on program's implementation issues and explored ways to improve the system and support providers in its effective use.
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As the end of the biennial renewal cycle approaches, all licensed nursing home administrators in Iowa are reminded to complete their license renewal requirements to maintain active status and continue serving their communities. The renewal period for nursing home administrator licenses in Iowa runs every two years, ending Dec. 31 of every odd-numbered year. IHCA has created a new resource that outlines the standards for continuing education completion and the process for timely renewals.
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Due to the lapse in federal appropriations, scheduled data refreshes and other routine updates were temporarily paused. With the resumption of government operations on Nov. 13, these updates are now being released. The SNF Provider Preview Reports have been updated and are now available. These reports contain provider performance scores for quality measures, which will be published on the compare tool on Medicare.gov and the Provider Data Catalog (PDC) during the January 2026 release. Providers have until Dec. 17, 2025, to review their performance data.
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The American Association of Post-Acute Care Nursing (AAPACN) and LTC 100 have partnered to create a new survey that gives long-term care nurses and certified nursing assistants (CNAs) the opportunity to share their voices and experiences. AAPACN and LTC 100 want to understand what contributes to job satisfaction, what challenges you face and what keeps you inspired to stay in this vital field. Survey responses are due by Sunday, Nov. 30.
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While the federal government shutdown continues, the Iowa Department of Inspections, Appeals and Licensing (DIAL) continues to be restricted from conducting many important regulatory oversight functions. Although this updated CMS memo (dated Oct. 31, 2025) outlines resumption of some regulatory activity, other regulatory actions remain on hold until the government shutdown ends, such as recertification (annual) surveys and processing of pending CMS-2567s resulting from surveys where immediate jeopardy or resident harm have not been identified.
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The submission deadline for the Skilled Nursing Facility Quality Reporting Program (SNF QRP) is fast approaching. All data must be submitted no later than 11:59 p.m. on this upcoming Monday, Nov. 17.
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Interactive, discussion-based tabletop exercises are being held across Iowa to help health care facilities identify and respond to multidrug-resistant organism (MDRO) threats while fulfilling CMS emergency preparedness exercise requirements. Each four-hour session focuses on Candida auris. The next exercises will take place Wednesday, Nov. 19, in Davenport, and Thursday, Nov. 20, in Manchester. The sessions are hosted by the University of Iowa College of Public Health, Carver College of Medicine and State Hygienic Laboratory, in collaboration with the Iowa Department of Health and Human Services.
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IHCA continues to track issues of importance to members, including the subjects mentioned in the Iowa Administrative Bulletin that is released every two weeks. IHCA is actively reviewing the new regulatory analyses and plans to make requests for modifications as necessary and communicate out important changes as they become finalized. The bi-weekly areas of note found in the Oct. 15 and Oct. 29 issues of the Iowa Administrative Bulletin include regulatory analyses related to adult day care, assisted living programs and Certificate of Need, as well as a newly noticed rule related to personal needs allowance.
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The October skilled nursing facility (SNF) survey trend report is now available on the IHCA website. This report is a member-only resource that provides listings of the most frequently cited tags and regulatory outcomes from Iowa facilities. Please share this report with the individuals at your facility involved with managing survey success, as it is a helpful resource when planning for future surveys. Congratulations to the IHCA SNF member facilities that recently achieved a deficiency-free recertification survey!
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The University of Iowa College of Public Health, Carver College of Medicine and The State Hygienic Lab, in collaboration with the Iowa Department of Health and Human Services, are hosting interactive, discussion-based exercises over the next year. These four-hour exercises help facilities identify and respond to multidrug-resistant organism (MDRO) threats across the state of Iowa and fulfill CMS emergency preparedness exercise requirements, with a specific focus on C. auris. The next tabletop exercise will take place in Davenport on Nov. 19.
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CMS released an updated QSO memo outlining contingency plans during the federal government shutdown. The update allows revisits to prevent a mandatory denial of payment for new admissions (DPNA), pauses most survey and enrollment activities and clarifies that only revisits addressing immediate jeopardy or harm may proceed. State-funded surveys can continue but will not count as federal work until funding is restored.
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With the federal government’s ongoing shutdown, state survey agencies, such as the Iowa Department of Inspections, Appeals and Licensing (DIAL), have been directed by CMS to place all interactions related to the survey process on hold. Therefore, the joint training session for both providers and survey teams has been postponed to a later date that has not yet been finalized. When more information is available, IHCA will share registration information with members in our Clinical and Executive Updates and through the IHCA Communities communication platform.
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The 2025 Long-Term Care (LTC) Survey Manual is now available for purchase through the AHCA/NCAL Bookstore. With AHCA’s easy-to-follow table format, this manual is an essential resource for LTC facilities to quickly access federal regulations and surveyor guidance. The April 2025 edition features updates to Appendix PP, staffing requirements, infection control, psychotropic medication use, QAPI, MDS and more that went into effect April 28, 2025.
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HealthCap is hosting a free webinar titled, "Assisted Living – Risky Business?" on Tuesday, Nov. 11 at 1:00 p.m. For those who are unable to attend on Nov. 11, this webinar will be recorded. From admission and discharge criteria to staff training expectations, negotiated risk agreements and regulatory considerations, this session will help you better understand the risks and opportunities in today’s ever-changing senior care landscape.
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With the federal government’s ongoing shutdown, state survey agencies, such as the Iowa Department of Inspections, Appeals and Licensing (DIAL), have been directed by CMS to place all interactions related to the survey process on hold. Therefore, the joint training session for both providers and survey teams has been postponed to a later date which has not yet been finalized. When more information is available, IHCA will share registration information with members in our Clinical and Executive Updates and through the IHCA Communities communication platform.
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The Q1 2025 home care (HC) survey trend report is now available on the IHCA website. This report is a member-only resource that provides listings of the most frequently cited tags and regulatory outcomes from Iowa agencies. Please share this report with the individuals at your organization involved with managing survey success, as it is a helpful resource when planning for future surveys.
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In recent months, the Iowa Department of Inspections, Appeals and Licensing (DIAL) had begun requesting nursing facilities remove disclaimer statements from plans of correction, per CMS directive. Upon requesting an explanation from the Kansas City Regional Office and CMS Central, it has been clarified that disclaimer statements can be included in plans of correction if the plan of correction adequately addresses any noncompliance contained in the CMS-2567 and private health information is not included. Therefore, nursing facilities may continue to include disclaimers in plans of correction.
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The October assisted living (AL) survey trend report is now available in the IHCA Resource Center. This report is a member-only resource that provides listings of the most common regulatory insufficiencies. Please share this report with the individuals at your program involved with managing survey quality, as it is a helpful resource when planning for future surveys. Congratulations to the IHCA AL members that recently achieved an insufficiency-free survey!
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IHCA has provided a breakdown of how the federal government shutdown impacts survey activity across different care settings. Please review the relevant section(s) for your organization. All providers are encouraged to stay proactive and compliant during this period to avoid future enforcement complications.
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On Oct. 1, 2025, CMS released QSO-26-01 regarding contingency plans related to state survey and certification activities in the event of a federal government shutdown. IHCA consultant Annette Lee of Provider Insights has provided an explanation and analysis regarding impacts to home health.
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IHCA has been made aware of delays affecting providers and Medicaid beneficiaries in the completion of level of care assessments conducted by Telligen. We have been in contact with the Iowa Department of Health and Human Services (DHHS) regarding this issue. DHHS has confirmed that it is aware of the backlog and is monitoring assessment completion rates on a weekly basis. To help address the delays, all assessments with due dates prior to July 1, 2025, will be conducted virtually. This protocol will be applied consistently across all waiver types and assessment categories.
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Iowa Department of Inspections, Appeals and Licensing (DIAL) has expanded virtual options for the written portion of the CNA competency exam, adding a second online pathway beyond the one launched in June 2025. Nurse aide candidates — regardless of training program location — can now register and complete the written exam from home or work. The skills evaluation remains in person at approved sites for now, with DIAL exploring remote skills testing; IHCA will share updates when available.
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The Iowa Department of Inspections, Appeals and Licensing (DIAL) has shared its plan to host a joint training session for providers and surveyors on Monday, Nov. 10. The training will take place at the State Historical Building in downtown Des Moines, tentatively scheduled from 9:00 a.m. - 1:00 p.m. In addition, a link to participate virtually will be provided for those who are unable to attend in person. Although specific details have not been made available yet, members are encouraged to save the date and plan to attend. Once final details have been released, IHCA will share the registration link.
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A recent rule change by the Iowa Board of Pharmacy revised administrative rules regarding controlled substance registrations and has resulted in a positive outcome for nursing facilities and assisted living programs in Iowa. Effective immediately, nursing facilities, assisted living programs and residential care facilities will no longer be required to maintain controlled substance registration with the Iowa Board of Pharmacy.
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The posted final Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.20.1 and MDS item sets v1.20.1v4 have been updated to align with the revisions to item J1900 related to the coding of falls. The MDS 3.0 RAI User’s Manual v1.20.1 and items sets were effective beginning Oct. 1, 2025.
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IHCA’s October Home Care Provider Update Call last week focused on recent developments affecting home health and home care providers, particularly the Rural Health Transformation (RHT) Program and its initiatives to expand access to care in rural Iowa. Discussion centered on three key home health initiatives: transitional coaching, technology integration such as remote patient monitoring, and funding decisions expected by mid-November. Annette Lee of Provider Insights also provided updates on star rating reports, value-based purchasing changes and training opportunities, underscoring the role of accurate data and staff engagement in improving quality outcomes.
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The University of Iowa’s Department of Family and Community Medicine invites health care professionals to join its 47th Annual Midwestern Conference on Health Care in the Older Adult, with a focus on geriatric mental health, held virtually on Friday, Jan. 30. Designed for primary care physicians, pharmacists, nurses, social workers and other health care professionals, this conference will instruct participants in the diagnosis, treatment and management of conditions common in older adults.
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IHCA continues to track issues of importance to members, including the subjects mentioned in the Iowa Administrative Bulletin that is released every two weeks. The bi-weekly areas of note found in the Sept. 17 and Oct. 1 issues of the Iowa Administrative Bulletin include regulatory analyses related to personal needs allowance, investigatory authority and procedures of the Medicaid Fraud Control Unit and newly noticed rules related to Medicaid enrollment, personal needs allowance and more.
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Telligen has been awarded a new five-year contract under CMS’ 13th Scope of Work to serve as the Midwest QIN-QIO, providing Iowa health care facilities with targeted quality improvement resources and support. Selected providers will receive individualized outreach based on CMS-defined outcomes, while tools and resources will remain publicly available on the Midwest QIN-QIO website. Participation in QIO initiatives is optional and non-regulatory, and IHCA will share additional details as the program’s work progresses.
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The September skilled nursing facility (SNF) survey trend report is now available on the IHCA website. This report is a member-only resource that provides listings of the most frequently cited tags and regulatory outcomes from Iowa facilities. Please share this report with the individuals at your facility involved with managing survey success, as it is a helpful resource when planning for future surveys. Congratulations to the IHCA SNF member facilities that recently achieved a deficiency-free recertification survey!
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The University of Iowa College of Public Health, Carver College of Medicine and The State Hygienic Lab, in collaboration with the Iowa Department of Health and Human Services, will host eight interactive, discussion-based exercises over the next year. These four-hour exercises will help facilities identify and respond to multidrug-resistant organism (MDRO) threats across the state of Iowa and fulfill CMS emergency preparedness exercise requirements, with a specific focus on C. auris. The next tabletop exercise will take place in Le Mars on Oct. 15.
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The Midwest QIN-QIO will host a virtual event next Wednesday, Sept. 24, from 12:00 – 1:30 p.m. CDT to introduce providers to its role in CMS’s 13th Scope of Work. The webinar will review provider participation benefits, highlight new components of the SOW, introduce key contacts and explore collaboration opportunities. IHCA has requested an alternative session for members unable to attend due to the 2025 Convention and Trade Show, and if that is made possible, IHCA will share information with members.
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With the transition to the Internet Quality Improvement and Evaluation System (iQIES), changes have been made regarding temporary waivers for Life Safety Code deficiencies. Members should be aware of a shift in practice related to required life safety corrective actions.
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On Sept. 10, CMS published an update to QSO-25-20-NH. Revisions within this memo extend the implementation timeline for new methodology to determine the number of long-stay residents receiving antipsychotic medications. Initially set to begin in October 2025, CMS extended the rollout until January 2026.
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CMS recently noticed the expiration of several memos to nursing homes and other provider types. Although no changes to practice are required because of memo expiration, members should be aware of a few updates.
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The Centers for Disease Control and Prevention (CDC) Nursing Home Infection Preventionist (IP) Training on CDC TRAIN will launch an updated version on Sept. 15, 2025; anyone currently enrolled should finish all modules by 11:59 p.m. on Sept. 14, as the current course will expire and registrations will not carry over. IHCA notes that regulations at F882 do not require IPs to retake or renew training — previous completion remains compliant — though additional training may be appropriate if a facility’s population or scope of care changes.
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The Centers for Disease Control and Prevention (CDC) recently released the 2025-2026 influenza vaccine recommendations in its Morbidity and Mortality Week Report (MMWR). Routine annual influenza vaccination is recommended for all persons aged ≥6 months without a contraindication to vaccination to protect against influenza and its complications. Full details, including updates from the 2024-2025 season, timing and selection of vaccine are outlined in the MMWR report and in the Advisory Committee on Immunization Practices (ACIP) summary of recommendations.
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AHCA's Behavioral Health Guide is now available on ahcancalED and is free to IHCA members. The guide aims to assist long-term care providers in developing and maintaining effective behavioral health programs, with a focus on regulatory compliance with F740 related to behavioral health services.
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The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) has released their final live education events schedule. The COE-NF grant is ending Sept. 29, 2025. After this date, technical assistance and live training events will no longer be available. The COE-NF team will continue to accept new requests for support until next Monday, Sept. 15.
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The August 2025 skilled nursing facility (SNF) survey trend report is now available on the IHCA website. This report is a member-only resource that provides listings of the most frequently cited tags and regulatory outcomes from Iowa facilities. Please share this report with the individuals at your facility involved with managing survey success, as it is a helpful resource when planning for future surveys. Congratulations to the IHCA member facilities that recently achieved a deficiency-free recertification survey!
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The final Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.20.1 is now available in the downloads section on the MDS 3.0 RAI Manual page on the CMS website. The MDS 3.0 RAI User’s Manual v1.20.1 will be effective beginning Oct. 1, 2025.
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The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) is offering a series of free virtual training events in September for all nursing facility staff. Topics include National Culturally and Linguistically Appropriate Services (CLAS) standards, trauma-informed care, Preadmission Screening and Resident Review (PASRR) essentials, addiction 101 and more. Additionally, details on the end of the COE-NF grant and where to find resources after the grant end date of Sept. 29 are now available.
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The Iowa Department of Inspections, Appeals and Licensing (DIAL) has notified IHCA that survey report processing may be delayed due to issues with the new Internet Quality Improvement and Evaluation System (iQIES). DIAL is working with CMS to resolve system glitches, but high ticket volumes have slowed response times. While the department is striving to meet the 10-day delivery requirement, occasional delays may occur, and providers are asked for patience during this transition.
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CMS has published a new frequently asked questions (FAQ) document to help skilled nursing facilities (SNFs) prepare for the upcoming data validation process. This process, scheduled to begin in fall 2025, will apply to the FY 2027 Skilled Nursing Facility Quality Reporting Program (QRP). In addition to the FAQ, CMS has released supplementary training and educational materials to further support SNFs as they prepare.
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The Iowa Department of Health and Human Services (DHHS) has posted the 1915(c) HCBS Waivers for public comment. The 30-day public comment period will close on Sept. 19 at 4:30 p.m.
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The University of Iowa, in partnership with the Iowa Department of Health and Human Services, will host a series of complimentary tabletop exercises this fall to help hospitals and long-term care facilities strengthen emergency response plans. These interactive, discussion-based sessions will focus on responding to multidrug-resistant organisms (MDROs), with an emphasis on Candida auris. Events will be held in Le Mars, Mason City, Davenport, Manchester and Ames, with additional spring dates to be announced.
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The final Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.20.1 is now available in the downloads section on the MDS 3.0 RAI Manual page. The MDS 3.0 RAI User’s Manual v1.20.1 will be effective beginning Oct. 1, 2025.
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In recent months, federal and state regulators have demonstrated an increased attention on Minimum Data Set (MDS) practices. AHCA has provided some reminders on key requirements for MDS roles and responsibilities, as well as resources for providers.
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CMS has announced plans to modernize the Clinical Laboratory Improvement Amendments (CLIA) program by moving to a fully electronic system. By March 1, 2026, nursing homes performing lab testing must transition to email notifications, electronic fee coupons and electronic CLIA certificates, as paper versions will no longer be available. Facilities can make the switch by notifying their state agency in writing or updating their CMS-116 application form.
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IHCA continues to track issues of importance to members, including the subjects mentioned in the Iowa Administrative Bulletin that is released every two weeks. The bi-weekly areas of note found in the Aug. 6 and Aug. 20 issues of the Iowa Administrative Bulletin include updates on nursing home administrator licensure, enrollment and reenrollment, conditions of eligibility, the long-term care ombudsman and more.
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CMS has posted final versions of updated MDS 3.0 item sets, which will become effective Oct. 1, 2025, to its Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page.
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In recent months, federal and state regulators have demonstrated an increased attention on Minimum Data Set (MDS) practices. AHCA/NCAL has provided some reminders on key requirements for MDS roles and responsibilities, as well as resources for providers.
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On Thursday, Aug. 14, IHCA hosted its monthly Home Care Provider Update Call to discuss the most recent changes for the home health and home care profession. The call included a comprehensive discussion on CMS's proposed rule changes and their impact on access to care, including modifications to value-based purchasing, HHCAHPS and various measures.
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The CDC’s Project Firstline and the National Infection Prevention Forum (NIPF) will hold their next Open Office Hours next Wednesday, Aug. 27. Designed specifically for infection preventionists, the session will feature subject matter experts answering both pre-submitted and live questions. Participants are encouraged to submit questions by Aug. 20, and sessions are not recorded.
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The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) August 2025 newsletter is now available. Topics in this issue include details on the end of the COE-NF grant in September, resources for International Overdose Awareness Day, nursing facility guidance updates, upcoming office hours, new COE-NF resources, upcoming virtual education events and more.
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CMS has announced a temporary pause in updates to the Nursing Home Care Compare website, effective July 30, 2025. This pause is part of CMS’s transition to a new cloud-based data system to record and manage survey outcomes and is intended to ensure the accuracy and reliability of publicly reported nursing home quality information. Regular updates to the site are expected to resume in October 2025. Despite the pause in public data updates, nursing homes are still required to post their most recent survey findings — the CMS-2567 Statement of Deficiencies — in a visible area within the facility.
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