Senators Challenge CMS Voting Guidance for Nursing Homes
A group of Senate Democrats sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz criticizing the agency’s July 20 memorandum that rescinded earlier voting-rights guidance for nursing homes and replaced it with a version focused more heavily on voter fraud, coercion, and undue influence concerns. The Senators, led by Sen. Elizabeth Warren (D-MA) and Sen. Alex Padilla (D-CA), are asking CMS to rescind the July 2026 memo and reinstate the earlier 2024 guidance it replaced. They argue that the new guidance could discourage or complicate residents’ access to voting assistance. CMS has maintained that the memorandum does not create new requirements and simply reinforces existing obligations under federal and state election laws. Nursing homes continue to be responsible for supporting residents’ rights to vote while ensuring assistance is resident-directed, properly documented, and compliant with applicable election laws. LeadingAge will continue monitoring developments and we encourage members to review the resident voting resources we have compiled in the leadup to the 2026 elections.
Nursing Home Risk-Based Survey Resources Now Available
The Centers for Medicare & Medicaid Services (CMS) released survey resources on August 13 for the new Risk-Based Survey that will be rolling out for nursing homes nationwide beginning in September. Available on the Nursing Homes page of the CMS website in the Downloads section, the survey resources include the typically-available resources used by state survey agencies during standard recertification surveys, adapted for use on the Risk-Based Survey. Training videos will also be available on the Quality, Safety and Education Portal (QSEP) in the future but are not available yet. The Risk-Based Survey is an exciting step forward in survey and certification reform and we appreciate CMS continuing to make survey resources publicly available. Reviewing these resources will help nursing homes know what to expect from surveys utilizing this new survey model. Recall, however, that CMS estimates approximately 12% of nursing homes will qualify for a Risk-Based Survey and not all qualified nursing homes will receive this survey model. For this reason, nursing homes should continue to refer to the standard recertification survey resources and the State Operations Manual (Chapter 7 and Appendix PP) to assist with compliance and survey preparation activities.
Federal Register Publication of the 2026 Unified Agenda of Federal Regulatory and Deregulatory Actions
The 2026 Unified Agenda of Federal Regulatory and Deregulatory Actions, which lists regulatory actions that federal agencies expect to undertake in the next 12 months, has been posted to the Federal Register’s public inspection site. It was previously posted on the Office of Management and Budget and U.S. General Services Administration’s website on July 3, 2026. The Federal Register version includes agencies’ regulatory flexibility agendas, which identify rules expected to have a significant economic impact on a substantial number of small entities, as required under the Regulatory Flexibility Act (see, for example, HHS’s regulatory flexibility agenda). It also contains an introduction highlighting selected rulemakings that reflect agency regulatory priorities. For the most comprehensive and user-friendly listing of planned regulatory actions, we recommend using the 2026 Regulatory Plan and Unified Agenda of Federal Regulatory and Deregulatory Actions that is posted online at www.reginfo.gov. This version is searchable by agency and encompasses the full set of planned regulatory actions for each agency, as opposed to the Federal Register publication which is limited to just a subset of those rulemakings.
