Update: Implementation of Haiti TPS Termination
As of the evening of July 27, USCIS has not issued updated guidance regarding employment authorization for Haitian TPS holders. The agency’s current guidance continues to state that affected Employment Authorization Documents (EADs) are valid through July 27, 2026, and employer instructions on the USCIS TPS Haiti webpage and related materials have not yet been revised. At the same time, advocacy organizations, including the Haitian Bridge Alliance, have stated that employers should not assume employment authorization has ended absent a formal court order lifting the injunction that remains in place in the TPS Haiti litigation. Given the rapidly changing legal environment, LeadingAge encourages members with questions about Form I-9 compliance, employment authorization verification, or personnel decisions to consult their own legal counsel before taking action. We also encourage affected individuals to seek advice from qualified immigration counsel or an accredited legal services provider regarding their specific circumstances. We will continue to monitor developments and provide updates as additional information becomes available.
House passes continuing resolution, Senate negotiating their own
On July 21, the House passed a continuing resolution (CR) that would keep the government open through December 4. The Senate has indicated they do not intend to take up the House-passed CR because it does not contain anomalies that the White House has requested. Currently, the Senate is trying to negotiate a similar length CR (i.e. one that would go until after the midterm elections). LeadingAge is closely monitoring government funding which is set to expire on September 30.
CMS Replaces Voting Rights Guidance for Nursing Homes, Placing New Emphasis on Fraud and Coercion
On July 20, the Centers for Medicare & Medicaid Services (CMS) rescinded earlier guidance that affirmed nursing home residents’ voting rights and replaced it with a new memorandum that places significantly greater emphasis on preventing voter fraud, coercion, and undue influence in long-term care settings. The new memo to state survey agency directors reiterates that nursing home residents retain their constitutional right to vote, but frames that obligation alongside extensive warnings about compliance with federal and state election laws and concerns about improper influence by facility staff.
The rescinded 2024 memo directed nursing homes to have a plan to help residents vote, including assisting with voter registration, absentee ballots, transportation to polling locations, and coordination with election officials. It encouraged nursing homes to coordinate with state and local programs to enable residents to vote but reminded communities that they are required to support residents in exercising their rights regardless of whether external assistance is available to come into the facility. By contrast, the new memorandum rescinds both the 2024 and earlier 2020 guidance and shifts the focus toward preventing potential misconduct. CMS cites allegations of election-related violations involving long-term care residents in Texas and Wisconsin and warns facilities against activities such as registering residents without their knowledge or consent or completing ballots on a resident’s behalf without authorization. The memo also encourages the use of bipartisan election workers, where permitted by state law, to reduce reliance on facility staff in the voting process.
While CMS states that the new memorandum creates no new regulatory requirements and simply reinforces existing obligations, the change in tone suggests federal survey and enforcement attention may increasingly center on how nursing homes balance voting access with safeguards against fraud and coercion. Providers should expect increased attention to documentation, resident consent, staff training, and adherence to state election laws when assisting residents with voting. Facilities may also review existing voting-support policies to ensure assistance is resident-directed, properly documented, and clearly separated from any activity that could be perceived as coercive or partisan. At the same time, providers continue to have obligations under federal residents’ rights regulations to support residents in exercising their rights as citizens without interference, discrimination, coercion, or reprisal.
Members can find these updates and more guidance on how to handle election year activities on the LeadingAge Kansas website.
PACE Memo on Policies to Expand Rural PACE Access Includes Ability to Receive RHTP Incentive Payments
On July 22, via an HPMS memo, the Centers for Medicare and Medicaid Services restated their support for strengthening the PACE program via a memo: Policies Related to Expanding Access to Program of All-Inclusive Care for the Elderly in Rural Areas. The memo references attention to and opportunities for PACE expansion through the Rural Health Transformation Program (RHTP). CMS reminds PACE organizations of classification and registration requirements of Mobile Clinics, references guidance on alternative care sites, reiterates the availability of telehealth services and opportunities for waivers of specific PACE regulatory requirements. States are reminded of quarterly deadlines for PACE applications and that PACE rates cannot be set above the amount that would otherwise have been paid for healthcare items and services. The memo closes by referencing the prior statement and noting, “it does not preclude a state from making payments to PACE organizations outside of the capitation rate for purposes unrelated to direct participant care, such as workforce and staffing support, health information technology updates, or other infrastructure needs.” As providers and advocates are seeking support for PACE through their RHTP, opportunities to advocate for supplemental payments appear allowable. The memo will be available in the HPMS Archive next week and can be found here.
Secretary Kennedy Extends Exclusion Authority to CMS
The authority to effectuate exclusions from participation in federal health care programs under the Social Security Act has long been held solely by HHS’ Office of Inspector General (OIG). HHS regulations under title 42 of the Code of Federal Regulations outline the role of the OIG in program integrity and enforcing program exclusions. During a July 20 press conference, Secretary Kennedy announced that he was delegating this exclusion authority to CMS, which they could use to apply a permanent exclusion. The regulations address the parameters for exclusions, with minimum terms of 5 years for mandatory exclusions and no cap on the duration of an exclusion. With both OIG and CMS now having the authority to exclude providers, this consolidation of power is potentially concerning, and we will continue to monitor the intersection with other policy proposals.
CHARTS Act Would Provide EHR Grants to Aging Services Providers
On July 22, Rep. Emanuel Cleaver (D-MO) introduced the Connecting and Advancing Technology for Health Records Systems (CHARTS) Act, legislation that would establish a two-year pilot grant program to support electronic health record (EHR) adoption and interoperability among nursing homes, home health agencies and other aging services providers. Under the bill, eligible providers could receive federal grants to implement, upgrade, or enhance EHR systems and improve their ability to exchange health information with other providers across the care continuum. The legislation would authorize $5 million annually over the next two years, and individual grants to each provider could not exceed $500,000. The legislation also directs the Department of Health and Human Services to evaluate the pilot program and issue a recommendation on broader expansion if the program demonstrates improved care coordination, quality outcomes, and efficiency. The bill represents a positive first step towards addressing the exclusion of many aging services providers from earlier federal EHR incentive programs and is intended to strengthen interoperability between hospitals, physicians, home health agencies, nursing homes, and other providers. LeadingAge will continue to monitor the legislation as it moves through Congress.
Updated Quarterly OASIS Q&As
CMS released July 2026 OASIS Q&A’s. This document is updated on a quarterly basis and is intended to provide guidance on OASIS questions that were received by CMS help desks. As a reminder, responses may be time-limited and may be superseded by future CMS guidance. In this edition of the Q&A’s CMS clarifies that they will begin using non-Medicare/non-Medicaid OASIS data for the purpose of calculating a home health agency’s HHQRP Annual Payment Update (APU) compliance for patients who begin receiving skilled home health care services with an OASIS SOC M0090 date on or after January 1, 2027. In this quarters update, CMS also notes with two questions on how to appropriately code M1060 Height and Weight and M1311 Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage, that the response offered in the July 2026 Q&A supersedes the guidance found in the OASIS-E2 Guidance Manual. Agencies should pay close attention to these two changes and inform staff of the guidance changes.
KFF Releases RHTP Tracker
On July 27, KFF released a compendium of state-level information on the Rural Health Transformation Program (RHTP). The RHTP was established in HR 1 and designates funding for the support and development of rural healthcare infrastructure. The tracker includes an interactive map and links to states’ funding awards, applications, and approved plans and budgets. KFF indicates they will update the tracker as more information is available. The map and tracker are available here.
Weekly Recap: July 29, 2026
