Federal Bill Advances, Signaling Increased Oversight and Fraud Prevention for Home Health and Hospice. All · HIGH

The "Protecting Seniors and Stopping Fraudsters Act" is gaining attention in Congress as lawmakers push for stronger fraud prevention and oversight across home health and hospice. If passed, agencies should expect increased scrutiny around ownership changes, enrollment, and compliance accountability. Advocacy groups support going after bad actors but warn that broad measures could hit legitimate agencies just as hard. Keep this one on your watch list.

CMS Releases Proposed Hospice Wage Index for FY 2027 Hospice · MOD

CMS published the proposed Hospice Wage Index for 2027. The geographic adjustments in this rule directly impact what you get paid and what you can afford to pay your staff. If you run hospice, pull the proposed numbers for your region now so you are not surprised when the final rule drops.

Home-Based Care Grapples with Heightened Fraud Enforcement, Enrollment Moratoriums, and Emerging Policy Shifts All · CRITICAL

Federal fraud enforcement activity across home health and hospice continues to intensify, with new enrollment moratoriums, heightened scrutiny around ownership and billing, and growing Medicaid oversight actions in states like California and Minnesota. Growth plans that looked straightforward six months ago may now require a second compliance and operational review before agencies expand further.

Hospice Growth Brings Tighter Margins, Staffing Strain, and Heightened Compliance Demands Hospice · MOD

Hospice agencies grew census in 2025, but margins got tighter, not wider. If your infrastructure did not scale with your admissions, you are growing into a compliance problem, not out of one. The agencies getting this right are investing in workflows that take administrative weight off clinicians so their teams can focus on the patient, not the paperwork.

Navigating AI in Home Care: Balancing Efficiency, Defensible Documentation, and Clinical Accountability All · HIGH

AI documentation tools are showing up everywhere in healthcare at home, and the ones that work share one thing in common: the clinician still has the final say. The upside is real. Faster notes, cleaner charts, fewer after hours documentation marathons. But if your team is trusting the AI output without reviewing it, you are building a compliance problem, not solving one. Any tool your agency adopts needs a human in the loop who owns the note, reads the note, and signs the note knowing it is accurate. And when vendors come calling with words like "automation" and "AI native," pressure test what that actually means for your clinical accountability. The jubilance around automation is not a documentation strategy.

VA Rate Cuts Spark Legal Challenge: Texas & New Mexico Providers Grapple with Up to 43% Reimbursement Drop All · HIGH

Agencies serving veterans in rural Texas and New Mexico are seeing VA reimbursement cuts as high as 43% on certain services. The VA says it is aligning with market rates. Providers say the cuts are arbitrary and are filing legal challenges. Some agencies are already pulling out of service areas and cutting staff benefits to stay afloat. If you carry VA patients, review your current rates and watch how this legal challenge plays out.

Updated MAC TPE Guidance: Know What Your MAC Expects All · MOD

CMS released updated guidance on how MACs will conduct Targeted Probe and Educate one on one education sessions. If your agency has been through TPE or is currently in a round, this clarification matters. Know what your MAC expects before you walk into that conversation, not after.

CMS Proposes Sweeping Medicaid Payment Caps: Anticipate Future Revenue Impact for Home-Based Care Agencies All · MOD

CMS proposed a rule to cap state-directed payments across Medicaid services as part of a broader effort to control long-term spending growth and align payment structures more closely with Medicare. If your agency touches Medicaid, case management needs to be on the priority list now, not after the final rule drops.

TrueTime QA All · HIGH

As case mix recalibration and LUPA threshold changes evolve, charts that once moved through cleanly may now carry a higher risk for payment reduction or review scrutiny if documentation gaps are missed early. That is not just a policy problem. It is a per-chart quality problem. TrueTime Chart Review helps agencies catch documentation gaps before a claim goes out, so teams know exactly what needs attention, not just that something feels off.

Enhancing Patient Outcomes Through Continuous Data Collection Between Visits All · HIGH

The next time a referral partner asks what happens between your visits, you want a better answer than "we check in next week." Remote patient monitoring and patient reported outcomes give you real data between scheduled visits. That data keeps patients more stable, catches problems earlier, and gives you something concrete to show hospitals and payers when they ask why they should send patients your way.

Hospice Operators Rethink Referral Strategies with Tech, Data, and Digital Storytelling Hospice · HIGH

Hospice referral strategies are shifting. The agencies winning right now are pairing traditional relationship building with digital storytelling and quality data that shows referral partners exactly what outcomes look like. If your outreach strategy is still just dropping off brochures and buying lunches, it is time to add a digital layer that tells your story when you are not in the room.

Doximity Invests Heavily in Physician AI; Prepare for Increased AI Use in Clinical and Referral Networks All · MOD

Doximity is investing heavily in AI tools for physicians, including ambient notetaking and clinical assistants, and expanding through partnerships with primary care groups like Aledade. Your referral partners are going to start working differently because of this. The agencies that understand how physician workflows are changing will be the ones that stay relevant in the referral conversation.

Boosting Home Care Operations: Strategies for Efficient Workflows and Engaged Teams All · MOD

Here is a retention question most agencies never ask: when was the last time you sat with a clinician and asked what part of their day feels like a waste of time? Not a survey. Not a suggestion box. A real conversation. The agencies keeping their nurses are not offering pizza parties. They are finding the one workflow that drives people crazy and fixing it. That is retention. One fix, one clinician at a time.

Protecting Agency Leaders: Mitigating Online Data Exposure Risks for Executive Safety and Recruitment All · HIGH

Your leadership team's personal information is more exposed online than you think. Home addresses, phone numbers, family details, all searchable. That is not just a safety problem. It is a recruitment problem. When a strong candidate Googles your DON and finds their home address on a data broker site, it sends the wrong message about how your agency protects its people. Take 30 minutes this week and search your leadership team. Then start removing what should not be there.

Why Star Ratings Were Tanking, And Nobody Could See It Home Health · MOD

An agency's star ratings were tanking on dyspnea outcomes and nobody could figure out why. The clinical team was assessing patients on supplemental oxygen at SOC, but scoring M1400 without accounting for oxygen non-compliance. Patients who were not using their O2 as prescribed were being scored as if their dyspnea was managed, starting them at a low baseline that left zero room to show improvement by discharge. The agency was quietly bleeding star rating points on every one of these cases without realizing the documentation pattern was the problem.

One Training Session. M1400 Fixed. Stars Recovered Home Health · MOD

After a focused education session on OASIS outcome interpretation, clinicians started scoring M1400 = 3 or 4 at SOC for oxygen non-compliant patients, accurately reflecting dyspnea at rest or with some movement when the patient was not following the O2 plan. With the correct baseline captured, discharge assessments showed real, measurable improvement to M1400 = 0 to 2 in most cases. The agency was positioned to recover outcome performance. The fix was not clinical. Nobody changed how they treated the patient. It was a documentation accuracy problem hiding inside an outcome interpretation gap, and one training session closed it.

Field Tested All · LOW

You know you have been in home health, hospice or personal care too long when you pull into a patient's driveway and their dog recognizes your car before the patient does.