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July 14, 2025
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As workforce challenges continue across the aging services sector, we know that immigration policy—both current and proposed—plays a growing role in shaping the availability and stability of our care teams.
We’re launching a short, 2-minute survey to better understand how immigration-related issues are impacting our members. Whether your organization currently employs foreign-born staff, is considering sponsorship, or hasn’t yet felt an impact — your input is vital. Your feedback will help shape our advocacy efforts, educational offerings, and support for workforce strategies across the state.
Click here to take the 2-minute survey. Questions? Contact Randi Hamill, Director of Workforce Development and Initiatives, at rhamill@leadingageohio.org. The July edition of Ziegler’s CFO Hotline Report highlights the deepening strain workforce challenges are placing on aging services providers. In a survey of nearly 200 not-for-profit senior living organizations, 36% of CFOs reported a significant increase in workforce costs, while another 60% noted a slight rise. Though not new, staffing challenges are becoming more financially and operationally burdensome.
CNAs remain the hardest roles to fill, followed by dining staff and RNs. Many providers are leaning on agency staffing, with 5.7% of nursing roles now filled through temp agencies. Single-site providers are increasingly using this approach, historically more common among multi-site organizations. Staffing shortages have led 25% of single-site and 18% of multi-site providers to turn away skilled nursing admissions—directly affecting care access and revenue.
On average, staffing now accounts for 56.1% of total operating costs, with many organizations seeing workforce expenses consume more than half their budgets. Most are responding by improving workplace culture, increasing wages, offering training, and creating career pathways. Yet only 8% reported no margin impact, while over half saw moderate to significant effects.
Despite these pressures, 61% are not pursuing international recruitment. Just 15% are trying, but most face visa barriers, and only a few have succeeded. Some providers are piloting creative solutions like staff housing, internal labor pools, and dedicated workforce recruiters.
As these issues persist, LeadingAge Ohio continues to track developments and advocate for solutions that help members build a strong, stable workforce. Top You Asked: Are water cultures for Legionella required as part of a facility’s water management program?
We Answered: No, routine water cultures for Legionella are not required as part of a water management program. CMS states, in Appendix PP, of the State Operations Manual, under F880: At this time, CMS does not require water cultures for Legionella or other opportunistic waterborne pathogens as part of routine program validation, although there may be instances when it is needed (e.g., a case of healthcare-associated legionellosis or a potential outbreak of legionellosis in the facility).
The facility should contact the local/state public health authority if there is a case of healthcare-associated legionellosis or an outbreak of an opportunistic waterborne pathogen causing disease. The facility must follow public health authority recommendations which may include, but is not limited to, remediating the pathogen reservoir and adjusting control measures as necessary.
The State Agency will work with local/state public health authorities, if possible, to determine if the water management program was inadequate to prevent the growth of Legionella or other opportunistic waterborne pathogens and whether the facility implemented adequate prevention and control measures once the issue was identified.
Additional guidance can also be found in the CDC’s Developing a Water Management Program to Reduce Legionella Growth & Spread in Buildings toolkit. Top The LeadingAge Ohio Annual Conference & Trade Show is more than an event—it’s our community’s signature opportunity to come together, learn, connect, and strengthen the mission that drives us all: ensuring quality, person-centered care and services for older adults across Ohio.
If you’ve been wondering whether to attend this year’s conference, here are just a few reasons you won’t want to miss it:
- Cutting-Edge Education Tailored to Your Needs
Our robust schedule offers timely, relevant sessions led by industry experts, covering everything from regulatory updates and clinical best practices to leadership development, workforce solutions, and innovative care models. Whether you’re a CEO, administrator, nurse leader, social worker, board member, or front-line manager, there’s practical, actionable content designed to support you in your role.
- Networking with Peers Who Understand Your Challenges
Now more than ever, the value of connecting in person with colleagues who face similar challenges can’t be overstated. Share ideas, learn how others are tackling workforce pressures, discuss creative programming, and gain encouragement from a community that’s here to support you.
- Explore the Trade Show for Solutions that Work
Our carefully curated trade show brings together leading vendors and solution partners who specialize in serving aging services organizations. This is your chance to see new products, ask questions face-to-face, and discover tools that can help you operate more effectively and efficiently.
- Be Inspired to Lead with Purpose
The conference isn’t just about solving today’s problems; it’s about shaping tomorrow’s opportunities. Thought-provoking speakers and special sessions will reignite your passion for serving older adults and provide strategies to lead with renewed vision.
- Support Your Team’s Growth and Retention
Investing in professional development shows your team you value them. Bringing staff to the conference is an excellent way to reward and motivate your best people, helping them feel empowered, informed, and engaged in their work.
- Celebrate Our Shared Mission
We’re a network of mission-driven organizations dedicated to older adults, and the conference is our chance to celebrate that work, recognize excellence, and remember why we do what we do.
Register Today! So you don’t miss out on Ohio’s premier event for aging services providers. Join us at the LeadingAge Ohio Annual Conference & Trade Show and help us build a stronger, more connected, and better-prepared community for the future. In 2025, LeadingAge Ohio is offering two robust collaboratives, both led by Stephanie DeWees—LeadingAge Ohio’s Long-Term Care Quality & Regulatory Specialist and founder of Squared Business Solutions. These series are tailored to long-term care organizations seeking practical, systems-based solutions for two of their toughest challenges: reimbursement and regulatory compliance.
The Reimbursement Collaborative: Strategic Solutions for QIP and PDPM Success helps providers connect the dots between quality performance and payment. Through monthly sessions beginning in July, participants will explore how QIP measures and PDPM classifications align, how to improve documentation to support stronger reimbursement, and how to leverage data to drive outcomes. Each organization will receive facility-specific reports to guide internal strategy and system-level change. Registration and details are available here.
The Survey Success Collaborative: Building Sustainable Systems for Compliance Excellence offers a focused track on long-term care survey preparedness and sustainable compliance practices. Launching just one week later, this series guides teams through survey expectations, EMR optimization, risk evaluation, and plan of correction development. Participants will leave with step-by-step tools, actionable insights, and a clearer path toward consistent regulatory success. Learn more and register here.
Taken together, these collaboratives offer not just information, but integrated, peer-informed solutions that can help long-term care providers thrive in a challenging and changing environment. On Tuesday, July 29, LeadingAge Ohio will participate in the 2025 Healthy Aging Expo at the Ohio State Fair, hosted in partnership with the Ohio Department of Aging. From 9:00 a.m. to 3:00 p.m., attendees can stop by LeadingAge Ohio’s interactive booth to receive free, one-on-one guidance on completing their advance care planning documents.
During these 15-minute appointments, hospice and palliative care leaders will walk individuals through key decisions about their healthcare preferences, helping them complete Ohio's recognized advance directive forms, including the healthcare power of attorney and living will. Attendees will leave with completed documents in hand or with a clear roadmap for finalizing their plans. Updated planning guides and helpful prompts—including a newly revised edition of Conversations That Light the Way—will also be available.
The Healthy Aging Expo will feature over 3,000 square feet of resources designed to support wellness, independence, and informed decision-making for older adults. Fairgoers age 60 and older receive free admission to the fair on July 29.
To learn more about the event, visit the Ohio Department of Aging website. LeadingAge Ohio invites members of the Marketing, Communications & Outreach (MCO) Network to join the next virtual Open Call on Thursday, July 31 at 11:30AM. This informal, member-driven conversation offers a space to connect with peers across the nonprofit aging services sector, share real-time challenges, and exchange practical ideas that are working in the field.
Participants are encouraged to come prepared with at least one recent success and one current challenge related to marketing, communications, or outreach. Whether you've launched an effective campaign, faced roadblocks in messaging or engagement, or have questions about emerging tools, this conversation is an opportunity to gain perspective and collaborate with others doing similar work.
This session is open to all members touching marketing, communications, or outreach for their organization, regardless of title or tenure. To join the call, register in advance through Zoom. Your LeadingAge Ohio membership extends to your entire team—but only if they’re listed in your organization’s profile. Staff who are included gain access to members-only tools and resources on our website and can register for education and events at the member rate. Keeping your company profile up to date with new staff helps ensure everyone receives the communications, training, and support they need to stay connected and informed. From clinical directors to administrative support, every role benefits from being in the loop.
Key contacts can log in to your organization profile to review and update employee listings. We recommend bookmarking this link for quick access any time updates are needed. We understand that turnover happens. If you're having trouble adding employees and would like assistance, contact Laurinda Johnson at ljohnson@leadingageohio.org to get your team connected. There's always something happening at LeadingAge Ohio, and we don’t want you to miss a moment. From educational opportunities to networking events, our calendar is packed with ways for members to stay informed, engaged, and connected.
Explore what's ahead and make plans to join us—whether you're looking to expand your knowledge, connect with peers, or get involved in shaping the future of aging services in Ohio.
View all upcoming events here and mark your calendar today!
In a special edition of Advocacy in Action on July 7, 2025, participants received a recap on the passage of House Bill 96, the FY26-27 state operating budget. Governor Mike DeWine signed the bill into law on June 30, but not before wielding his veto pen to strike 67 provisions in the measure, some related to aging services and Medicaid.
The LeadingAge Ohio policy team outlined final budget provisions, including overall spending reductions in Medicaid; the critical inclusion of a LeadingAge Ohio-endorsed amendment that corrected an error related to the transition to the Patient Diven Payment Model (PDPM) formula for nursing facility reimbursement; the inclusion of an amendment around prompt start of services for PACE; and the abolishment of the Joint Medicaid Oversight Committee (JMOC), among other provisions.
Staff also ran down the list of Medicaid and aging services-related line-item vetoes, including a requirement for Medicaid to pay claims even if electronic visit verification (EVV) data was not available at the time of payment; a provision establishing a $110 Medicaid rate add-on for dialysis services delivered in nursing facilities, arguing that while supportive, the administration did not want rates established in statute; and explicit language tied to the Personal Needs Allowance increase, which the administration deemed was not needed in order to institute the increase, among other vetoes.
The team also briefly touched upon the passage and signing of H.R. 1, the federal budget, which was passed by Congress and signed by President Trump over the July 4th weekend. Members are encouraged to register for LeadingAge National’s weekly National Policy Pulse call held on Monday’s at 3:30PM to understand what is included in the federal legislation, and how it impacts aging services. You can also follow LeadingAge National’s serial post for further updates.
Please register to join us on July 21, 2025, for the next Advocacy in Action monthly call. For more information on the state and federal budgets, contact Eli Faes at efaes@leadingageohio.org. Top The LeadingAge LTSS Center @UMass Boston has unveiled a redesigned Resource Library, offering easier navigation and enhanced search tools to help users find the evidence-based resources they need.
The updated library houses a wide range of materials—including reports, briefs, case studies, journal articles, guides, and tools—focused on key areas such as affordable housing, aging and health, family caregiving, financing, home-based care, nursing homes, and workforce issues.
With a more user-friendly interface, the Resource Library continues to support aging services professionals with research-backed guidance that informs policy, practice, and innovation across the long-term services and supports continuum.
Example resources available in the LTSS Center:
Access the full resource library here. Planning to attend the 2025 LeadingAge Annual Meeting in Boston? Mark your calendar—VIP Week begins July 21. Provider members who register between July 21 and July 25 will automatically receive the VIP package, which includes $100 off early-bird pricing, early access to hotel blocks, and other exclusive perks.
The 2025 Annual Meeting will be held November 2–5, with the Global Ageing Network Summit taking place as a pre-conference event on November 1. Registration opens Monday, July 21—make sure your My.LeadingAge login is ready so you can take advantage of these limited-time benefits. Click here to learn more.
Don’t have an account with LeadingAge? Follow these instructions. Top Ohioans age 55 and older in Franklin and Summit counties now have access to the state’s Program of All-Inclusive Care for the Elderly (PACE), thanks to a recent expansion announced by the Ohio Department of Aging (ODA). This proven, person-centered model provides comprehensive medical, social, and personal care services for older adults who would otherwise require the level of care provided in a nursing facility.
PACE is currently available in Cuyahoga, Lorain, Franklin, and Summit counties, with further expansion planned in Ashtabula, Hamilton, Lucas, Mahoning, Montgomery, and Trumbull counties by early 2026. ODA estimates that more than 220,000 Ohioans could be eligible for the program, most of whom are dually eligible for Medicare and Medicaid. Private pay options are also available.
An interdisciplinary team works with families to determine eligibility and ensure participants receive care suited to their specific health and personal goals. For more information or to explore enrollment, visit Aging.Ohio.gov/PACE. Top The Centers for Disease Control & Prevention (CDC) shared the following message through a weekly summary: CDC Publications on Demand allows you to order free public health print materials such as factsheets, posters, audit tools, and brochures. This service will end in September 2025. To ensure you have the materials you need for future use, please place any final orders (large quantities are encouraged) no later than August 15, 2025. Order free print materials on CDC Publications On Demand by selecting any relevant topic, including Sepsis, Hand Hygiene, Antibiotic Use, Dialysis or C. diff, etc. from the “Topic” or “Program” boxes and clicking “Apply,” or by calling 1-800-CDC-INFO. Top A recent Immediate Jeopardy (IJ) citation in an Ohio nursing facility underscores the importance of maintaining a responsive and up-to-date water management program. While the IJ was the result of multiple failures related to the facility’s infection prevention and water management practices, one notable issue was the facility’s failure to reassess risk after a change in water usage on a particular unit. When the area experienced reduced occupancy, the resulting stagnation risk was not addressed, and no updates were made to the water management plan or related control measures.
According to the CMS State Operations Manual Appendix PP, under F880, “Facilities must be able to demonstrate its measures to minimize the risk of Legionella and other opportunistic pathogens in building water systems such as by having a documented water management program.” This program must be based on nationally accepted standards—such as those from ASHRAE, CDC, or the EPA, and must include two key elements:
- An assessment to identify where Legionella and other opportunistic waterborne pathogens (e.g., Pseudomonas, Acinetobacter) could grow and spread.
- Measures to prevent the growth of these pathogens, and how to monitor them.
A facility’s risk assessment should reflect how its water system is actually being used. When occupancy patterns change, whether due to renovation, repurposing of rooms, or census shifts, those changes may alter water flow and increase the potential for stagnation. Without adjusting the assessment and plan to account for these changes, facilities may miss key risks that compromise resident safety.
The full context of this citation and others was reviewed during the July 9, Survey Tips and Tactics call. The CDC’s Water Management Toolkit offers helpful guidance, including a case example of an unoccupied floor. In that case, appropriate control measures were implemented to reduce the risk of Legionella growth, such as flushing unused fixtures and monitoring water temperatures and disinfectant levels. The toolkit emphasizes that assessments and controls should not be static; they must evolve with the facility’s operations.
LeadingAge Ohio encourages facilities to monitor compliance using the surveyor guidance found in the State Operations Manual Appendix PP . Additionally, the survey pathways can be found in the Survey Resources zip file on the CMS Nursing Home webpage and under the downloads section on this CMS webpage. LeadingAge Ohio has provided survey tips to help navigate the changes in the revised QSO-25-14- NH memo. The previously provided survey tips can be accessed on the LeadingAge Ohio webpage under the Communications tab, then The Source tab. CMS has updated the survey resources on the CMS Nursing Home webpage in accordance with the revised QSO-25-14- NH memo. LeadingAge has developed webinars and resources on the requirements of participation which are located on the LeadingAge learning hub. LeadingAge continues to add QuickCasts on the regulatory groups. Updated resources have also been added on the Nursing Home RoP Tools and Resources webpage.
For more information about the requirements of participation and citations occurring in Ohio, please join us on the monthly STAT: Survey Tips and Tactics call. Register now for the August 13 call at 11:00AM. LeadingAge Ohio is sharing tips to assist members during the survey process. Send questions you would like addressed in future Tips of the Week to Stephanie DeWees at sdewees@leadingageohio.org. Top United Church Homes (UCH) has been awarded a $275,750 grant from the National Council on Aging through the U.S. Administration for Community Living Innovation Lab to expand falls prevention efforts nationwide.
One of just 18 organizations selected, UCH will use the funding to deliver two original, evidence-based programs—STAY STRONG, a fitness program focused on strength and balance, and STEADY STEPS, an educational and social engagement series—across more than 75 affordable housing communities in 15 states and two Native American nations.
Programming will be offered virtually through UCH’s YouTube channel, reaching over 3,000 older adults with support from physical therapists, service coordinators, and trained resident ambassadors.
“This funding allows us to implement innovative strategies that will enhance the safety and quality of life for older adults,” said UCH President and CEO Ken Young.
To follow more news from United Church Homes, visit their newsroom. Top LeadingAge Ohio holds valuable education webinars and in-person events throughout the year. Opportunities are added weekly. See the complete Schedule of Events. You have probably heard by now that coming in January 2026, there will be a new way to calculate your facility’s case mix score. LeadingAge Ohio Partner Arbor Rehabilitation has some details from the state to fill in the gaps. For those who froze their score back in 2023, that rate will apply through December 31, 2025. For those that did not freeze their case mix score, there will be no change in the direct care rate calculation from July 1, 2025, through the same date. In this scenario, your normal, calculated RUG score will apply and be based upon the average of the fourth quarter of 2024 and the first quarter of 2025. To read the full article, please click here. LeadingAge Ohio Partner Value First is running the 5-Star Sweepstakes and your organization could win one of five $10,000 prizes. What would you do with $10,000? Maybe replace aging equipment or throw a staff party? The choice will be yours if you win one of the five grand prizes. For complete information on this sweepstakes, please click here. Top
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Upcoming Events
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July 17, 2025
1:00PM - 2:00PM | Webinar Series |
| July 24, 2025
1:00PM - 2:00PM | Virtual
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| August 5, 2025
10:00AM - 1:30PM | LeadingAge Ohio Office
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