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July 17, 2025

Featured News

Analyzing the “One Big Beautiful Bill” – State Impact Remains Unclear

The passage of the federal "One Big Beautiful Bill" (OBBB) introduces substantial reforms to Medicaid, Medicare, and the Affordable Care Act premium tax credits, focusing on cost containment, program integrity, and greater state flexibility.

Key Provisions

Key provisions include the introduction of work requirements, tightened eligibility verification, financial incentives for states to ensure accurate administration, and revisions to federal subsidies—measures aimed at reducing federal expenditures to balance tax cuts and other spending priorities.

While certain elements of the bill are designed to support workers, the broader fiscal restructuring has sparked concern about the long-term viability of safety-net programs vital to older adults. These shifts could affect access to services, the operations of senior care providers, and overall resident wellbeing—especially for Medicaid providers, nursing homes, and non-profit healthcare organizations.

At the state level, Minnesota’s response remains in flux. Governor Walz's staff has indicated that the federal legislation might prompt a second special legislative session later this year, though no formal plans have been announced. As of now, the impact on aging services in Minnesota is unclear. Providers are encouraged to refrain from making operational or budgetary changes until more definitive guidance is issued by state leadership.

LeadingAge Analyses

We wish to acknowledge and thank LeadingAge National for its swift and thorough efforts in developing summary information following the passage of the OBBB on July 4, 2025. Their timely analysis provided critical insights that greatly supported the creation of the below information on the bill’s wide-ranging impacts.

Provider Taxes and State Directed Payments

  • Limits on Medicaid Provider Taxes
    • The law bans new or increased provider taxes not imposed before July 4, 2025, and reduces hold harmless thresholds beginning in 2027. These constraints may reduce state funding capacity for supplemental payments to providers, impacting Medicaid-supported services.
  • Redefinition of Redistributive Taxes
    • New definitions and limitations prevent provider tax models that overly burden Medicaid services, targeting states using steeply redistributive tax structures. Affected states face reduced tax revenue, which could affect provider incentives and service funding.
  • Limits on State Directed Payments (SDPs)
    • SDPs approved by May 1, 2025, are capped and will be reduced by 10% annually from 2028. Future SDPs must align with Medicare rate benchmarks, limiting states' flexibility to use SDPs as a funding tool and possibly restricting provider payment enhancements.

Rural Health Transformation Program

  • Rural Health Transformation Program ($50B over 5 years)
    • The law creates a $50B fund for rural health systems from FY2026 to FY2030, distributed through state-submitted transformation plans. Though the program may not fully offset Medicaid cuts, it offers aging service providers a potential, though limited, funding opportunity if included in state plans.

Medicaid Eligibility Changes

  • Retroactive Eligibility Reductions
    • Retroactive Medicaid eligibility is shortened to one month for expansion enrollees and two months for traditional enrollees starting in 2027. Providers may face higher uncompensated care costs and must expedite Medicaid application processes to reduce financial risk.
  • Increased Medicaid Redetermination Frequency
    • Beginning in December 2026, Medicaid expansion enrollees will undergo eligibility redetermination every six months instead of annually. This increases administrative burden on states and risks coverage loss for aging services staff and housing residents.
  • Mandatory Medicaid Work Reporting
    • Medicaid expansion enrollees must meet 80 hours/month of work or engagement, with complex exemption criteria and state system burdens starting in 2027. This could lead to coverage loss for residents and employees, further straining safety-net providers.

Affordable Housing for Older Adults

  • Permanent Enhancement of Low-Income Housing Tax Credit (LIHTC)
    • The new law increases state LIHTC allocations by 12% and lowers the 4% credit bond financing threshold from 50% to 25%. These changes, effective after December 31, 2025, are expected to generate 1.2 million affordable homes over 10 years and will significantly aid developers in addressing senior housing shortages.
  • Green and Resilient Retrofit Program (GRRP) Rescission
    • H.R. 1 rescinds $138 million in unobligated funds from HUD’s GRRP, terminating HUD’s contractual support for multifamily property improvements. While existing GRRP awards remain intact, awardees now bear full responsibility for completing their projects without HUD technical assistance.
  • Medicaid and SNAP Work Requirements
    • H.R. 1 imposes work requirements for Medicaid recipients aged 19–64 in expansion states, affecting potentially hundreds of thousands in HUD-assisted housing. It also raises the SNAP work requirement age limit to 65 and removes key exemptions, threatening food and healthcare access for vulnerable older adults.

Tax Policy

  • Permanent Exclusion for Employer Student Loan Repayments
    • Employer payments on student loans are now permanently excluded from taxable income, removing the prior expiration in 2025. This boosts long-term employer flexibility in supporting staff education benefits.
  • No Tax on Overtime Provision
    • A new temporary deduction (2025–2028) allows workers to deduct up to $12,500 ($25,000 for joint filers) in overtime income, subject to reporting and income limits. Implementation details are pending IRS guidance, but the provision could affect workforce reporting and payroll processes.
  • Bonus Depreciation and Section 179 Expensing
    • Restoration of 100% bonus depreciation and expansion of Section 179 (up to $2.5 million) will enhance cash flows for projects involving heavy capital investments. This benefits value-add strategies in sectors like senior living, enabling improved financial viability for improvement-heavy properties.
  • Employee Retention Credit (ERTC) Limitations
    • The law cuts off acceptance of ERTC claims for Q3 and Q4 2021 unless submitted by January 31, 2024. It also extends IRS audit authority and imposes due diligence penalties on promoters, increasing scrutiny and enforcement surrounding COVID-related tax credits.
  • 529 Plan Expansion for Credentialing
    • Tax-free 529 distributions can now be used for postsecondary credentialing expenses related to non-degree programs. This change supports workforce development in sectors like aging services by covering certifications such as CNA training.
  • 1% Floor for Corporate Charitable Giving
    • Corporate charitable contributions will only be deductible if they exceed 1% of taxable income, capped at 10%. This change, effective for tax years after 2025, is expected to reduce corporate giving by $4.5 billion annually, potentially harming nonprofit funding.
  • Excess Compensation in Tax-Exempt Organizations
    • The new law broadens the definition of employees subject to the excess compensation tax to include any individual earning over $1 million, not just the top five earners. This could increase the tax burden for tax-exempt organizations starting in 2026.
  • Increased Reporting Thresholds for Contractors
    • The 1099 reporting threshold for independent contractor payments increases from $600 to $2,000, adjusted for inflation. This reduces administrative burdens for businesses starting in 2025.

Safe Lift: Through the Eyes of the Resident Video Now Available

Interviews with residents as part of the LeadingAge Minnesota Foundation’s Mechanical Lift Project (Safe Lift) revealed a common and important theme: residents often do not feel like a true member of the team during the transfer process. They also described feeling like the transfer is simply a task to be completed — missing the opportunity for personal, human connection between staff and resident.

The Resident Perspective: An Essential Voice in Safe Lift Training

One of the core practices in the Safe Lift Roadmap emphasizes the importance of including resident perspectives in mechanical lift training. Providers are encouraged to take a person-centered approach by involving a resident in training sessions to directly share what it feels like to be transferred via a lift.

Another option is to utilize the new video resource: Safe Lift: Through the Eyes of the Resident, which features two residents sharing their personal experiences. They discuss what it means to rely on a mechanical lift, their worries, and what staff can do to offer comfort and reassurance.

This powerful tool can help staff better understand the emotional and physical experience of residents, fostering more compassionate care during transfers.

Register for Safe Lift Virtual Training – Aug. 6

LeadingAge Minnesota members are invited to participate in a free Safe Lift virtual training session to enhance safety practices when using mechanical lifts. The training is scheduled for Aug. 6 from 1:00 – 2:30 p.m.

This training will help you implement strategies outlined in the LeadingAge Minnesota Foundation’s “Roadmap to Effective Mechanical Lift Safety Practices” and introduce the Safe Lift: STOP for Safety campaign — a simple three-step process to perform a structured safety pause before resident transfers.

What is Safe Lift?

Safe Lift is an evidence-based initiative from the LeadingAge Minnesota Foundation designed to tackle the ongoing challenge of mechanical lift-related falls in care settings.

Unlike traditional training-only approaches, Safe Lift uses principles of human factors and ergonomics to examine equipment and process design issues that contribute to these incidents – ensuring that solutions go beyond staff training to address systemic issues.

How Do I Get Involved?

For questions, please contact Julie Apold at 651-659-1407 or japold@leadingagemn.org.

State News

New Consent and Fingerprinting Timeline for DHS Background Studies Effective July 14

The Minnesota Department of Human Services (DHS) is implementing a procedural change to the background study process, effective July 14, 2025. Originally announced on June 16, this update is being reiterated to ensure broad awareness among providers. The change brings the background study process into alignment with federal requirements by shortening the timeline for completing required steps.

Key Changes to the Background Study Process

Effective July 14, all background studies submitted—whether initiated by an entity or by the study subject—must adhere to the following new timeline:

  • Step 1: Consent and Disclosure
    • Must be completed within four (4) calendar days of the background study submission.
    • This is a change from the previous 14-day window, during which both steps (consent and fingerprinting) were required.
  • Step 2: Fingerprints and Photograph
    • Must be completed within 10 calendar days after the consent and disclosure step is completed.
    • The 10-day countdown begins immediately once the consent/disclosure is submitted—early completion does not extend this deadline.

Applicant-Initiated Background Studies

If a study subject initiates their own background study:

  • They will complete the consent and disclosure as part of the online application process.
  • Once the entity receives and submits the application, the 10-day window for fingerprinting and photographing begins.

What Happens If Deadlines Are Missed?

  • If either step (consent/disclosure or fingerprint/photo) is not completed within its respective timeline, the study will automatically close.
  • A new background study application will then be required, causing delays in onboarding or continued employment.

Important Reminders

  • No Timeline Extensions: Completing the consent/disclosure early does not give more time for fingerprinting.
  • Not Retroactive: Studies submitted before July 14 will still follow the previous 14-day combined timeline.
  • Applies to All Background Studies: Including both new and renewal applications.

Resources and Support

DHS has committed to updating the NETStudy 2.0 User Manual and FAQs to reflect this change. These materials will be available shortly. Weekly reminders will continue to be sent to ensure smooth implementation.

For more information or assistance, contact the DHS NetStudy 2.0 Contact Center:

Please ensure this information is shared with all staff involved in the hiring or background study processes to avoid delays or disruptions in compliance.

Customized Living Providers: Be Alert to Disability Waiver Policies Limiting Coverage and Your Facility’s Standing

Assisted living facilities that provide customized living (CL) services to people on the Brain Injury (BI) and Community Access for Disability Inclusion (CADI) waivers must follow specific limitations based on the setting’s CL enrollment date.

What to Check Prior to Admission

Before authorizing CL services, lead agencies should confirm the setting is eligible to support a person based on the applicable limitations. Providers should be aware of the limitations that apply to their settings to assure payment for services is accessible prior to completing the admission process. We have recently received several calls from members who were asked by case managers to admit a resident for whom they were not eligible to receive payment.

The following link provides program information and limitations for customized living, the payment program for assisted living services (and locations exempt from assisted living licensure): CBSM - Customized living (including 24-hour customized living).

Disability Services Division

The Disability Services Division has placed a list on their website of providers enrolled to provide customized living as well as a list of customized living providers not able to serve individuals under the age of 55: CBSM - Resource: Customized living provider settings only allowed to serve people on the BI and CADI waivers who are age 55 and older.

The resource is to be used in conjunction with the description of each category on the list, also found on the DHS website.

Federal News

CMS Revalidation Deadline Extended to Jan. 1, 2026

The Centers for Medicare & Medicaid Services (CMS) has extended the deadline for off-cycle Medicare provider revalidation to Jan. 1, 2026 — a significant shift from the previously announced Aug. 1, 2025 deadline. This marks the third postponement of the requirement.

Important Note: The extension offers much-needed relief to nursing homes still working to meet the updated reporting obligations. While the extension provides more time, the reporting requirement itself remains in effect. CMS is expected to formally announce the extension soon.

Facilities should continue preparing to comply and avoid delays closer to the new deadline. For more details about how and what to submit, please review our posting discussing those details here.

Notable News

Send Your Wishes of Recovery and Good Health to Sen. Hoffman

It’s hard to believe that one month has passed since a gunman opened lethal fire on two state legislators and their families. As many of you know, that incident resulted in the deaths of Speaker Emerita Melissa Hortman, her husband Mark, and their family dog. The shooting also critically wounded Senator John Hoffman and his wife, Yvette.

Making Progress

Senator Hoffman was recently discharged from the hospital and is now starting the next phase of his recovery in a post-acute setting before returning home. We know that you share a deep sense of the achievements and hard-fought milestones he will need to meet during this phase, given your familiarity with long-term care services.

Send a Card or Letter

If you would like to send your well wishes and good health to the Hoffmans, we invite you to send your cards and letters to the LeadingAge Minnesota office. We will coordinate delivery to the family on behalf of the Association and its members. Send your notes in a sealed envelope, as addressed below by July 30:

Senator John Hoffman & Yvette Hoffman
c/o LeadingAge Minnesota
3001 Broadway St NE, Suite 300
Minneapolis, MN 55413

Grant Opportunity – Rural Health

Medica Foundation is accepting applications for their Rural Health funding area. Grants up to $10,000 will be awarded for community-led solutions that address health needs and social determinants of health in rural communities.

A variety of demographics and focus areas are prioritized, including seniors, senior care, behavioral health, culturally focused care, oral health, primary care for underserved communities, and transportation, among others.

For more details on this grant and the other open opportunities currently available to our members, visit our member-only resource, Grant Grid: Funding Opportunities for MN Senior Care Providers. This resource includes over 30 grants, scholarships, loans, workforce development programs, and more funding opportunities for Minnesota senior care providers to consider.

Reminder: Please Submit Your 2024 Revenue by August 29

Yesterday, an email from LeadingAge Minnesota was sent to the dues contact for our provider members with a personalized link to report your organization’s 2024 adjusted gross revenue. Thank you to everyone who has already completed this important step!

Your timely submission ensures we can calculate your 2026 membership dues fairly and continue building the advocacy, education, and resources that support our community together.

Deadline: Please submit your revenue report by August 29 to avoid a 10% increase applied to your 2023 revenue.

If you have any questions or need help with the process, please contact:

  • Jessica Lacher, Director of Membership & Strategic Partnerships
  • JLacher@leadingagemn.org
  • 651-603-3530

Thank you for your partnership and for all you do to support older adults and those who care for them.

Interactive New American Resource Map – Now Live!

We’re excited to share that the New American Resource Map is now available! This interactive tool highlights organizations, programs, and resources across Minnesota to help connect your staff—especially New Americans—with resources that support their lives outside of work. When our staff are well-supported, retention rates increase, and our entire long-term care community benefits.

What You’ll Find on the Map

This evolving resource features a variety of community-based supports, including:

  • Local nonprofits offering family and basic needs support
  • Culturally specific programs for immigrants and refugees
  • English-language learning and tutoring services
  • Immigration attorneys and legal referral organizations
  • Childcare guides and early education programs
  • Workforce centers, job coaching, and employment support
  • Transportation and mobility resources
  • Resettlement services and welcome centers

Whether you’re looking for legal help, English Language Learning classes, or a reliable childcare provider, this map makes it easy to find trusted support nearby.

Who This Map Supports

For New American Staff:

The resource map is a connection to services and support in Minnesota. It helps individuals and families:

  • Navigate immigration processes and find legal counsel
  • Access language learning, job training, and employment programs
  • Connect with culturally relevant community spaces
  • Build a sense of belonging and support in their new home

While created with New Americans in mind, the map is a valuable tool for all staff seeking local support and connection.

For Long-Term Care Employers:

This map empowers employers to:

  • Provide culturally relevant referrals and resources to support your team members
  • Deepen recruitment pipelines with local community partners
  • Foster stronger relationships with local organizations and leaders
  • Advance inclusive workforce strategies in meaningful, authentic ways

Help Us Grow the Map!

This map is a dynamic tool—and we need your help to keep it strong and relevant. If you know of a local organization, service, or program that supports New Americans, refugees, or families in your area, please take a moment to share it. The best maps are built with local knowledge—and yours is invaluable.

Send your recommendation to Kirstan Ketter and include:

  • The name of the organization
  • One-to-three sentences about what they offer
  • Website or contact information (if you have it)

Every suggestion brings us closer to making this map a truly powerful tool for connection and support. Let’s build it together—one community resource at a time.

Why This Matters

Nearly one-third of healthcare workers in Minnesota are immigrants, and long-term care organizations have long benefitted from the skills, values, and resilience of New Americans. This map is more than a list—it’s a bridge between senior care providers and the communities they serve. Let’s work together to strengthen those connections.

This tool is made possible through the New Americans Long-Term Care Workforce Grant from the Minnesota Department of Human Services.

Member News

Lakehouse HealthCare and Rehabilitation Center Shares Vision with Minneapolis Mayor

LeadingAge Minnesota staff members Jessica Lacher and Shelli Bakken recently joined members Leon Tarlow and Reuben Knobel of Lakehouse Healthcare and Rehabilitation Center for a meet-and-greet with Minneapolis Mayor Jacob Frey.

The group discussed workforce initiatives at Lakehouse and shared exciting updates about the longstanding care center in the city’s Bryant neighborhood. Plans include the addition of an in-house hospice area and a dialysis unit.

Thank you to Leon and Reuben for taking time to engage with the community and elected officials!

St. Francis Health Services Showcases New Technology, Welcomes State Senators

LeadingAge Minnesota member St. Francis Health Services had a busy and exciting week filled with innovation and advocacy. Heritage Manor Healthcare Center in Chisholm made headlines in the Mesabi Tribune for hosting a public event that introduced two new additions to its programming: Pepper, an interactive humanoid robot, and Mobii, a state-of-the-art projection system.

Integrating Technology

Guests at the event were treated to live demonstrations and hands-on opportunities to explore how the technology will be used in daily programming. Pepper is designed to engage and entertain residents by singing, reading stories, leading brain teasers and exercise sessions, or operating in autonomous mode to answer questions—similar to voice assistants like Alexa and Siri, according to Autumn Herzog, grant coordinator for St. Francis Health Services.

Welcoming State Senators

Elsewhere in the state, two other care centers welcomed their respective state senators for in-person visits. Sen. Bill Lieske visited Farmington Health Services, and Sen. Jordan Rasmussen stopped by Browns Valley Health Center. Both took time to speak with residents and staff, listening to their experiences and discussing the challenges facing long-term care funding in Minnesota.

St. Francis Health Services is grateful for the opportunity to share its innovative work and to connect directly with policymakers on issues that matter to its community.

Thank you to the team at St. Francis Health Services for your continued advocacy work post session!

Sound of Solace: A Benefit Honoring Leaders and Their Families

LeadingAge Minnesota member Mary T. Inc., founded and operated by Dr. Mary Tjosvold, is hosting a benefit concert at Crooners Supper Club — also owned by Tjosvold — on Monday, July 28, at 7 p.m.

Sound of Solace

“Sound of Solace” will be an evening of song, support and community, held in memory of Rep. Melissa Hortman and her husband, Mark, and in support of Sen. John Hoffman, his wife, Yvette, and their daughter, Hope, as they continue to recover.

The concert will feature some of the Twin Cities’ most acclaimed vocal and stage performers, including Jennifer Grimm, Tyler Michaels King, Jen Burleigh-Bentz, Ben Dutcher, Austene Van, Dane Stauffer, Kersten Rodau and others. It will serve as a heartfelt tribute to these public servants and the challenges their families are facing.

All ticket revenue will be evenly split between the Hortman and Hoffman families, providing support as they navigate the challenging road ahead.

Learn more and get tickets: Sound of Solace – Crooners Supper Club

Education Solutions

Courage at Work: Annual Meeting Opening Keynote

Register now for the premier leadership conference of the year, the 2025 Annual Meeting & Leadership Forum, Sept. 16-19 at Grand View Lodge in Nisswa.

This year’s conference theme is Courageous Thinking, which aligns with one of LeadingAge Minnesota’s organizational values of the same name.

Courage at Work: How to Take More Risks and Own Your Brilliance is the opening keynote, delivered by Candace Doby, founder of The Can-Do Company, leadership communication strategist and author.  Learn strategies to manage fear of failure, activate personal courage, and take worthwhile risks so you can foster courageous leadership and fuel your organization’s growth.

As a follow-up to the keynote, Doby will facilitate an afternoon workshop, Create a Courage-Ready Culture™, to assist you creating a culture where employees are engaged, ready, willing, and able to courageously speak up, step up, and show up.

Registration for the Annual Meeting is open now. Register before the August 15 early bird deadline to save $100. Find complete details, including conference registration, golf social registration, and lodging here.

Still Time to Register for Assisted Living Conference

Don’t miss this year’s Assisted Living Conference on Aug. 13-14 in Brooklyn Center. This popular event is two full days of education, vendors, and conversations about all things assisted living.

The conference delivers targeted training, essential updates, and practical tools to help you meet state requirements and provided exceptional care for your residents.

A sampling of session topics includes meeting food and nutrition guidelines, recruitment and retention of talented staff, landlord-tenant laws and reasonable accommodations, behavior management best practices, and so much more.

Find details and register here.

Quality Specialist Certificate Program Sells Out

LeadingAge Minnesota’s Quality Specialist Certificate Program, August 20 – Dec. 4, has quickly sold out to capacity.

This is a testament to the importance of staying informed about regulatory requirements and driving continuous improvement in your organization. To be placed on a wait list for openings, send your request to education@leadingagemn.org.

Questions? Contact Olivia Scott, Events and Education Coordinator at education@leadingagemn.org.

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