Aug. 20, 2026

Featured News

Nursing Home Rates Posted by DHS

On August 20, 2026 by Jeff Bostic

After months of delay due to late submission by DHS of the State Plan Amendment (SPA) to the Centers for Medicare and Medicaid Services (CMS), nursing home rate notices for January 1, 2026, were posted on Friday, Aug. 21 to the nursing facility provider portal.

Editor's Note: The original article, published Thursday, Aug. 20, has been updated to reflect rates being posted by DHS on Friday, Aug. 21.

These rates implement a number of changes approved by the 2025 Legislature, and the retroactive nature of the changes creates significant complications for providers, residents and employees. The new rates are retroactive to January 1, 2026. DHS will automatically reprocess claims in September to reflect the new rates, while providers will be responsible for settling up to these new rates with their private pay residents.

Here are the key aspects of the 2026 rates that members will see on their rate notice:

• The minimum wage rate increase (calculated for each facility based on 2025 data the provider submitted) will be effective retroactive to 1/1/26. It appears on the rate notice only on the total rates page as a single amount that is added to all case mix classes.
  • The minimum wage requirements themselves will be effective 9/10/26, which is thirty days after the SPA was approved by CMS.
  • That means, starting 9/10/26, nursing homes and contractors providing services in nursing homes need to pay all employees: $19.09/hr with higher requirements for:
    • CNAs: $22.60/hr
    • TMAs: $23.60/hr
    • LPNs $27.12/hr
  • These figures are somewhat higher than what the workforce standards board has announced due to a quirk in the state’s Paid Family and Medical Leave law, which does not allow for that tax on employees to reduce them below a minimum wage level.
• January 1, 2026 operating rates have been calculated based on the 2024 cost report information according to the usual Value-Based Reimbursement update schedule.
  • Each component of the operating rate (direct care, other care related, other operating) is capped at an increase from 2025 rates of no more than the rate of inflation (3.22%).
  • These caps are a new policy that reduces year-to-year increases in a way that undermines providers’ ability to make appropriate investments in in their employees and care for residents.
• The January 1, 2026, surcharge increase adopted by the state was approved by CMS, but only through September 30, 2026.
  • As a result, starting 1/1/26, the rate paid to nursing homes to cover the surcharge will be $19.02, up from the current $8.86. That will be the case until 9/30/26, when it will revert to the previous level.
  • The final page of the rate notice shows both a 1/1 rate and a 10/1 rate, the only difference being the removal of the surcharge. Providers should be aware that they will not be getting a 10/1 rate notice—the current notice shows what the rate will be starting that date.

The completion of rate notices after this unprecedented delay brings a form of resolution, but it now leads to significant implementation challenges ahead. The retroactive rate changes, upcoming September 10 wage requirements, and implications for private-pay residents create a compressed timeline and substantial administrative and financial demands for providers.

We have developed several resources to assist members with the challenges of implementing a greatly delayed rate change:

• Sample letter to private pay residents explaining the reason for retroactive billing
• Talking points for residents, families and employees about the retroactive rate change and the minimum wage requirements
• An updated nursing home workforce standards board web page that includes an FAQ about the new minimum wage standards

We are very disappointed by the mess that was created this year by DHS. The mismanagement of the rate updating and subsequent CMS approval has a significant impact on providers and the older adults and families you serve. If you have not received your rate notice from DHS, please contact Alicia Harrington.

Federal Court Dismisses Nursing Home Workforce Standards Board Lawsuit

On August 20, 2026 by Mark Schulz

On August 17, U.S. District Court Judge Nancy Brasel issued an Order dismissing the lawsuit that LeadingAge Minnesota, along with our Long-Term Care Imperative (LTCI) partner, filed in March 2026 challenging the Nursing Home Workforce Standards Board (NHWSB).

Our suit challenged the constitutionality of the 2023 Minnesota Nursing Home Workforce Standards Act (Act), and with it the validity of all rules adopted by the NHWSB. On March 11, we filed a Complaint and a Motion for Preliminary Injunction in the Minnesota U.S. District Court. In response, the State of Minnesota filed a motion to dismiss the case, with the support of SEIU Healthcare Minnesota & Iowa, which joined the suit for the purpose of submitting legal arguments in defense of the Workforce Standards Board.

We asserted four claims:

1. that the Act violates due process by empowering private parties to regulate competitors,
2. infringes First Amendment associational rights,
3. restricts labor market competition in violation of the Sherman Antitrust Act,
4. and conflicts with the National Labor Relations Act by establishing a parallel bargaining structure.

On May 15, our attorneys, along with counsel for the State and SEIU, appeared for a lengthy hearing at the federal courthouse in Minneapolis to present our respective arguments and answer questions from the court.

After taking time to consider the parties’ positions on the legal issues involved, Judge Brasel sided with the defendants and granted the State’s motion to dismiss our case.

We are disappointed with the court’s decision and respectfully disagree with its conclusions. We are carefully analyzing Judge Brasel’s Order, evaluating options including filing an appeal, and working with our legal team to determine the best path forward.

Please contact Mark Schulz if you have any questions.

Stars Among Us: Recognition Begins with a Nomination

On August 20, 2026 by Barbara Landeen

Every Stars Among Us Award begins the same way: with someone taking the time to nominate a deserving person or program.

Think about the remarkable people in your organization—the caregiver whose compassion makes a difference every day, the volunteer who gives generously of their time, the colleague who has made an extraordinary impact, or the team whose innovative work has improved the lives of older adults.

They may be deserving. Their coworkers may appreciate them. Residents, clients, and families may know how special they are.

But recognition begins with a nomination.

Tell Their Story

Someone has to tell the story. Someone has to share the examples that demonstrate their impact. Someone has to say, “This person deserves to be recognized.”

That someone could be you.

Nominations for the 2027 Stars Among Us Awards are open now. If someone has been on your mind during the past few weeks, don't wait for someone else to nominate them. Take the first step and help us celebrate the people and programs that make Minnesota's aging services community extraordinary.

Recognition begins with a nomination. Whose story will you tell?

Find complete Stars Among Us Awards details here. Nominations are open through Sept. 28, 2026.

Quick links:

• Nomination brochure
• Stars Among Us Nomination Guide with helpful hints and tips
• Submit a nomination

Questions? awards@leadingagemn.org.

Federal News

CMS Releases Surveyor Resources for SNF Risk-Based Surveys

On August 20, 2026 by Kari Everson

On August 13, 2026, the Centers for Medicare and Medicaid Services (CMS) released the surveyor resources for the newly implemented Risk Based Survey (RBS) process.

The Risk Based Survey

The Centers for Medicare and Medicaid Services recently announced the formal, national implementation of the Risk-Based Survey (RBS). Minnesota was a pilot state for this survey type and members who have experienced this process have reported positive experiences.

This RBS is an abbreviated survey process that requires communities to meet certain standards to be eligible, and information can be found in QSO-26-14-NH. For more information, here is our recent advantage article on RBS.

Updated Surveyor Resources

The updated materials start with the naming convention RBS. Included in the resources are the following:

• RBS Entrance Conference Form
• RBS Facility Tasks Job Aid
• RBS Mapping Document Streamlined
• RBS Procedure Guide
• RBS Screening Job Aid
• RBS IP Care Areas and Probes
• RBS Pathways (Critical Element Pathways)
• RBS CMS-802

If you receive a RBS these resources will help you determine what to expect and how to move through this process. If you have questions, please contact Kari Everson.

Bridging the Gap: Turning Section GG Accuracy into Better Outcomes

On August 20, 2026 by LeadingAge Minnesota

Section GG has become one of the most influential sections of the Minimum Data Set (MDS), yet it remains one of the most misunderstood. While many clinicians recognize its importance for Medicare reimbursement, Section GG extends far beyond payment. Accurate coding directly impacts Quality Measures, Value-Based Purchasing, Five-Star performance, state Medicaid case-mix systems, discharge planning, and the resident's overall clinical story.

Despite its significance, many skilled nursing facilities continue to experience inconsistent GG coding—not because staff lack clinical knowledge, but because processes, communication, and education often fail to keep pace with evolving expectations. The encouraging news is that most of the opportunities for improvement are operational and can be addressed through standardized workflows and interdisciplinary collaboration.

Coding Usual Performance, Not Best or Worst

One of the most common challenges is determining the resident's usual performance. Section GG requires facilities to code the resident's typical level of function during the assessment period, not the resident's best or worst performance. A resident recovering from surgery or a stroke may require substantial assistance one day and only supervision the next. Selecting the highest or lowest level of function instead of identifying the resident's usual performance can significantly alter reimbursement and quality outcomes.

Observation, Not Assumption

Another frequent opportunity involves relying on assumptions rather than observation. Staff may unintentionally code what they believe a resident is capable of doing instead of what actually occurred. Section GG should always reflect observed performance supported by interdisciplinary documentation from nursing, therapy, and certified nursing assistants. Every member of the care team contributes valuable information that helps paint an accurate picture of the resident's functional abilities.

Selecting the Correct Level of Assistance

Facilities also continue to struggle with selecting the correct level of helper assistance. Distinguishing between setup assistance, supervision, partial assistance, substantial assistance, and dependent can be challenging without ongoing education. These distinctions may appear minor, but even a one-level difference can affect quality metrics and reimbursement. Routine competency training using real resident scenarios helps improve consistency and confidence among staff responsible for documenting functional performance.

Appropriate Use of "Not Attempted" Codes

The use of "Not Attempted" codes presents another opportunity for improvement. Codes such as 07, 09, 10, and 88 should only be used when the specific RAI Manual definitions are met and supported by documentation. These codes should never become the default option simply because an activity was not observed during a shift. Clear documentation explaining why an activity was not attempted is essential to support accurate coding and withstand audit scrutiny.

Communication Across Disciplines

Perhaps the greatest opportunity lies in improving communication across disciplines. Section GG should never be viewed as solely a therapy responsibility or an MDS responsibility. The highest-performing organizations recognize that accurate functional coding depends on collaboration between nursing, therapy, restorative nursing, MDS coordinators, and clinical leadership. When each discipline contributes its observations, the resulting GG coding more accurately reflects the resident's true functional status.

The Value of Daily Clinical Meetings

Daily Medicare or PDPM clinical meetings have proven to be one of the most effective strategies for improving GG accuracy. These brief interdisciplinary discussions allow the team to review recent functional changes, identify documentation gaps, confirm usual performance, and ensure coding decisions align with the resident's clinical presentation before the assessment is finalized. Addressing questions concurrently is significantly more effective than attempting to reconstruct the resident's performance days later.

Regular Auditing as a Bridge

Regular auditing is another valuable tool for bridging the gap. Reviewing completed GG coding alongside supporting documentation often reveals patterns that can be addressed through targeted education. Rather than viewing audits as compliance exercises, successful organizations use them as opportunities to coach staff, strengthen documentation practices, and improve consistency across departments.

The Benefits of Getting It Right

The benefits of accurate Section GG coding extend well beyond regulatory compliance. Facilities that prioritize functional accuracy often experience more appropriate Medicare reimbursement, stronger state Medicaid case-mix classifications where applicable, improved Quality Measure performance, better Value-Based Purchasing outcomes, and stronger Five-Star ratings. Equally important, accurate coding supports safer discharge planning by ensuring care teams clearly understand the resident's functional abilities and ongoing needs.

Telling the Resident's Story

At its core, Section GG is about telling the resident's story accurately. Every transfer, every walk to the bathroom, every meal completed independently, and every improvement achieved through skilled care contributes to that story. When documentation and coding truly reflect the resident's usual performance, facilities are rewarded with more accurate reimbursement, stronger publicly reported outcomes, and greater confidence during audits.

Bridging the gap in Section GG does not require coding residents higher or lower—it requires coding them correctly. By investing in interdisciplinary collaboration, standardized processes, concurrent reviews, and continuous education, skilled nursing facilities can transform Section GG from a documentation requirement into a powerful driver of clinical excellence, financial stewardship, and quality outcomes.

When organizations focus on coding accuracy instead of simply coding completion, everyone benefits. Residents receive care that reflects their true functional needs, clinicians gain confidence in the assessment process, leadership obtains more reliable quality data, and facilities are better positioned to thrive in an increasingly outcome-driven healthcare environment. In today's skilled nursing landscape, accurate Section GG coding isn't just best practice, it's a strategic advantage.

Member News

Supporting Older Adults Through Counseling

On August 20, 2026 by LeadingAge Minnesota

Learning and professional development can take many forms, and LeadingAge Minnesota’s education partners offer additional opportunities for professionals to grow and explore new areas of expertise. One of those partners, Saint Mary’s University of Minnesota, offers graduate programs that help professionals build specialized knowledge and skills for the next step in their careers.

Saint Mary’s recently shared the story of Liam O’Sullivan, a student in its M.A. in Counseling & Psychological Services program. With a background spanning nursing, mental health and palliative care, Liam brings a unique perspective to his studies and a strong interest in supporting older adults.

In this Q&A, Liam shares what drew him to counseling, how his experiences working with older adults have shaped his approach to care, and what he’s learning as he prepares for the next chapter of his career.

Tell us about yourself - where you're from, your professional background, and what drew you to counseling as a career?

I grew up in London, England, and later in Germany. I was always the existential ponderer in the family; completing my BA in Philosophy at a politically aware university showed me that I needed to grapple with those issues in a way that would connect me to them more viscerally. Starting out as a nursing aide caring for people after strokes, I was made aware of how naïve I was about the practical issues of illness, but that I had a knack for talking to people in distress.

After moving into critical care, I saw that impressive and compassionate effort went into physical treatment, but that unaddressed mental health and psychosocial issues were more slippery, often sabotaging aspects like safe discharge and ongoing collaboration. That inspired me to do graduate training as a mental health nurse and get involved in qualitative research on patient experience and stigma. Working as a clinical lead in palliative care, I saw how layers of trauma, oppression and discrimination, desperate coping using substances, and the frustrations for patients of managing stigmatized illnesses required a holistic approach towards care.

Underneath all that, there were always those questions of meaning for patients and practitioners, which were hard to articulate and could undermine motivation for both unless they were explicated. Moving to the US was the perfect opportunity to focus down into existential and humanistic ways of counseling clients, and I start my MA practicum in January. I hope to work with older clients with disenfranchised grief, intergenerational trauma, and existential anxiety caused by our fast-moving and unequal world.

What made you interested in the M.A. in Counseling & Psychological Services program at Saint Mary's, and what have you learned so far that has informed your work with clients?

Saint Mary’s has a solid reputation in the Twin Cities for creating prepared and employment-ready practitioners, and job prospects are what every student wants to have! Completing an MA that covers topics including neuroscience, multicultural awareness, and psychopathology has helped me understand that psychotherapists can do so much in their careers.

The scope of practice is vast and covers group work, skills development, teaching and supervision, somatic interventions, systemic counseling for biological families and families of choice, organizational change… I am hardly doing the profession justice with this list. I hope to continue what is politely called a ‘portfolio career’ and is more honestly me going down rabbit holes that tend to collapse into one big transdisciplinary cavern.

As an immigrant to a state that has had so much upheaval in recent years, attending a course in the heart of such a diverse place has helped me understand the local context of care. The course is teaching me where my own experiences and identities may give fresh perspectives, or might need me to pay more humble attention to learn.

Tell us about the settings you've worked in with older adult clients - what key takeaways have you gotten from those experiences?

Much of my work with older adults has been in busy inner-city hospitals after an inpatient crisis admission. A state of crisis for seniors is sadly so often uncovered by an acute event such as a fractured hip, a recognition of dehydration by visiting carers, or family finding rotting food in a refrigerator. It would be so easy to blame the client for not seeking help, coping with alcohol, or even hiding their suffering. This points to the isolation that older adults often experience and feel.

I’ve found that it is important to take a systemic and clinical view that asks questions like: how can older men express their grief over the death of a spouse when they have been socialized to hide their feelings all their lives? What ageism is in me that automatically assumes a resourceful older person needs rescuing, but a less well-equipped younger person needs autonomy? How, and for what, can I engender hope in an older person who has lost much? And what practical support can I anticipate us needing, such as removing barriers to communication for people with hearing loss, cognitive deficits, or lack of technical know-how?

What advice would you give to someone just starting out in counseling & psychological services who's interested in working with older adult populations?

I am just starting out myself in a lot of ways, being a psychotherapy student, though I’ve worked with older adults for twenty years. I would say that when I was in my early twenties, as so many of my co-students are, there was a lot of countertransference onto me from clients as a ‘grandchild’ figure. It was sometimes difficult to feel taken seriously, especially when I was at the stage of life in which I felt I was still proving myself. Looking back, I did the best when humbly but confidently offering clients help and cracking a few jokes, rather than infantilizing them or holding them at arms’ reach. It was then that they would disclose thoughts of self-harm, their fear of managing their own urostomy, or feel safe enough to try transferring from bed to chair for the first time after a stroke.

Getting to know my co-students and professors has reaped rewards, helping me make connections with talented colleagues and feeling supported by like-minded people. I have been able to get involved in paid projects, such as creating a webinar for the Minnesota Association for Marriage and Family therapy and am putting together a submission for the Association for Death Education and Counseling’s conference next year. There is never enough time in a busy training course for experiential learning, and any practice you can get in interpersonal skills work is worth its weight in gold. Rolling your sleeves up as a support worker or nursing aide is demanding work while studying, but will get you informed about all areas of care, and you ahead of the curve.

Liam O’Sullivan is a student in the MA Counseling and Psychotherapy program at Saint Mary’s University of Minnesota. You can access his co-presented webinar on Family Therapy for Caregivers of Older Adults here.

Education Solutions

New 5-Pack Webinar Bundle Makes CEUs More Flexible and Affordable

On August 20, 2026 by Sharon Hollister

LeadingAge Minnesota is making it easier to fit professional development—and continuing education—into your schedule with the new 5-Pack Webinar Bundle.

The bundle lets you choose any five webinars from a curated collection of more than 25 on-demand programs covering timely topics in behavioral and mental health, clinical practice, operations, regulatory compliance, workforce and leadership. Because every program is available on demand, you can focus on the topics most relevant to your work and complete them when it works for you.

And bundling your learning saves money. The 5-Pack Webinar Bundle is $275 for LeadingAge Minnesota members ($385 for prospective members) — a savings of $100 compared with purchasing five webinars individually.

Each webinar is eligible for one clock hour of continuing education and has been designed to meet CEU approval criteria for Minnesota BELTSS licensees. General certificates of attendance are also available.

Whether you're planning ahead for license renewal, exploring an emerging issue, or simply looking to strengthen your skills, the 5-Pack Webinar Bundle gives you the freedom to build professional development around your priorities—and your schedule.

Choose your five and start learning on your time. Click here to get started.

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