Being aware of, and prepared for, industry changes is essential for steering your business towards a successful 2025.  This article gives you five regulatory changes to keep on your radar.

If you work in long-term and post-acute care, 2025 will bring some new changes to regulatory practices. We’ve compiled a list of reliable resources to help you prepare for what’s to come when 2025 arrives. The Centers for Medicare and Medicaid Services [CMS] recently introduced several pending changes. Whether you are at the frontlines caring for people directly, helping to lead a team, or heading an entire organization, you can use these tips to stay aware of current and pending regulations: 

The 2025 Patient-Driven-Groupings Model (PDGM)  

CMS is readjusting the 2025 Patient-Driven-Groupings Model (PDGM) for home health agencies providing skilled care. Changes will affect how Medicare reimburses agencies for the care they provide to patients with varying conditions in an episode of care. Stay on top of it by scoping out this CMS site for continued developments.

The 80-20 Staff Mandate

Employees caring for Medicaid-insured people should be aware of potential changes due to the 80-20 staffing mandate. If you are part of a homemaker, home health aide, personal care, or habilitation team (such as independent, assisted, or group living settings), be aware of the newly proposed 80-20 staff mandate to help improve the quality of care delivered to people with Medicaid as their primary insurance. Learn more about the rule and what it means for access to care here.  

The Hospice Outcomes and Patient Evaluation (HOPE) Tool

Hospice teams need to educate themselves on the new HOPE tool. Drafts of the most current tool can be found below, along with further updates related to the HCAHPS data set for 2025. The former Hospice Item Set [HIS] will be replaced by the HOPE tool in 2025 for a more comprehensive analysis that will focus on patient and family needs not just at admission and discharge but also at periodic Hope Update Visits [HUV] during episodes of care. Learn more about it on the CMS website.

MDS 3.0 and the 2025 SNF Quality Reporting Program [QRP] changes.

Ensure skilled nursing facility (SNF) staff understand MDS 3.0 and the new 2025 SNF Quality Reporting Program [QRP] changes.  The QRP includes an improved analysis of social determinants of health in the coming years. Aimed at keeping the best possible access to care for all people and improving healthcare outcomes, updates on both of these important SNF items are available now. 

The Accelerating Access to Dementia & Alzheimer’s Provider Training (AADAPT) Act

Although the bipartisan-supported Accelerating Access to Dementia & Alzheimer’s Provider Training (AADAPT) Act was introduced earlier in 2024, it is still making its way through the approval channels. The act aims to improve memory care by encouraging accurate and efficient diagnosis of Alzheimer’s and related dementias in the community through timely training of providers nationwide. As providers become experts at diagnosing Alzheimer’s, robust staff training related to caring for these individuals in the community will surely follow. Find out more about the AADAPT Act and its movement by reading this article on the Alzheimer’s Impact Movement website.

What regulations are you keeping your eyes on for 2025? Let us know in the comments section!