Why CMS’s New LTC Guidance is a Blueprint for Transformation
By Bryanna Wegner | June 27, 2025
Editor’s Note: This article was written and submitted by senior living executive Bryanna Wegner. If you are a senior living executive at an organization or a community with an idea for an article that you’d like to write and publish in Senior Living News you’re welcome to submit your idea or written article to Jim Nelson at jnelson@seniorlivingnews.com. We welcome all ideas relating to senior living.
While many executives leading long-term care (LTC) homes may interpret imminent surveyor guidance from the Centers for Medicare & Medicaid Services (CMS) as just another regulatory requirement, I challenge that assertion. Instead, the revised guidelines provide a strong leadership moment rife with opportunity for executives to strategically elevate their organization’s standards of care.
In my career leading clinical strategy across multi-state networks of senior living communities, I’ve seen firsthand how strategies that this guidance empowers will establish measurable impact for residents, families, and care teams alike. The work is challenging. But the question before us as healthcare leaders is not whether we can comply with the CMS update. Of course we can. The real question is: What will we choose to build on top of that compliance?
To answer that question, let’s take a look at what’s in the CMS guidance.
Critical Aspects of the New CMS Guidance
CMS is signaling a future that demands more transparency, more precision, and above all, more humanity in the care we provide. The revised guidelines touch nearly every aspect of nursing home operations from staffing and infection control, to discharge procedures and Quality Assurance Performance Improvement (QAPI).
More specifically, here are my takeaways about the most important aspects of CMS’s revised guidance:
- Admissions, Transfers & Discharges: This guideline enforces a streamlined, resident-centered approach that clarifies previously ambiguous language and refocuses attention on the dignity of transitions in care.
- Infection Control & Staffing Transparency: CMS has renewed focus on Multidrug-Resistant Organisms (MDRO) prevention, and the use of Payroll-Based Journal (PBJ) data, to align staffing patterns with actual resident outcomes.
- Medical Director Oversight: This part of the guidance redefines clinical leadership responsibilities that aligns with the multidisciplinary reality of today’s care teams.
- Psychotropic Medication Use: CMS strengthened the safeguards for resident involvement and clearer documentation of medical necessity — a long overdue shift from convenience-driven prescribing to collaborative care planning.
- Resident Assessments & Quality Measures: This guideline enhances the emphasis on accuracy and accountability, particularly around antipsychotic use and significant condition changes.
- QAPI & Health Equity: With this guidance, CMS is issuing a call to move beyond metrics into meaningful, equity-focused quality improvement that reflects the true diversity of our resident populations.
CMS Updated Guidance: Validation Not Disruption
These changes are not just a matter of compliance. Rather, they advance accountability, equity, and the evolution of our sector in response to aging demographics, workforce challenges, and heightened public scrutiny.
I view these updates not as a disruption, but as a validation of the direction our industry needs to be striving toward. Clinical excellence, staff development, and operational integrity are not merely regulatory goals — they’re moral imperatives. To achieve those imperatives, today’s leaders need to anticipate, advocate, and invest in scalable systems, empowered care teams, and proactive planning.
Executives must recognize that the new CMS regulations are not a ceiling above care quality, but a springboard from which to innovate, elevate, and lead. The revised guidance provides an opportunity to leverage technology and cultivate a workforce that sees these changes as a blueprint for the kind of care we want the organizations we lead to deliver. Every person in our aging population (specifically veterans in the case of HMR Veterans Services) deserves to continue their story with dignity, community, and exceptional care, regardless of where they are in their personal journey.
Looking Ahead: Time to Think Differently
Returning to my original question — what will leaders choose to build on top of compliance? — the answer is clear: Executives must embrace this leadership moment to build trust, excellence in the care we deliver, and a high quality of life that puts residents, their families, and care teams at the center of everything we do.
Why? Because beneath the surface of new definitions, documentation requirements, and expanded oversight lies a sharper, more urgent call: to think differently about how we deliver care and how we show up as leaders in our industry.
This moment serves as a reminder that the best operators are not waiting for mandates to drive change.
Call to Action: Tbd
This article has been lightly edited for style and formatting.
