HCAOA Annual Event Preview

by Kristin Rowan | Sep 25, 2026 | Advocacy, Events, Home Care, Partner News, Regulatory

by Kristin Rowan, Editor

HCAOA Annual Event Preview

Woah!

Orlando, Florida is known for its warm weather and sunny days. But, next week, Orlando will be “cool!” The opening keynote speaker at the HCAOA National Home Care Conference is Mr. Cool himself, Arthur Fonzarelli. Henry Winkler, aka “The Fonz”, is an Emmy Award-winning actor, director, producer, and best-selling author. He is also an advocate for people who learn differently. This year’s keynote address will certainly kick things off with humor and inspiration, but “Ayyy” that’s just the beginning.

Headliners

Joining Winkler in this year’s lineup are Disney executive Louie Gravance talking about service excellence and comedian turned motivational speaker Jeff Civillico. Gravance is the featured speaker for the opening session on day 2 of the event. Civillico is the emcee on the main stage throughout the conference.

Education

If you’re heading to HCAOA next week, expect a busy schedule. The hardest part will be deciding which sessions to attend when some of the best minds in the industry have overlapping time slots.

Home Care CEOs and software solutions providers will present real-world applications and use cases for AI in home care, workforce solutions for developing caregivers and preparing for the future, operations guidance on benchmarking, cultivating cultural connections, recruitment, employment law, and finance and marketing.

For Floridians, HCAOA has a state-focused session track including regulatory and compliance updates a Florida Advocacy Forum.

Fun & Games

Some of the best networking opportunities are often accompanied by a glass of wine, a coffee, or an award. Don’t miss the vendor networking breakfast and lunch, the networking reception on Monday night, and the presentation of the Caregiver of the Year Award on Tuesday morning. And, of course, if you stick around after the reception on Monday, you’re bound to find most of us at the hotel bar.

Worth the Trip

The Home Care Association of America hosts a stellar event every year and this year is shaping up to be no different. I look forward to seeing many of you in Orlando next week. Plan your schedule here.

# # #

Kristin Rowan is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news. She is also a sought-after speaker on Artificial Intelligence, Technology Adoption and Lone Worker Safety. She is available to speak at state and national conferences as well as software user-group meetings.

Kristin also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. She works with care at home software providers to create dynamic content that increases conversions for direct e-mail, social media, and websites. Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

The Alliance Hosts Second Annual Advocacy Week

by Rowan Report | Sep 25, 2026 | Advocacy, Events, Home Care, Home Health, Hospice, Regulatory

FOR IMMEDIATE RELEASE

Contact: Hannah Kristan
communications@allianceforcareathome.org
202-355-1647

Over 150 Advocates Convene on Capitol Hill to Champion Care at Home

National Alliance for Care at Home Hosts Second Annual Advocacy Week on Capitol Hill

Alexandria, VA and Washington, DC, Sept. 16, 2026. – This week, more than 150 care at home advocates from across the country met with 285 congressional offices to discuss key legislative and regulatory priorities for expanding and protecting access to care at home. The meetings were part of the 2026 National Alliance for Care at Home Advocacy Week, an important opportunity to unite the entire care at home continuum under one voice.

Alliance Advocacy Week, now in its second year, offers a unique opportunity to bring together leaders, advocates, and supporters to amplify that home is where care happens, driving positive change and shaping the future of care to ensure that access to these essential services is protected and expanded.

"Our strength has always been our unity..." Jennifer Sheets

“This is a defining moment for care at home. When more than 150 advocates walk the halls of Congress together, speaking with one voice on behalf of patients, families, and providers, we send an unmistakable message. Care at home already has bipartisan support and recognition as a cost-effective, patient-preferred solution. As demand continues to grow, we are committed to being a strong partner with Congress to help federal policy grow with it,” said Jennifer Sheets, CEO of the Alliance. “Our strength has always been our unity, and Advocacy Week proves what we can accomplish when the entire continuum stands together to protect and expand access to the care people need, where they want to receive it most.”

Alliance Hosts Second Annual Advocacy Week

Key Issues

Advocates focused on five key issues during their congressional meetings:

End the home health and hospice provider moratoria and instead focus on implementing existing mechanisms to apply targeted, risk-based enforcement that roots out bad actors while protecting patients and legitimate providers.

Ensure that Medicare and Medicaid program integrity strategies are targeted and data-driven, focused on stopping fraudsters without harming legitimate providers or access to care, and supporting the Protecting Seniors and Stopping Fraudsters Act.

Stabilize Medicare home health payment rates by supporting the Medicare Home Health Payment Integrity and Protection Act to reverse an access crisis that has already left more than one-third of patients referred for home health without the care they need.

Protect and strengthen access to Medicaid HCBS by supporting policies and funding that let people receive care in their homes and communities, and that strengthen the direct care workforce making that possible.

Expand access to home care services by supporting the Credit for Caring Act to provide a federal tax credit of up to $5,000 to support family caregivers who provide 49 billion hours of unpaid care to relatives.

Advocacy Week Activities

In addition to congressional meetings, Alliance Advocacy Week featured in-depth policy briefings, a training for first-time advocates, and a panel discussion with seasoned government affairs professionals. The Alliance celebrates another successful Advocacy Week on behalf of care at home providers across the country and looks forward to continuing its work with policymakers and key stakeholders.

# # #

About the National Alliance for Care at Home

The National Alliance for Care at Home (the Alliance) is the leading authority in advancing care in the home. We envision an America where everyone has access to the highest quality, person-centered healthcare wherever they call home. Through advocacy, education, and convening, we connect providers and stakeholders to strengthen care delivery across the home-based care continuum — spanning home care, home health, hospice, palliative care, and Medicaid home and community-based services. Learn more at www.AllianceForCareAtHome.org.

©2026 The National Alliance for Care at Home. This press release was issued by The National Alliance for Care at Home and is reprinted here with permission. For more information, please see contact information above.

Viventium | Apploi: CEO Interview

by Kristin Rowan | Sep 25, 2026 | Admin, Partner News, Recruitment & Retention, Vendor Watch

by Kristin Rowan, Editor

Viventium CEO Interview: Adam Lewis

From time to time, The Rowan Report invites our partners to participate in a video interview. Earlier this year, we sat down with Viventium CEO Navin Gupta. Last week, we had the pleasure of speaking with Adam Lewis, Founder of Apploi and General Manager of Talent and Workforce Management at Viventium.

Adam brings years of experience and passion for care at home to Viventium after its acquisition of Apploi earlier in 2026. The Viventium and Apploi merger creates a seamless, end-to-end management platform from recruitment to the first paycheck.

# # #

Kristin Rowan is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news. She is also a sought-after speaker on Artificial Intelligence, Technology Adoption and Lone Worker Safety. She is available to speak at state and national conferences as well as software user-group meetings.

Kristin also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. She works with care at home software providers to create dynamic content that increases conversions for direct e-mail, social media, and websites. Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Private Duty Fraud Enforcement

by Elizabeth E. Hogue, Esq. | Sep 4, 2026 | Admin, Clinical, Home Care, Medicaid, Waste Fraud and Abuse

by Elizabeth E. Hogue, Esq.

The Future of Private Duty/Home Care

It Begins with Fraud Enforcement

Use of private duty/home care services continues to increase. It has become increasingly clear, however, that companies will not be permitted to care for patients who need these services without considerable additional oversight.

The proverbial “bottom line” is that private duty/home care companies will be under greater scrutiny and regulation. The instances of gross mistreatment of patients, some of which we have described in previous articles, are too shocking and lurid. And caregivers about whom lip service is given about their need for support have been mistreated by private duty companies.

And Then There's This:

The feds are convinced that there is rampant fraud in state Medicaid Programs to the tune of millions, if not billions, of dollars that has not been addressed. The number of fraud strike forces, task forces, etc. targeting companies that provide services to Medicaid recipients are now too numerous to count.

Fraud enforcement is definitely “in fashion” and enforcers are eager to put private duty/home care companies in the color orange! If this a fashion statement you want to make?

To Illustrate:

The National Fraud Enforcement Division of the U.S. Department of Justice (DOJ) recently announced that it has prosecuted 6200 defendants who collectively billed federal health care programs, including Medicaid, TriCare, the VA and others, $45 billion.

In a press release issued on August 4, 2026, the Division stated:

“Home care fraud is everywhere, and the victim is all of us taxpayers. Medicaid claims date and the experience of veteran prosecutors all point to the systematic exploitation of reimbursable home care programs….Today. we sound the alarm on the scale of this fraud by announcing some truly egregious cases, in which numerous people are charged with filing fraudulent claims for caregivers who were not actually providing home care services, but in fact were dead, in prison, or trafficking drugs. This racket ends today.”

And There's More!

“Let today’s announcement be a warning to those engaging in similar activity: if you seek to exploit our health care systems for personal profit, you should expect the FBI and our partners to uncover your scheme and bring it to an end. Every dollar stolen through fraud is a dollar diverted from patient care, and the FBI will continue its work to safeguard the public’s trust and hold accountable those who abuse these vital programs.”

Finally the press release promises that enforcers “…will pursue anybody who seeks to profit at the expenses of American taxpayers, regardless of whether the wrong doing is in the boardroom or in the sickroom.”

In other words, it’s not just the perpetrators who will be punished. The companies, owners and managers will also face punishment.

So, what are some of the offenses pursued so far?

One of the defendants was captured on tape:

”This home health care is the best kept secret…I made a buck plus (each of) the last five years. That’s a half million dollars… ain’t checking on nobody.”

It may be tempting for owners and managers to say: “That’s on them.” Not so! Companies and management will be held accountable for the actions of their employers and contractors.

Private duty/home care companies will see a tsunami of regulation. Use of fraud and abuse prohibitions is just the beginning.

# # #

Elizabeth E. Hogue, Esq The Rowan Report

Elizabeth Hogue is an attorney in private practice with extensive experience in health care. She represents clients across the U.S., including professional associations, managed care providers, hospitals, long-term care facilities, home health agencies, durable medical equipment companies, and hospices.

©2026 Elizabeth E. Hogue, Esq. All rights reserved.
No portion of this material may be reproduced in any form without the advance written permission of the author.

MatrixCare Leaves Resmed

by Kristin Rowan | Sep 4, 2026 | M&A, Vendor Watch

by Kristin Rowan, Editor

MatrixCare is Independent Again

Resmed Acquisitions

In 2019, Resmed (formerly ResMed) acquired MatrixCare for $750 million. Resmed also acquired Healthcare First (2018) and Citus Health (2021) and bundled them under the MatrixCare brand. Resmed also acquired Brightree in 2016 and several other software companies that are outside the care at home ecosystem.

PE Firm Acquires MatrixCare; Names CEO

On September 1, 2026, private equity firm Frazier Healthcare announced its acquisition of MatrixCare. According to records, the sale included both Healthcare First and Citus Health. Brightree was not included.

Frazier named Jonathan Lujan as CEO of MatrixCare. Lujan, a Frazier Executive in Residence, most recently served as CEO of Sight Growth Partners, an administrative services provider in the vision care field. The press release from Frazier notes that Lujan has experience in healthcare and technology.

“Frazier has spent several years evaluating the post-acute care technology sector and believes MatrixCare has established itself as a leading platform serving skilled nursing, senior living, and home health and hospice providers. We are excited to partner with the MatrixCare team and to invest in the product innovation and capabilities customers need as the post-acute care landscape continues to evolve.”

Ryan Lucero

General Partner, Frazier Healthcare Partners

MatrixCare Announces Independence

In a separate press release on Tuesday, MatrixCare announced its independence from Resmed. The press release also included the appointment of Lujan as CEO, but did not mention Frazier Healthcare. Lujan’s experience and job history was identical in both announcements.

Lujan Statement from Frazier

In the Frazier press release, Jonathan Lujan says:

“MatrixCare has built a trusted platform with a strong market position and a critical role in the daily operations of post-acute care providers. I am excited to work alongside the MatrixCare team and Frazier to build on that foundation, accelerate product innovation, and help our customers deliver better outcomes for the people and providers they serve.”

The MatrixCare press release also included a quote from Lujan:

“Today marks an important milestone for MatrixCare. As an independent company, we have the focus and the resources to invest directly in our platform and our people. We will build on more than 40 years of trust earned with skilled nursing, senior living, home health, and hospice providers, and we will move faster to deliver the innovation our customers need. This is the start of MatrixCare’s next chapter, and I’m excited to lead the team into it.”

Final Thoughts

It is unclear at this time why the MatrixCare announcement did not mention Frazier Healthcare. The company left the Healthcare First and Citus Health platforms out of the press release as well. Whether Lujan works for Frazier or MatrixCare is also ambiguous. The Rowan Report reached out to MatrixCare for comment and has requested an interview with Lujan.

# # #

Kristin Rowan is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news. She is also a sought-after speaker on Artificial Intelligence, Technology Adoption and Lone Worker Safety. She is available to speak at state and national conferences as well as software user-group meetings.

Kristin also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. She works with care at home software providers to create dynamic content that increases conversions for direct e-mail, social media, and websites. Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

HHAeXchange Launches RCM Services

by Kristin Rowan | Sep 4, 2026 | Admin, Home Care, Medicaid, Partner News, Vendor Watch

by Kristin Rowan, Editor

HHAeXchange Announces RCM Services

An Interview with Phil Feldman

In April of 2026, HHAeXchange unveiled their new end-to-end Revenue Cycle Management (RCM) service. HHAeXchange is a leading provider of homecare program management designed for Medicaid Home and Community-Based Services. (HCBS).

Addressing Top Concerns

HHAeXchange’s 2025 Provider Voice Survey asks homecare agencies about the pain points facing the industry. Administrative workload and cost are significant areas of concern for homecare agencies, cited by 41% of providers. RCM services address these concerns by removing administrative tasks from agencies, freeing up personnel to focus on growth, community outreach, referrals, and caregiver training.

“Homecare providers are navigating diverse payers, rising costs, growing administrative demands, and an increasingly complex financial and regulatory environment. RCM Services relieves agencies of the operational burden of billing and collections while improving cash flow and business performance. By offloading revenue cycle management to experts who deeply understand homecare and the HHAeXchange platform, agencies gain clarity, efficiency, and more time to focus on care.”

Paul Joiner

CEO, HHAeXchange

From Submission to Resolution

End-to-end RCM services handle the full revenue cycle. The RCM Services team at HHAeXchange handles everything from the initial claim submission to handling discrepancies, resolving rejections, appealing denials, and shortening the cycle of aging receivables.

Improved Cash Flow

RCM services go beyond billing and collections. HHAeXchange uses operational intelligence to track denial trends, authorization issues, and payer challenges. With these issues addressed at the beginning, claims are cleaner, denials are reduced, and agencies stay in compliance. These are issues cited by 70% of homecare agencies.

With improved cashflow, agencies have the resources to grow, to invest in their staff, to scale operations, and to create a more stable work environment.

Phil Feldman, National Director of RCM

The Rowan Report sat down with Phil Feldman, the National Director of RCM for HHAeXchange. Feldman, and the RCM service platform, came from Sandata and joined HHAeXchange in the acquisition in 2024. We asked Feldman about RCM services:

The Rowan Report:

What makes HHAeXchange’s RCM different?

Phil Feldman:

The RCM service platform is specific. It is specific to home care, specific to Medicaid, and specific to HHAeXchange. Agencies are connected to resources within the organization. We have existing relationships with payors that we can resolve directly. And the customer-facing team, the experts handling your revenue cycle, are employees of HHAeXchange, not a partner or a 3rd party.

RR:

What is the agency experience with HHAeXchange’s RCM service?

Feldman:

We are currently only offering the RCM services within the HHAeXchange platform. You have one vendor and one platform. When there’s a finger to point, it points right back at us.

Every account has at least one RCM advisor who serves as the primary point of contact, working with the agency on their billing schedule, their time-keeping week, and the whole process from close to claim.

The intelligence in the platform goes beyond mechanically processing claims and takes a holistic approach. The system checks for demographic descrepancies from intake like member IDs, gender alignment, ID updates from new payors, overservicing on claims, providing services past the end date or outside allotted days. We look directly at the agency’s denial trends and go upstream in the revenue cycle to fix the whole process, not just one claim.

Results

With just under five months since the full launch, and nearly a year of data from beta test agencies, Feldman says their agency claims are in the 90% collection rate. Claim denials, clawbacks, and remit time are trending down. A full data set is forthcoming, but for now, Feldman is relying on anectodal evidence: Their customers are referring agencies that are looking for RCM solutions.

“You’re the best thing ever. I have a lot of friends that I consult with and help them run their business. I want to introduce them to you.”

– An Indiana Agency Owner

Final Thoughts

Hiring and retention issues, reimbursement rates, administrative workload, operational costs, denials, payor compliance, authorizations…these issues are universal across home care and aren’t going away any time soon. If you’re looking for ways to optimize your current workforce, reduce overhead costs and tasks, and create a steady cash flow for your agency, outsourcing RCM is one way to do it. If you’re already an HHAeXchange customer, well, it just makes good sense to work within the system you know, with advisors who take time to understand your agency, and the backing of decades of experience.

# # #

Kristin Rowan is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news. She is also a sought-after speaker on Artificial Intelligence, Technology Adoption and Lone Worker Safety. She is available to speak at state and national conferences as well as software user-group meetings.

Kristin also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. She works with care at home software providers to create dynamic content that increases conversions for direct e-mail, social media, and websites. Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

The Alliance Responds to the Integrity and Protection Act

by Rowan Report | Aug 14, 2026 | Advocacy, CMS, Home Health, Medicare, Regulatory

FOR IMMEDIATE RELEASE

Contact: Hannah Kristan
communications@allianceforcareathome.org
202-355-1647

The Alliance Celebrates the Introduction of the Medicare Home Health Payment Integrity and Protection Act of 2026

Alexandria, VA, August 7, 2026. Today, the Alliance applauds the introduction of the Medicare Home Health Payment Integrity and Protection Act of 2026 (S.B. 5250) by Senator Collins (R-ME) and Senator Blackburn (R-TN). This important piece of legislation will provide core payment integrity reforms by correcting the Centers for Medicare & Medicaid Services’ (CMS) flaws in calculating Medicare rate updates, while also streamlining program integrity measures to target fraud concerns early, stopping bad actors from entering the Medicare program. Critically, this legislation does not rely on sweeping enforcement strategies which risk further restricting access to care for Medicare beneficiaries and causing unintended harm to legitimate providers.

The Medicare Home Health Payment Integrity and Protect Act seeks to restore the Medicare home health rate to what it would have been without consecutive years of compounding cuts. Those cuts were built on data entirely unrelated to the payment system adopted in 2020, along with data tainted by the inclusion of fraudulent providers in the rate analysis. This is an important step in modernizing the home health benefit, ensuring that beneficiary access is not disrupted by providing payment rates that better reflect the true cost of care.

The program integrity reforms included in this legislation build on the industry supported bill from Representative Beth Van Duyne in the Protecting Seniors and Stopping Fraudsters Act (H.R. 8883), which gives CMS stronger tools to combat healthcare fraud without imposing unnecessary burdens on legitimate providers.

“The National Alliance for Care at Home applauds the introduction of the Medicare Home Health Payment Integrity and Protection Act of 2026 by Senator Collins. This bill corrects longstanding flaws in home health reimbursement and takes a meaningful step toward a home health benefit that is stable and built for how care is delivered today. We strongly support the bill for its payment reforms, as well as measures to protect patients and preserve the integrity of the Medicare home health benefit.”

Jennifer Sheets

CEO, National Alliance for Care at Home

Sheets continues, “Consistent with our community’s commitment to provide the highest-quality, person-centered care in the home, we support the bill’s goal to strengthen access while focusing on targeted oversight, protecting the legitimate providers who serve patients every day. We look forward to working with Senator Collins, a long-time champion of care at home, to build support for this important and timely legislation.”

“When billions of dollars are improperly siphoned from the Medicare home health program, this can undermine the integrity of the payment system used to reimburse legitimate providers and threaten care for the seniors who depend on it. I have long been a strong supporter of home health care, which allows millions of Americans to remain in the comfort, security, and privacy of their own homes, while helping to avoid unnecessary hospitalizations and nursing home admissions,” said Senator Collins. “Fraudulent home health providers harm beneficiaries and diminish reimbursements for honest agencies that are already confronting workforce shortages and rising costs. My legislation would give CMS stronger tools to stop fraud before payments are made and prevent fraudulent spending from distorting the data used to reimburse honest agencies for medically necessary care.”

The Alliance will continue to serve as a key partner to lawmakers and regulators working to reform and protect the Medicare home health benefit, ensuring that payment rates better reflect the true cost of care.

# # #

About the National Alliance for Care at Home

The National Alliance for Care at Home (the Alliance) is the leading authority in advancing care in the home. We envision an America where everyone has access to the highest quality, person-centered healthcare wherever they call home. Through advocacy, education, and convening, we connect providers and stakeholders to strengthen care delivery across the home-based care continuum — spanning home care, home health, hospice, palliative care, and Medicaid home and community-based services. Learn more at www.AllianceForCareAtHome.org

© 2026 This press release was sent to The Rowan Report from the National Alliance for Care at Home and is reprinted with permission. For more information or to request permission to use this content, see contact information above.

LeadingAge Reacts to the Integrity and Protection Act

by Rowan Report | Aug 14, 2026 | CMS, Home Health, Medicare, Regulatory

Leading Age React to Integrity and Protection Act

FOR IMMEDIATE RELEASE

Contact: Lisa Sanders
lsanders@leadingage.org
202-508-9407

LeadingAge Statement on the Medicare Home Health Payment Integrity and Protection Act of 2026

August 7, 2026 Washington, DC—Statement from Katie Smith Sloan, president and CEO, LeadingAge, the association of nonprofit and mission-driven providers of aging services, including home health, on the Medicare Home Health Payment Integrity and Protection Act of 2026, recently introduced by Senator Susan Collins (R-ME):

“Access to health care and services is an important benefit today, as America grows older—by 2050, adults age 65 and older will increase from 17% to nearly 25% of the population. What’s more, care at home is what people prefer and it also delivers strong patient satisfaction and quality outcomes. Yet the valuable Medicare home health benefit is under threat. Senator Collins’ bill rightly seeks to rectify two contributors to that unfortunate situation: bad actors seeking to exploit the program, and…years of reductions due to a flawed methodology. “

Katie Smith Sloan

President and CEO, LeadingAge

Sloan continued, “A longtime champion of Medicare home health, Senator Collins appreciates the shortcomings of current payment approaches; we are particularly encouraged by the bill’s recognition that the standard prospective payment amount requires a recalibration.

The Centers for Medicare and Medicaid Services’ (CMS) patient-driven groupings model (PDGM), in place since 2020, applies permanent and temporary payment adjustments, as required by Congress, premised on isolating “assumed versus actual” behavior change. The widely recognized problem is that in practice, neither CMS nor any other stakeholder, has managed to isolate the specific behavior due to PDGM from other factors that have also changed over the same time frame: patient acuity, referral patterns, staffing markets, the shift in post-acute utilization, potential fraud, and the lasting effects of the public health emergency.

LeadingAge Reacts to Integrity and Protection Act

Rather than continue use of the problematic behavioral adjustments methodology, it makes sense to set a rate that reflects the patients agencies actually serve, and pause further assumption-driven adjustments. Home health providers need this relief, and the older adults and families who depend on care at home need the stability and access sensible rate-setting would deliver.

We appreciate Senator Collins’ leadership in presenting a much-needed reset of the Medicare home health payment to promote its stability and ensure access.

In addition, we also share the desire to address fraud in this setting. LeadingAge has long expressed concern about the increase of home health providers in Los Angeles County.

This bill’s oversight provisions are reasonable, appropriately targeted policies that would help maintain the benefit’s integrity. Those, along with the important proposed payment changes, will help to ensure support for legitimate providers—including our nonprofit and mission-driven members. We look forward to working with Senator Collins to advance this legislation.”

About Leading Age

We represent more than 5,300 nonprofit and mission-driven aging services providers serving older adults and touching millions of lives every day. From our national headquarters in Washington, DC, and in collaboration with our state partners representing members active in 50 states, the District of Columbia, and Puerto Rico, we use advocacy, education, applied research, and community-building to make America a better place to grow old. Our membership encompasses the entire continuum of aging services, including skilled nursing, assisted living, memory care, affordable housing, retirement communities, adult day programs, hospice, Programs of All-Inclusive Care for the Elderly (PACE), and home-based care. We bring together the most inventive minds in the field to lead and innovate solutions that support older adults wherever they call home. For more information, visit leadingage.org.

© 2026 This press release was sent to The Rowan Report from LeadingAge and is reprinted with permission. For more information or to request permission to use this content, see contact information above.

VA Policy Causes Death of Veteran

by Kristin Rowan | Aug 14, 2026 | Advocacy, Regulatory, Veterans Affairs

by Kristin Rowan, Editor

VA Policy Causes Death of Veteran

For the last couple of months, we’ve been reporting on the rate and hours changes from the VA in Texas and NM. Caregivers are taking pay cuts. Agencies are operating at a loss in order to continue serving our veterans. Many veterans are losing their caregiver, losing the comfort of having a familiar person in their home, losing the progress they’ve made against depression, PTSD, and isolation. And now, we’ve heard a story that we just cannot believe.

Last week, I spoke with an agency owner operating across four states. The agency has been impacted by the rate cuts in Texas and New Mexico. His story is disturbing and highlights the darkest realities of this policy. Here is his story:

End of Care

The administration in one VA not only cut the rates and cut veteran hours, but also just ended care for some veterans and kicked them out of the program. There were no in-home visits or assessments. A member of the VA office made phone calls and asked veterans if they needed care. One of these phone calls reached a veteran with dementia. She didn’t remember the 16 to 20 hours of ADL care she was receiving to dress, eat, and bathe every day. She told the caller she did not need care and the VA dropped her from the program completely.

End of Life

Another veteran, another call to determine whether he needed care, and another drastic cut in hours. This veteran needed home visits daily. He needed supervision and check-ins. The VA didn’t see it that way and cut his care down to six hours per week. The agency shifted from regular visits to twice a week. The caregiver saw him on Friday. He fell on Friday after the visit or sometime on Saturday. He lay in his home, alone and afraid, all weekend long. He died sometime Monday. The caregiver found him when she returned to the home on Tuesday.

End of a Deadly Policy

The rate cut at the federal level, the care balance between Home Health Aide and Homemaker, the cut in hours, the end of care without an assessment, and the unwillingness of the policymakers to acknowledge the lives they have put at risk has to end. If Texas and New Mexico serve as test runs for policy change and rate cuts across the country, all our veterans could suffer like the ones in this story, and countless others. Your agency could be next. If you haven’t already, please join the fight for veteran care.

Write a letter to Secretary Collins admonishing him for the rate cut and for believing it wouldn’t impact care.
Mail to: Office of the Secretary, Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420
Send a general inquiry to Ask VA
Join the coalition with Polsinelli – PolsinelliHomeCare@polsinelli.com

Final Thoughts

These stories are not the only ones out there. Veterans across Texas and New Mexico are suffering from the loss of care. Agencies dedicated to that care are shuttering their doors from upside down reimbursements. My source said it better than I ever could.

“My hope is that by sharing some of the difficult situations we’ve encountered, the article will help shed light on the real-world consequences of these decisions. I hope it encourages meaningful discussion about how we can better support our senior veterans. I truly believe there are better ways to reduce costs than by limiting access to the care they depend on. These men and women have already sacrificed so much in service to our country. As they age, caring for them should be one of our highest priorities, and we should treat each of them with the respect and gratitude they have earned.”

# # #

Kristin Rowan is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news. She is also a sought-after speaker on Artificial Intelligence, Technology Adoption and Lone Worker Safety. She is available to speak at state and national conferences as well as software user-group meetings.

Kristin also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. She works with care at home software providers to create dynamic content that increases conversions for direct e-mail, social media, and websites. Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Three Choices at the End of Life

by Rowan Report | Aug 7, 2026 | Clinical, Hospice

by guest author Barbara Karnes, RN

Cure, Life-Sustaining, or Comfort Care

When someone is facing a life-threatening illness, they and their loved ones are often asked to make medical decisions they never expected to face. Unfortunately, most of us don’t fully understand the choices before us. Knowing the difference between cure, life-sustaining treatment, and comfort care can help you make decisions that honor the kind of life – and death – you want.

Cure, life-sustaining treatment, and comfort care. These are the three paths available when we are faced with a life-threatening illness.

Cure

Cure means providing a return to a “normal” functioning life. I put normal in quotes because the word can be misleading. What is normal for one person may not be normal for another. Cure implies being able to participate in and enjoy the activities of everyday living. It means the malady is gone or controlled.

Life-Sustaining Treatment

Life-sustaining treatment means keeping the physical body alive by whatever means are deemed necessary. Many people refer to these treatments simply as “life support.” They can include artificial nutrition and hydration, ventilators, dialysis, respirators, and other advanced medical procedures. The goal becomes preserving life, even when the quality of life is greatly diminished.

Quality Improvement Project Hospice Domains

Comfort Care

Comfort care focuses on the quality of the life you are living rather than simply the length of that life. It includes physical care along with emotional, mental, and spiritual support. Comfort care addresses what is most important to your well-being now that your body is no longer able to meet all of your needs. It also guides and nurtures your family and those closest to you as everyone prepares for the end of life while continuing to live fully each day.

"Fix" or Provide Care?

We often get so caught up in getting “fixed” at any price that we lose sight of what our goal really is. Treatment does not necessarily mean cure. Yet most of us assume that if we do everything possible, we will get better. Sadly, too often we sacrifice the quality of the life we have today while pursuing a cure that may no longer be possible.

When deciding between cure, life-sustaining treatment, or comfort care, information and knowledge are vital components to making decisions. We need honest conversations about the likely outcome of treatment, the chances of success, life expectancy, and quality of life. Once you’ve had those conversations and decided what kind of living is most important to you, share those wishes with your physician, your family, and those closest to you—and put your decisions in writing.

There is no right or wrong choice. There is only the choice that best reflects your values and how you want to live the time you have.

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Barbara Karnes, RN, is an award-winning end-of-life educator, award-winning nurse, NHPCO Hospice Innovator Award winner 2018, and 2015 International Humanitarian Woman of the Year

While at the bedside of hundreds of people during the dying process, Hospice Pioneer Barbara Karnes noticed that each death was following a near-identical script. Each person was going through the stages of death in almost the same manner, and most families came to her with similar questions. These realizations led Barbara to sit down and write Gone From My Sight, the “Little Blue Book” that changed the hospice industry.

Gone From My Sight is the original, and remains the most widely used, patient/family educational booklet on the signs of approaching death. It has been in print continuously since 1985 and has sold over 35 million copies worldwide. With its publication and distribution, Barbara created one of the most important tools in the end-of-life movement today.

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com