On April 11^th, 2025, the Centers for Medicare & Medicaid Services (CMS) released proposed rules for Skilled Nursing Facilities (SNF) and Inpatient Rehabilitation Facilities (IRF) annual updates. Each rule proposes updates to Medicare payment and quality measurement policies for Fiscal Year 2026, which begins October 1. The proposed rules indicate a 3.2 percent increase in payments for rural SNFs and a 2.7 percent increase for rural IRFs.

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that provides updates to the fiscal year (FY) 2026 Hospice Quality Reporting Program (HQRP). The proposed rule estimates that in FY 2026, hospices in rural areas would experience on average, a 2.7 percent increase in estimated payment compared to FY 2025. The rule also proposes to clarify in the hospice payment regulations that the physician member of the interdisciplinary group (IDG) may recommend admission to hospice care, which would align with certification regulations and the Conditions of Participation (CoPs). CMS also proposes to clarify that the hospice face-to-face encounter attestation must include the physician’s/practitioner’s signature and date.

This proposed rule from the Centers for Medicare & Medicaid Services (CMS) seeks public comment on payment updates and policy changes to Medicare’s acute care inpatient hospital and long-term care hospital prospective payment system (IPPS/LTCH). For fiscal year 2026, CMS proposes a 2.4 percent increase to base rates for acute care hospitals that successfully participate in the Inpatient Quality Reporting program and are meaningful electronic health record users.  Additionally, CMS proposes to discontinue the low wage index hospital policy, which provided an upward adjustment for hospitals in areas with the lowest wages, and a transition policy for hospitals significantly impacted by the discontinuation of this policy. There are several proposed changes to the suite of quality programs – Inpatient Quality Reporting, Value Based Purchasing, Hospital Readmission Reductions, Hospital Acquired Conditions, Medicare Promoting Interoperability, and LTCH Quality Reporting. Finally, CMS proposes several changes to the Transforming Episode Accountability Model (TEAM), the Innovation Center mandatory payment model in which hospitals in select geographic areas coordinate care for people undergoing one of five surgical procedures, including allowing post-acute care to occur in rural swing beds without a prior 3-day hospitalization.

– Nominate by May 15.  The Partnership for Quality Measurement (PQM) seeks expertise for the Endorsement & Maintenance committee and for Pre-Rulemaking Measure Review.  Members of the PQM can be patients, patient advocates, clinicians, quality measure experts, or any other interested party providing feedback on quality measures being considered for programs implemented by the Centers for Medicare & Medicaid Services (CMS).   Learn more about responsibilities and time commitments and nominate yourself or someone else by May 15.

Helen Hawkey, Executive Director of the PA Coalition for Oral Health (PCOH), received the 2025 M. Dean Perkins Distinguished Service Award presented by the Association of State and Territorial Dental Directors (ASTDD) at the 2025 National Oral Health Conference.

Helen was presented the award by PCOH board member, Kelly Braun from the Pennsylvania Office of Rural Health. The Distinguished Service Award is for a member, associate member, non-member, or organization who has made a significant contribution to ASTDD programs, initiatives, or dental public health.

PCOH serves as the dynamic leading voice to improve oral health across the Commonwealth of Pennsylvania. PCOH promotes oral workforce development, advocates for community water fluoridation, and advances and advocates for oral health policy and infrastructure across all systems. By bringing together a diverse group of leaders from across the state from schools of public health, philanthropic organizations, businesses, dental organizations, health insurance firms, advocacy organizations, state agencies, and other champions, PCOH has built a powerful coalition of more than 1,000 individual and organizational stakeholders.

An excerpt from her nomination notes, “Helen Hawkey has consistently demonstrated an unwavering commitment to advancing dental public health, leaving an indelible mark on the state and national level. Through tireless leadership, effective advocacy, and fostering unity between stakeholders and decision-makers, Helen has played a pivotal role in promoting the necessity of dental public health and ensuring its sustainability. Notably, she has made significant contributions in the areas of assessing the status of oral health in Pennsylvania, championing policy development that promotes access to dental care, and ensuring there is a solid infrastructure to carry out future work.”

Click here to view the full list of all award recipients and nominations presented by ASTDD.

Even by rural hospital standards, Keokuk County Hospital and Clinics in southeastern Iowa is small.

The 14-bed hospital, in Sigourney, doesn’t do surgeries or deliver babies. The small 24-hour emergency room is overseen by two full-time doctors.

CEO Matt Ives wants to hire a third doctor, but he said finding physicians for a rural area has been challenging since the covid-19 pandemic. He said several physicians at his hospital have retired since the start of the pandemic, and others have decided to stop practicing certain types of care, particularly emergency care.

Another rural hospital is down the road, about a 40-minute drive east. Washington County Hospital and Clinics has 22 beds and is experiencing similar staffing struggles. “Over the course of the last few years, we’ve had not only the pandemic, but we’ve had kind of an aging physician workforce that has been retiring,” said Todd Patterson, CEO.

The pandemic was difficult for health workers. Many endured long hours, and the stresses on the nation’s health care system prompted more workers than usual to quit or retire.

Read more.