If you work in skilled nursing, assisted living, home health, or hospice, there's a regulatory development worth watching closely over the next few months, even though the full details aren't public yet.
The Centers for Medicare & Medicaid Services (CMS) has sent a proposed rule to the White House Office of Management and Budget (OMB) for review. Its stated goal: modernize the Conditions of Participation, Conditions for Coverage, and related requirements for Medicare- and Medicaid-participating providers, reducing administrative burden while giving providers more flexibility to deliver care. OMB has classified it as "economically significant" —a designation reserved for rules expected to have a major nationwide impact—and it's expected to publish as early as August.
This rule is CMS's formal response to a 2025 request for information on possible deregulation. In response, the two largest nursing home advocacy organizations, AHCA/NCAL and LeadingAge, submitted nearly 80 pages of recommended changes, including a push toward risk-based surveys and streamlined quality reporting across overlapping programs.
It also sits inside a much larger deregulatory agenda. The administration's 2026 Regulatory Plan calls for eliminating more than 700 rules across federal agencies, and specifically directs CMS to reform accreditation processes, reduce the number of quality measures it uses, accelerate the shift from fee-for-service to value-based care, and modernize how new technologies get covered.
At this point, the actual regulatory text isn't public. CMS hasn't named which specific requirements are on the table, and this is a proposed rule, meaning a public comment period and a final rule still lie ahead before anything actually changes for providers. Based on how CMS has handled similar burden-reduction rules in the past, that full process typically plays out over a year or more.
Here's the pattern worth understanding: CMS has been consistent in saying burden reduction isn't meant to be a rollback of accountability. In past rounds of deregulation, the requirements most likely to change have been documentation formats and duplicative reporting, not the underlying obligation to train and demonstrate competency. Abuse prevention, infection control, and core safety training have historically proven durable even through aggressive burden-reduction efforts.
If anything, a shift toward risk-based oversight raises the stakes on real competency, not paperwork. Facilities with strong internal training and quality systems are the ones best positioned to benefit as survey scrutiny shifts from "did you document it" to "can you prove it."
Right now, the most useful thing providers can do is keep strengthening their training and quality systems and stay tuned for the actual rule text. One assumption is worth resisting in particular: that lighter paperwork requirements signal less need for training. History suggests the opposite: providers who keep investing in real competency now will be the best positioned once the rule is final, whichever way the specific details land.
Tracking regulatory developments like this, and translating them into what they actually mean for your training and compliance program is exactly the kind of work we do every day. As this rule moves from proposal to final text, we'll keep breaking down what's changing, what isn't, and what it means for your organization, so you're never caught off guard.
Want to talk through what this could mean for your compliance strategy? Schedule a conversation with our team to see how Showd.me helps you build training that holds up no matter which way the regulatory winds shift.