Day one of the federal government reopening started Thursday after Congress and President Trump gave approval to a legislative funding package that keeps the entirety of the government open until at least Jan. 30, 2026.

Now that the longest shutdown in U.S. history is over, the long-term care profession is ready to look forward.

Clif Porter, president and CEO of the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), said the industry applauds congressional leaders for reaching an agreement and is ready for what’s next.

"As Congress and the Administration get back to working order, we look forward to working with policymakers on advancing meaningful policies that will support high-quality care in America’s long term care facilities," he said.

What Is the Bill About?

A rundown of what’s in the funding package includes the aforementioned deal to keep the government as a whole funded through Jan. 30, 2026, with selected entities like the Dept. of Agriculture and military construction funded for a full year, and not just until end-January. The law also includes the provision for a vote in December in the Senate on a Democratic healthcare bill, which most likely will be focused on Affordable Care Act subsidies.

For the long-term care universe, the most important developments with the government reopening are, according to AHCA/NCAL, led off by telehealth waivers.

The waivers expired on Sept. 30 when the shutdown began, but the new agreement reinstates the telehealth flexibilities retroactively from Oct. 1, 2025, through Jan. 30, 2026.

AHCA/NCAL said key waivers that were restored temporarily include:

-          Removal of the geographic limitations for medical telehealth services so they again can be furnished nationwide. 

-          Restoration of physical therapy, occupational therapy, and speech-language pathology providers as eligible to furnish telehealth services. 

-          Restoration of a delay in Medicare in-person requirement for mental health services furnished through telehealth or audio-only telecommunications technology.  

-          Restoration of the use of telehealth to conduct face-to-face encounters for hospice recertification purposes. 

Other priorities are the temporary and retroactive restoration of the Work Geographic Index Floor, which is the nationwide 1.0 payment floor multiplier for the work component of Medicare Part B services paid under the Physician Fee Schedule. This is effective Oct. 1, 2025, through Jan. 30, 2026. 

An extension of funding for quality measure endorsement, input, and selection is also in the package. And, finally, on sequestration, the legislation prevents the triggering of statutory 4 percent PAYGO sequestration cuts to Medicare, AHCA/NCAL said. 

Surveys Back to Normal

While the shutdown did not affect Medicare and Medicaid reimbursement payments, most other regular activities of the Dept. of Health and Human Services and its Centers for Medicare and Medicaid Services did not occur. That will all change now.

“With most government staff returning to their positions, agencies will begin processing the backlog of work created during the shutdown. This includes, but is not limited to, impacts on the following activities: survey activities including recognition of surveys conducted during the shutdown; deferred survey components; deficiency findings and enforcement actions; the resumption of normal corrective actions; Medicare certification for new facilities, including initial surveys; Immediate Jeopardy special situations; and updates to the Five-Star Quality Rating System. 

HUD financing was another area slowed by the shutdown. In mid-October, Erik Howard, president and COO of Capital Funding Bancorp, Inc. and president, CFG Bank, told Park Place Live that the shutdown had stopped work on new loans, but not the ability to apply. The full functioning of the HUD loan program will now restart in the coming days.

If you have comments or questions, contact Patrick Connole at pconnole@parkplacelive.com.