Is contract therapy still delivering value in the PDPM Medicaid era — or just staffing at a premium? Skilled nursing leaders are rethinking their rehab strategy. This guide outlines how to evaluate contract vs in-house therapy, assess oversight and compliance risks, and determine which model truly protects margins and outcomes in 2026.

The therapy model that once drove outcomes and reimbursement in senior living no longer exists. PDPM and PDPM Medicaid have fundamentally altered incentives, leaving many operators with declining minutes, misaligned contracts, and growing risk they may not even see yet.

The 2026 Home Health Final Rule is officially here—and while much of the attention has focused on reimbursement adjustments, one of the most consequential shifts is happening elsewhere. CMS is dramatically increasing its focus on fraud, compliance, and enforcement. For many home health agencies, especially smaller or single-location providers, this

The 2026 Final Rule isn’t out yet, but agencies can’t afford to wait. This breaks down the deeper operational and strategic shifts home health leaders should be making now—including technology upgrades, organizational restructuring, and the new VBP measures that will reshape reimbursement. If your agency plans to stay competitive in 2026, this is where the work begins.

As states shifted to PDPM Medicaid, therapy-driven strategies no longer determine success. Explores how specialty physicians in cardiology, nephrology, and pulmonology help providers capture acuity, strengthen documentation, and improve case mix index accuracy under the new reimbursement model.