This article is part of the 2025 Mid-Year Housing Industry Update. Click here to read the full newsletter.
The senior housing and long-term care sector is navigating a wave of legal, regulatory, and funding changes in 2025. These developments carry significant implications for operators, developers, and housing professionals serving aging populations. At the LeadingAge Oregon Annual Conference, Ballard Spahr attorneys Gabriela Sanchez and Jeff Duncan shared key legal and regulatory developments shaping the future of the senior housing sector. The highlights below reflect insights from their session.
National Updates
SNF Admission Agreement Restrictions: The Centers for Medicare & Medicaid Services (CMS) has clarified that admission agreements at skilled nursing facilities (SNFs) may not include third-party payment guarantees. Even indirect language that could imply personal financial liability for a resident's representative is considered noncompliant.
CMS Staffing Rule Challenges: The CMS staffing mandate (requiring 3.48 nursing hours per resident per day and 24/7 RN coverage) was vacated by a Texas federal court on the grounds that it exceeded congressional authority. However, in a separate case, an Iowa court declined to block the rule, indicating ongoing legal uncertainty. The rule's future remains in flux and merits close monitoring.
SNF Revalidations Deadline: All SNFs participating in Medicare or Medicaid must meet new ownership and control disclosure requirements by August 1, 2025. As of May, only about 20% of facilities had completed the process, signaling the need for urgent compliance efforts.
Affordable Housing Funding Uncertainty: The current federal administration has proposed substantial cuts to HUD programs, including a 44% reduction in overall funding and reduced support for fair housing initiatives and staffing. While similar proposals in the past were blocked by Congress, the renewed uncertainty has created planning challenges for affordable housing providers.
Oregon-Specific Updates
CBC Facility Oversight: Oregon's Department of Human Services (ODHS) has increased enforcement under Home- and Community-Based Services privacy standards, including requirements for bathroom locks and updated evacuation protocols. In some cases, facilities report being cited for violations before investigations are complete. ODHS has also begun offering "Letters of Agreement" in lieu of formal license conditions (enforceable but not subject to hearing or appeal).
HB 3838: This legislation would establish a new board with broad powers to set minimum pay, benefits, and training requirements for community-based care workers. It also introduces a private right of action for violations, which could increase compliance risks for providers.
SB 228: This bill affirms the right of memory care residents and their families to form independent family councils. Facilities would be required to provide space and a liaison, and to respond to council concerns in a timely manner.
SB 739: ODHS would be required to initiate an on-site investigation within 24 hours (or the next business day) for complaints involving death or serious harm. The bill includes additional procedural steps, such as notifying residents and designated contacts in the event of substantiated findings and clarifying steps for facilities to demonstrate compliance.
This evolving landscape reflects both heightened federal scrutiny and increased state-level regulation. Senior housing stakeholders, especially those operating across jurisdictions, should keep a close eye on further developments in staffing, compliance, and funding policy throughout the remainder of 2025.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
