What we're reading. What it means for your agency.
CMS rule changes, OASIS-E2 transition issues, OIG enforcement, EVV state updates,
and Carelytic product news — translated into operational implications for home health
agency leadership.
April 1 wasn't just an OASIS form change. It was the end of the iQIES manual-entry safety net. Field reports show clinicians defaulting to E1 logic on the new items — and the rejections that creates.
OASIS-E2 took effect April 1. CMS shut down the iQIES manual-entry interface the same day. Agencies that hand-keyed OASIS into the legacy UI as a fallback no longer have one — every assessment must come from a certified EMR or data submission pathway.
Michigan went hard-edit January 1. Missouri begins April. Illinois cuts over to HHAeXchange in March. If your EVV records aren't in spec, the claims that used to bounce as warnings now don't pay.
Three states are moving EVV from soft-warning to claim-denying enforcement in Q1 2026. Multi-state agencies need state-by-state payer-rule checks in the EVV pipeline before April — otherwise A/R ages on visits that already happened.
The DOJ-mandated divestitures from UnitedHealth's $3.3B Amedisys deal hit the market in late 2025. For independent agencies, that's the largest concentration of mid-market acquisition targets in a decade — and the largest competitive threat in your service area, depending on the market.
The UnitedHealth–Amedisys merger closed August 14 with a court-ordered 164-location divestiture. As those locations come to market, mid-market HHAs face two questions simultaneously: are any of them in your acquisition lane, and how aggressive will Optum be in your existing markets?
RN turnover at 17.6%. LPN shortage at 20%. Home-care worker turnover projected at 64% by 2030. The 2026 NSI report and HRSA workforce projections converge on one conclusion: clinical workforce is now the binding constraint on every mid-market HHA's growth.
The 2026 NSI National Health Care Retention Report and updated HRSA workforce projections both landed in the same quarter. The headline numbers: RN turnover 17.6%, LPN shortage 20%, ~40% of RNs say they'll leave the field by 2027–29, home-care worker turnover projected at 64% by 2030.
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