Nursing Home Ownership Transparency: CMS's New Rule Promises Accountability, But Is It Enough for Seniors and Families?

In a long-overdue move toward accountability, the Centers for Medicare & Medicaid Services (CMS) is ramping up requirements for nursing homes to disclose detailed ownership information, a step experts say could lead to more targeted audits and enforcement actions against facilities that deliver substandard care. The rule requires skilled nursing facilities (SNFs) to submit comprehensive ownership data through the Medicare Provider Enrollment, Chain, and Ownership System (PECOS). Starting January 1, 2026, providers must identify not just direct owners but also influential business associates and related parties, with this information feeding into public tools like Care Compare by summer 2026. For readers of the Aging-in-Place Planning and Elderlaw Blog, this development is a double-edged sword: It holds promise for weeding out problematic operators, but its actual impact on quality and consumer choice remains uncertain amid implementation hurdles and historical enforcement gaps. We've addressed the topics of ownership and for-profit/non-profit many times,  but there is no more effective planning than proactive prevention.  In the worst cases, we offer readers tips, tricks, strategies, and tools to evaluate risk factors such as ownership and select the 'best' of available care options. This article introduces the new rule's key elements, evaluates whether it's a meaningful reform or mere window dressing, and offers strategies for seniors and families to leverage it while steering toward the safer shores of aging in place.

The Rule in a Nutshell: What CMS Is Requiring and Why Now
The CMS ownership transparency rule, finalized in late 2024 after years of delays, requires nursing homes participating in Medicare or Medicaid to update their enrollment forms (CMS-855A) with granular details on ownership structures. This includes:

• Direct and Indirect Owners: Anyone with a 5% or more ownership stake, including private equity firms or REITs.

• Related Parties and Associates: Managers, board members, and entities with financial influence, even if not formal owners.

• Revalidation Process: Facilities must resubmit data off-cycle, with the first wave due January 1, 2026, and ongoing updates every 30 days for changes.

The goal? Shine a light on opaque chains that operate hundreds of homes, where ownership complexity has shielded poor performance. CMS will integrate this data into Care Compare, allowing consumers to see links between owners and quality ratings. The rule stems from post-COVID scrutiny, in which OIG audits revealed that 24% of facilities failed staffing standards amid ownership shifts.Meaningful Reform or Window Dressing? A Critical Look
On paper, the rule is a win for transparency.  Even if the federal government gridlocks or slows the pace of reform to a standstill, states appear to be stepping in "just in case," considering bills and regulations that force transparent ownership, with Maine and Oregon leading the way. 
But critically, it's window dressing without teeth: Implementation delays (from August 2024 to January 2026) and vague "influential associate" definitions burden providers without guaranteeing action. For seniors considering facilities, it may flag risks, but it's unlikely to prevent falls or ensure sufficient staffing levels. Besides, the industry's history is a pattern of short-term improvement after regulators shine a light on a facility's substandard quality, followed soon afterwards by a return to the same substandard quality that first caught regulators' attention.  Ultimately, it's meaningful for informed choice but insufficient for systemic change, reinforcing why aging in place outshines institutional care.Conclusion: Transparency as a Tool, Not a Panacea
CMS's ownership rule is a step toward light in dark corners, but families deserve more. While this article has provided a thorough overview of the developments and strategies, it is by no means comprehensive. The landscape evolves rapidly. Readers must remain vigilant. By combining awareness with proactive planning, families can safeguard independence and thrive as they age in place. For support, consult a professional.  Your security depends on proactive engagement.

Walking Your Way to a Sharper Mind and Safer Steps: New Studies Highlight the Power of Daily Movement for Dementia and Fall Prevention

A brisk walk around the block or a leisurely stroll through your neighborhood isn't just a breath of fresh air; it's a powerful prescription for brain health and stability as you age. Two new studies, both published in October, underscore how simple, everyday walking can slash the risk of dementia, falls, and other age-related threats, offering a low-effort win for seniors committed to aging in place. The first, led by University of Sydney researchers and reported by McKnight's Senior Living, analyzed data from 57 studies involving over 226,000 adults worldwide, finding that 7,000 daily steps (about 3.5 miles) correlates with a 38% lower dementia risk, 28% fewer falls, and 47% reduced cardiovascular death. The second, from the same team and also covered by McKnight's, zoomed in on brisk walking, showing it cuts all-cause mortality by 24% and cardiac risks by 21% in older adults. Whether you are a person providing care for another seeking resilience, or a person seeking to protect your own independence and reduce the chance of needing care from others, walking is an indispensable tool.
For readers of the Aging-in-Place Planning and Elderlaw Blog, this isn't abstract science; it's validation of the everyday choices we've championed in "Simple Lifestyle Choices: Proven Steps to Reduce Dementia Risk and Stay Home Longer" and "Frequent Use of Technology Slows Cognitive Decline: Empowering Seniors to Thrive in a Digital Age." As we explored in "Rethinking Elder Abuse Strategies: How Prophylactic Planning Can Safeguard Autonomy and Aging in Place," small habits like walking pair beautifully with legal tools like advance directives, and supported decision-making (SDM) agreements to keep you independent and at home. This article unpacks the studies' findings, why walking works its magic, and practical ways to lace up for a longer, steadier life. We even consider solutions for those who are walking impaired or disabled. The Studies: A Deep Dive into Steps, Speed, and Senior Health
The University of Sydney's research, published in The Lancet Public Health and British Journal of Sports Medicine, pooled data from 57 studies spanning 2014-2025 and involving adults over 40 from 10+ countries, including the U.S. They focused on "free-living" steps, everyday movement, not gym sessions, using accelerometers for precision.

• 7,000 Steps a Day: Your Dementia and Fall Shield: The first study found 7,000 steps (roughly 60 minutes of moderate walking) slashes dementia risk by 38%, falls by 28%, and all-cause mortality by 47% compared to 2,000 steps (sedentary baseline). Even modest bumps (2,000 to 4,000 steps) yield big gains: 14% lower risk of diabetes and 22% fewer depressive symptoms. Lead researcher Melody Ding, PhD, noted, "Aiming for 7,000 steps is a realistic goal... even small increases from 2,000 to 4,000 steps a day are associated with significant health gain."

• Brisk Walking: The Speed Boost for Heart and Longevity: The second study, on 78,500 adults, showed brisk walking (3 mph+ or 100 steps/minute) reduces mortality by 24%, cardiac disease by 21%, and cancer risk by 18% versus slower paces. Co-author Katherine Owen, PhD, added, "For people already active, 10,000 steps is great, but beyond 7,000, the extra benefits for most outcomes were modest; pace matters more than sheer volume."

These findings align with a 2024 Alzheimer's & Dementia review, linking movement to 40% of modifiable dementia risks, and emphasize that "free-living" steps fit seamlessly into daily routines.Why Walking Works: A Simple Explanation of the Science
Think of your brain and body as a garden: Sedentary life is drought, letting weeds like amyloid plaques and inflammation overrun. Walking waters it, boosting blood flow, releasing BDNF (a "fertilizer" for new neurons), and cutting cortisol (a stress hormone that shrinks the hippocampus). The studies show it combats dementia by enhancing neuroplasticity (38% risk drop), prevents falls by strengthening muscles and balance (28% reduction), and wards off heart disease by improving circulation (47% lower death rate). Brisk pace amplifies the benefits: faster steps spike endorphins and oxygen delivery, like revving your engine for better mileage.
For aging in place, it's gold: walking keeps you mobile, and monitoring progress with a $30 pedometer or a watch app creates a routine that uses cognitive-preserving technology, reducing the risk of nursing home placement due to frailty. And as our "Simple Lifestyle Choices" article noted, combining it with nutrition slashes dementia 40%: no gym needed, just your neighborhood.Calling Back: Lifestyle Choices and Tech as Your Daily AlliesThese studies echo our "Simple Lifestyle Choices" piece, which highlighted movement as a cornerstone of risk reduction alongside sleep and diet. Walking's dementia shield pairs nicely with the drop in cognitive decline reported in "Frequent Use of Technology Slows Cognitive Decline," where apps like Lumosity or Echo reminders keep your mind sharp. Together, they form a free, home-based toolkit: monitor steps on a smartwatch, join virtual walking groups, and use SDM agreements to enlist supporters for motivation.Practical Steps: Lace Up for a Longer, Steadier Life

• Start Small, Build Steady: Aim for 2,000-4,000 steps (10-20 minutes) if sedentary, add 1,000 weekly. Use a free app like Google Fit.

• Brisk It Up: Swing arms, pump legs, and increase pace; 100 steps/minute feels like a purposeful stroll. 

• Make It Yours: Walk with a podcast, a friend, or while listening to a book on audible.

• Make it Safe:  Choose a safe place (your backyard) and if you walk in public, take security measures like walking with a group and using bone conduction headphones for your phone, music, or listening pleasure (helping you remain alert to your surroundings). 

• Legal Tie-In: Add to directives or SDM Agreements: "Fund and encourage daily walking or physical activity and monitoring of steps and heart rate."

• Monitor Wins: Log steps in a journal or app; celebrate with a favorite treat; small victories compound.  Consider a virtual "challenge" walk or journey that utilizes your phone to track progress, and rewards completion with medals or other prizes.  These range from modest to less than modest in cost, depending on the reward and the experience. 

Moving with Purpose: Benefits for Every Body and Every Mind

If walking isn’t possible right now, whether you use a wheelchair, a walker, or face other mobility challenges, know this: movement of any kind still sharpens your mind and protects your independence. Research shows that even seated or assisted motion, like gentle arm circles, leg lifts while seated, wheelchair propulsion, or guided range-of-motion exercises, delivers the same or similar cognitive and emotional rewards as walking.  Rhythmic, intentional movement increases blood flow, just as a brisk stroll does. Any repetitive motion triggers mood-altering endorphins and serotonin, cutting depression risk.  Rolling to the porch, joining a seated exercise class, or wheeling through the garden keeps you engaged with neighbors and nature, proven to lower loneliness as effectively as a daily walk.

Adaptive programs like Chair Yoga, Seated Zumba, Wheelchair Tai Chi, and Arm Ergometer sessions (often free through senior centers or Medicare Advantage Plans) are designed for you. Many communities now offer accessible garden paths and wheel-friendly walking groups so no one is left behind. Your movement matters. Whether it’s a stroll with a walker, a push of the wheels, or a gentle stretch from your favorite chair, every motion is a victory for your brain, your spirit, and your right to age in place on your own terms.   

Conclusion: Steps to a Stronger Tomorrow
Walking's simple power, translating to less dementia and fewer falls, proves home is where health thrives. While this article has provided a thorough overview of the studies and their implications, it is by no means comprehensive. The landscape evolves rapidly. Readers should remain vigilant. Combining awareness with lifestyle choices and proactive planning can safeguard independence while aging in place. For support, consult professionals—your security depends on proactive engagement..  Put "You" back in your planning. 

Sources: J. Roszkowski, Brisk walking may decrease mortality, reduce cardiac and other health risks, study finds, McKnight's Senior Living (July 29, 2025), Walking can reduce risk of dementia, falls and other health risks, new study finds,  McKnight's Senior Living (July 25, 2025).