Closing the Quarter, Preparing for What Comes Next
by Jamie Daugherty, Executive Director

As September draws to a close, there is value in taking a moment to look at what the past three months have taught us. For home-based care leaders, that can be difficult. There is usually another staffing concern, regulatory update, or operational decision waiting for our attention.

But a quarterly review does not need to become another major project. It should help us answer a few useful questions: What has changed? What have we learned? And what deserves our attention before the year ends?

Throughout this quarter, our weekly conversations have covered federal policy, advocacy, workforce strategies, technology, survey readiness, consolidation, and strategic planning. Those topics connect in very practical ways. Each affects our ability to support employees, sustain services, and care for people in their homes.

What we should carry forward

One recurring theme has been the importance of turning information into action. Reading a proposed rule, attending a member call, or discussing a workforce challenge is a starting point. The value comes when that information helps us make a better decision.

Our discussion of artificial intelligence and innovation raised questions about where technology can meaningfully reduce work. Our workforce discussion brought attention to the everyday conditions that help people stay. Survey readiness reminded us that reliable processes depend on consistent follow-through. And last week’s strategic planning topic challenged us to choose priorities we can realistically support.

Taken together, those conversations offer a useful way to review the quarter: What actually improved because of something we learned?

Perhaps an agency clarified a confusing process, strengthened orientation, addressed a recurring documentation problem, or reconsidered a project that was consuming more time than it justified. Those changes matter, even when they do not come with a major announcement.

Q4 brings specific policy decisions and deadlines

For hospice providers, October brings immediate implementation work. The FY 2027 hospice final rule includes updated payment provisions and changes to election statement addendum requirements for elections beginning October 1, 2026. Agencies should confirm that their admission materials, workflows, and staff education reflect the final requirements. This deserves attention beyond the billing department; the people explaining the benefit to patients and families need to understand the changes. FY 2027 hospice final rule

For home health agencies, the CY 2027 proposed rule provides a basis for planning, while final policy decisions still need to be incorporated when issued. The proposal addresses payment methodology, case-mix recalibration, quality reporting, and Medicare enrollment provisions. For Q4 planning, agencies should identify which assumptions in their 2027 budgets or operations may need revision once the final rule is available. CMS proposed rule fact sheet

Hospice enrollment policy also belongs on the watch list. CMS imposed a six-month nationwide moratorium on new Medicare hospice enrollment effective May 13, 2026. Its initial period reaches into November, making further CMS announcements relevant to organizations considering new hospice enrollment. Plans should allow for the possibility of an extension rather than assume enrollment will automatically reopen. Federal moratorium notice

These developments affect different providers in different ways. Across home health, hospice, in-home care, and the other services represented by OAHC, the practical task is to identify what applies, assign responsibility, and make sure implementation reaches the people doing the work.

Make the quarter-end review useful

Before adding goals for the next three months, I would encourage leaders to ask their teams three questions:

• What became more difficult this quarter? Look for recurring delays, staffing gaps, confusing processes, or barriers to accepting and serving patients.
• What worked well enough to repeat? Identify the changes that helped employees, improved communication, or made care more reliable.
• What remains unfinished—and still deserves to be finished? Some items need a clear owner and deadline. Others may no longer warrant the same priority.

The answers do not require a lengthy presentation. A focused conversation with the people closest to the work may be more useful than another report.

It is also worth looking beyond agency totals. If referrals are being declined, why? If overtime is rising, where? If employees are leaving, what patterns are emerging? The purpose is to understand what the numbers mean for the people providing and receiving care.

Choose a manageable finish to the year

The final quarter can become crowded quickly. Budget preparation, holidays, staff time off, regulatory implementation, and ongoing patient care all compete for attention.

My encouragement is to choose a small number of priorities that will make a meaningful difference by December. That might mean completing a required workflow change, improving coverage plans, resolving a persistent quality concern, or preparing a realistic implementation plan for a 2027 initiative.

Each priority should have someone responsible for moving it forward, a clear definition of completion, and enough time or resources to succeed. If everything is a priority, our teams are left to decide which expectations they can reasonably meet.

This is also a good time to ask what we can simplify. A duplicate report, an unnecessary approval step, or an outdated process can consume time that employees need elsewhere.

Keep Oregon’s experience part of the conversation

As we prepare for Q4, I encourage members to continue sharing what they are seeing with OAHC. Specific examples help explain how policy and operational pressures affect access to care: a community that is difficult to staff, a service delay, or a requirement that creates an unexpected obstacle.

Those experiences give substance to advocacy and help identify concerns that extend beyond one organization. Providers may differ in size, ownership, and structure, while sharing an interest in dependable access to quality care.

We still have time to make useful progress before the year ends. The strongest finish will come from understanding what this quarter has shown us, making deliberate choices, and giving our teams a clear sense of what matters next.