Number One Hospital: National Daily Hospital Executive Briefing Thursday 08/28/25 Vol. 1

#HospitalOps #CMS #HealthcareWorkforce #PriceTransparency #CaliforniaSB525 #EDBoarding #Noncompetes #HospitalLeader #NursingExecutive #NursingLeader #EmergencyPhysician #Nursing #Hospitals

Forward

The pace of change in healthcare can feel overwhelming, but clarity comes from stepping back and distilling what matters most. This daily update highlights a handful of new findings and practical innovations that directly affect hospital operations, patient care, and workforce planning. Each section includes original sources so you can dig deeper as needed. My aim is to provide you with a clear, concise resource you can rely on — one that saves you time and sparks ideas for action.

Daily Hospital Ops Update — Thu, Aug 28, 2025 (08:30 PT)

Fast, exec-ready brief across today’s CMS rules, price transparency, CA SB 525, workforce, ED flow, referral leakage, and hiring regs—each with primary sources linked for quick action.

1) CMS Payment Rules (IPPS / OPPS‑ASC / PFS)

FY 2026 IPPS Final Rule (acute + LTCH) — final published Aug 4; CMS hub live with rule text, tables, and impact files. Priorities: payment updates, measure changes (IQR modifications/removals), and LTCH updates.
Link: CMS IPPS Final hub → https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/fy-2026-ipps-final-rule-home-page. Centers for Medicare & Medicaid Services
Federal Register (display PDF): https://public-inspection.federalregister.gov/2025-14681.pdf. Federal Register Public Inspection
CY 2026 OPPS/ASC Proposed Rule — comment window open (CMS says comments due Sept 15). Review outpatient rate updates, PHP/IOP policies, and transparency items.
Link: CMS Fact Sheet → https://www.cms.gov/newsroom/fact-sheets/calendar-year-2026-hospital-outpatient-prospective-payment-system-opps-and-ambulatory-surgical. Centers for Medicare & Medicaid Services
CMS OPPS page (deadline call‑out) → https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient. Centers for Medicare & Medicaid Services
CY 2026 Physician Fee Schedule (PFS) Proposed Rule (+ QPP/MSSP changes) — comments due Sept 12. Key items: conversion factor updates, QPP policy proposals, and MSSP adjustments (e.g., BASIC track one‑sided risk max 5 years starting with 2027 agreements; quality/assignment tweaks).
PFS Fact Sheet → https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-pfs-proposed-rule-cms-1832-p. Centers for Medicare & Medicaid Services
Docket page (CMS‑1832‑P) → https://www.cms.gov/medicare/payment/fee-schedules/physician/federal-regulation-notices/cms-1832-p. Centers for Medicare & Medicaid Services
MSSP/ACO Fact Sheet (within PFS rule) → https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-proposed-rule-cms-1832-p-medicare-shared. Centers for Medicare & Medicaid Services

2) QPP / MSSP ACO (what to scan this week)

QPP resources for CY 2026 proposals — compare policy tables and submission details.
Link: QPP Resource Library → https://qpp.cms.gov/resources/resource-library. qpp.cms.gov

3) Hospital Price Transparency (MRF compliance & enforcement)

CMS HPT RFI on accuracy/completeness (closed July 21) + guidance on encoding dollar amounts in MRFs; ongoing enforcement dataset updated July 23, 2025.
Overview page → https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency. Centers for Medicare & Medicaid Services
Guidance (encode dollar amounts) → https://www.cms.gov/files/document/updated-hpt-guidance-encoding-allowed-amounts.pdf. Centers for Medicare & Medicaid Services
Enforcement dashboard → https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-price-transparency-enforcement-activities-and-outcomes. CMS Data

4) California SB 525 Healthcare Minimum Wage (today’s operational takeaways)

DIR FAQ + posted schedules — confirm which tier you’re in and the July 1, 2025 step‑ups for covered employers; mind exempt‑salary thresholds tied to health‑care minimum wage.
DIR FAQ → https://www.dir.ca.gov/dlse/Health-Care-Worker-Minimum-Wage-FAQ.htm. CalDIR
Practical briefing on July 1, 2025 increases → https://www.shrm.org/topics-tools/employment-law-compliance/california-health-care-minimum-wage-increase-effective-july. SHRM
Note: SB 828 (trailer bill) adjusted certain effective dates (1‑month delay language). Text tracker → https://legiscan.com/CA/text/SB828/id/3000775. LegiScan

5) Workforce / Recruitment / Retention

BLS: Health care added +55,000 jobs in July 2025 (Hospitals +16k; Ambulatory +34k).
BLS News Release → https://www.bls.gov/news.release/empsit.nr0.htm. Bureau of Labor Statistics
AHA Workforce Scan (2025) — tech‑enabled staffing, upskilling, flexible models.
AHA page → https://www.aha.org/aha-workforce-scan. American Hospital Association

6) ED Boarding & Patient Access (ED/OR/LOS)

Evidence update: JAMA Network Open analysis of CMS’s proposed Emergency Care Capacity & Quality (ECCQ) framework shows worsening access: prolonged ED LOS (>8h) rose from 7.8% → 13.9% (2017–2024); inpatient boarding (>4h) 2.6% → 6.2%.
Article → https://pmc.ncbi.nlm.nih.gov/articles/PMC11992599/. PMC
Emergency preparedness/OIG — July 29 report urges CMS to strengthen AO standards/training (implications for surge/boarding plans).
HHS‑OIG audit → https://oig.hhs.gov/reports/all/2025/cms-should-take-additional-actions-to-help-hospitals-prepare-for-a-future-emerging-infectious-disease-outbreak/. Office of Inspector General