The incoming year 2026 is fast becoming a seismic checkpoint for home care agencies — not just in terms of demand or reimbursement, but regulation.
Consider this: The CMS projects a 6.4% reduction in aggregate payments to home health providers next year — approximately a $1.135 billion drop. – cms.gov
At the same time, a growing chorus of legal and regulatory experts warn that everyday payroll mis-steps, mis-classification of staff, travel-time oversights, and weak policy documentation aren’t remote hazards — they’re immediate liabilities.
Over 11 speakers—from attorneys to policy analysts, from tech-governance specialists to value-based-care futurists—lay out a clear message: top home care compliance experts are signalling that home care compliance is becoming strategic.
From real-time audit toolkits to outcome-driven transparency; from caregiver training in multiple languages to cross-functional governance of AI-powered care—this isn’t just about staying out of trouble. It’s about enabling growth, mastering change, and positioning your agency as regulation-ready.
What follows is a deep dive into the perspectives shaping this tidal shift — the home care regulatory changes roadmap for agencies who want to lead rather than simply survive.
Attorney & Founder, Legally Nanny
He emphasizes about regulatory shifts in home care, especially in California – Bob King warns that home care agencies are increasingly exposed to major wage-and-hour regulatory risk—everything from everyday mis-steps in pay calculation to substantial class & PAGA exposures.
He highlights key trap areas: on-call pay, travel time, missed rest/meal breaks, rounding abuses, and mis-classification of employees versus contractors.
2026 Compliance Takeaway:
Bob urges agencies to implement a real-time audit toolkit (time-keeping/bonuses/travel pay), standardize documentation (handbooks, classifications), and respond quickly if a regulator or complainant raises issues—to avoid claims that balloon into six-or seven-figure liability.
Wage-and-hour Litigator and Counselor, Littler Mendelson
Vaughn stresses that wage-and-hour compliance will become a central regulatory pressure point in 2026. Home care agencies must align not just with the federal Fair Labor Standards Act but with each state’s own laws—where state rules are more protective, they apply.
He flags rising litigation risks around travel time, on-call pay, changing weekly pay rates, incorrect overtime calculation and misclassification of caregivers (especially third-party agency-employed ones).
Get proper documentation, conduct periodic audits, train supervisors, & treat wage–hour compliance as a strategic protection rather than a ticking time-bomb.
Chair, Home Health & Home Care Practice Group, Pierson Ferdinand LLP
Asaad emphasises legal-risk regulation: in 2026, agencies will face more scrutiny of terminations, classification, arbitration, and wage/pay practices. He warns that ambiguous policies, inconsistent enforcement, mis-classification (employee vs contractor,) and weak documentation can trigger costly claims.
He sees arbitration agreements becoming a strategic regulatory tool to avoid class/collective actions—especially in wage-hour matters. Essentially: strong internal policy architecture + ongoing audit = risk-reduction in a tougher regulatory environment.
Managing Partner, Cypress HomeCare Solutions
He frames the regulatory shifts in home care for 2026 as part of the broader transformation: digital oversight, home-based care expansion, outcome-based regulation.
Agencies must comply with:
Roth suggests regulation will increasingly favour agencies that deliver outcomes, integrate tech, demonstrate measurable client satisfaction, and integrate with broader healthcare ecosystems. The regulatory story in 2026 is “home care meets healthcare” — not siloed.
Senior Director, Best Practices and Compliance, Home Care Association of Florida
Heid points out state-specific regulatory shifts, for example in Florida, that will cascade into 2026: mandatory outcome assessment changes (e.g., expanding OASIS in home care), rising affiliation with Medicare Advantage, and the election-driven possibility of new home care benefits.
She advises agencies to prepare early, adopt AI/tech to manage compliance burdens, and build payer-partnership agility. She foresees that the regulatory environment in 2026 will demand more tech-enabled compliance and operational readiness—especially in states under pressure.
President and CEO, Transcend Strategy Group
Johnston speaks to leadership-and regulation-linked shifts: in 2026, regulatory compliance will not just mean “meeting minimum requirements” but “leveraging regulation as advantage.” With tech and AI entering home care, leaders must adapt to regulatory regimes around data, AI-enabled care, cross-functional oversight, and outcome transparency.
She says agencies will face deeper regulation of tech use (privacy, security, performance) and will need to adopt structured governance, cross-team collaboration, and strategic adaptation. Regulation becomes a growth enabler—not just a burden.
VP, Compliance and Education, Showd.me
Emily focuses on caregiver safety & compliance, which she says will be increasingly regulated in 2026. Home visits in uncontrolled environments mean agencies must move from check-list compliance to continuous risk-management loops (pre-visit screens, dynamic red/yellow/green flags, caregiver empowerment to walk away).
She notes training will need to be multilingual, mobile-first, adaptive and competency-based, and agencies will face more audit-ready demands for reporting outcome metrics (not just completion).
Compliance will no longer be a back-office cost—it will drive home care workforce retention and quality of care.
Partner, Sirona Strategies
Drobac points to a confluence of regulatory shifts shaping home care in 2026: Medicaid reimbursement pressures (provider tax freezes, work-requirements), which will squeeze funding; the growth of value-based care models (e.g., ACO REACH) challenging traditional volume-based home care regimes; and accelerating digital health/telehealth regulations that haven’t kept pace.
She urges agencies to engage in policy feedback, diversify payer-sources, partner early with value-based models, and plan for increased fraud-prevention and program-integrity scrutiny as regulation tightens.
Managing Director, The Home Care CPAs
Although focused on finance, Charumbira flags regulatory-driven shifts that will impact 2026: as reimbursement tightens, agencies will need to integrate compliance with cost-control and revenue-cycle practices.
Hidden cash leaks (short visits with high travel time) create regulatory and financial exposure.
She says agencies will need stronger internal metrics frameworks (billing vs payroll vs hours delivered) to respond to regulators who increasingly expect transparency, tying operational performance to regulatory reporting.
Financial and regulatory strategies are converging.
President & CEO | Hurricane Marketing Enterprises
Weiss signals that with government funding being cut or repurposed (Medicaid/VA changes), home care regulation in 2026 will pivot on the agency’s ability to align with new funding models, partner across payers, and stay ahead of shifting rules.
He implies agencies will face tighter regulatory oversight of funding sources, compliance with evolving payer rules, and the need to use operations software (like CareSmartz360) as part of their regulatory defence and growth stack. Compliance + growth = survival.
Certified Senior Advisor (CSA)® Compliance Officer, Society of Certified Senior Advisors
Witherspoon’s perspective—from the senior-advisor realm—underscores emerging regulatory expectations around ethical governance, credentialing, and accountability in home care and advisory services.
In 2026, agencies working with seniors will face tighter standards for transparency, continuing education, background screening, disclosures and complaint mechanisms.
She argues that reputational regulation (ethics codes, certifications) will sit alongside statutory compliance—and agencies who ignore it risk ballooning reputational and regulatory costs.
If 2025 leaves one clear takeaway, it’s that regulation in home care has graduated from “checkbox compliance” to strategic momentum. Whether it’s wage-hour readiness, classification clarity, travel-time accuracy, digital outcome tracking, or tech governance—agencies that treat these areas as a risk will be reactive; those that treat them as a growth lever will be proactive.
With tighter reimbursement, more regulatory scrutiny, and evolving expectations, smart agencies will embed policy, tech, and operations into a unified engine.
Use these expert perspectives as your 2026 blueprint:
Start now with home care compliance and home care agency regulations.
Download Blog
Our users reported 95% customer satisfaction in 2024. Schedule a personal walkthrough to see CareSmartz360, home care software in action.
AI Hub
