Happy New Year Missouri Members!  

A new year always brings fresh energy and optimism but is never totally “out with the old and in with the new”.  Our field’s challenges and opportunities carry over.  

As the General Assembly convenes, carryover is visible in pre-filed bills by Missouri legislators.  Even before Session commences in earnest next week, we see perennial and fresh proposals to expand APRN practice rights – either by continuing to whack away at restrictions or to do away with them altogether.  We also see new and repeat ideas for Certificate of Need process reform – some welcome; some not.  And legislators have re-introduced past proposals or offered new ones to protect aging services consumers and residents from clinical and commercial abuse.  LeadingAge MO will express our point of view on different bills that would:

• Regulate senior living and healthcare referral agencies
• Add penalties for violating rules governing compassionate care visits, and
• Substantially expand regulation and penalties for adult abuse and neglect  

In addition, of importance to aging services, the State faces daunting fiscal challenges – a $1 billion budget hole occasioned by tax cuts, expired COVID support, and reduced federal matching.  In a tough budget environment, LeadingAge Missouri and its members must work hard to preserve acceptable levels of  Medicaid reimbursement for facilities and home healthcare.  We invite you to help on “Advocacy Day at the Capitol” February 18.  Sign up here to add your persuasive voice and expertise to advance our field’s public policy agenda.  We will provide all you need to be effective, and we think you’ll enjoy the process and collegial fellowship!  

Also mark your new calendars for April 22, to join colleagues in Washington DC to advocate for important federal policies.  LeadingAge’s Leadership Summit, April 20-22, concludes with “lobby day” when Missouri members educate our congressional delegation on federal policies that support older Missourians and the organizations that serve them.

Members, as 2026 begins, our field is entering a transformational era marked by a historic demographic shift (the oldest Baby Boomers are now turning 80!) and a dramatic surge in innovation and experimentation. The “Silver Tsunami” is driving national occupancy rates toward record highs above 90%, fueling a landscape where demand outpaces the supply of new units. While this high demand offers growth potential, aging services providers face critical headwinds, including persistent labor shortages (exacerbated by immigration policies!), high interest rates, and elevated construction costs that continue to slow new development. To thrive in 2026 and future years, operators will increasingly experiment with more sophisticated models integrating smart-room technology and AI-driven health monitoring and personalized wellness to meet the heightened expectations of increasingly more tech-savvy older adults.

But 2026 and future years are not without carryover challenges.  There are workforce shortages – especially for nurses and caregivers – which drive provider labor costs and force creativity in pursing and financing staff attraction and retention strategies.  Adding insult to injury, in 2026 Missouri providers must absorb a minimum wage increase to $15 from $13.75.  

Further, our field will continue to be challenged by development and capital constraints. High interest rates and capital scarcity have pushed new construction to the lowest levels since 2012, creating a projected shortfall of nearly 600,000 units by 2030.  In addition, the elusive – but critical – middle market faces development and affordability challenges.  As rental rates stabilize with annual growth above 4%, providing quality care for middle-income seniors, who lack substantial retirement savings, is a growing socioeconomic hurdle.

Finally, our field’s biggest 2025 federal policy victory – rolling back untenable nursing home staffing mandates – opens the door for Missouri action.  Staffing ratio mandate legislation did not gain traction last year, and has not yet been introduced for 2026 consideration, but proposals are expected.  Regulatory burden will always be a policy challenge for our field.  

Despite these challenges, in 2026 our field is optimistically eyeing remarkable opportunities presented by:

• Surging demand and occupancy, which support growth and innovation!
• Technological advances (like AI-assisted smart home devices, remote patient monitoring, & predictive health analytics that bolster efficiency with smaller staffs)
• New housing models (like intergenerational living and Life Plan Communities more deeply blending active lifestyle programming with long-term care), and
• Improved investor confidence and capital markets, which support the resilience of senior living as an asset class despite higher construction and financing costs.

Members, 2026 is here and we will make it great!  Make it your New Year’s resolution to support your field by engaging with LeadingAge!  We are here to serve and support you!  Working together, we will make a positive difference for the older adults we serve!

Yours in service,