A leaked budget document from the White House shows nursing home-related changes, notably potential elimination of health care workforce programs focused on geriatrics and other aging services, and a prioritization of survey and certification funding.

The “pre-decisional” document titled, “The Department of Health and Human Services (HHS) 2026 Discretionary Budget Passback,” released by Inside Medicine, included several other areas of focus related to nursing homes, including a budget for nursing home workforce development and elimination of the long-term care ombudsman program. A focus on mandatory surveys and certification surveys is also highlighted in the doc, with a two-year funding period of availability.

Nursing home association LeadingAge said that plans outlined in the document, combined with massive workforce cuts underway at HHS, suggest the agency “appears disinclined” to provide funding that addresses the needs of Americans.

“The leaked preliminary draft budget for FY26 for the Department of Health and Human Services (HHS) eliminates dozens of programs central to the health and welfare of older adults and the people who serve them,” said Linda Couch, senior vice president of policy and advocacy for LeadingAge. “We continue to review this draft as we await the full suite of budget documents once the request is formally transmitted to the Hill.”

The elimination of some workforce programs would jeopardize other programs by merging them into block grants, which may or may not be funded at the states’ discretion, Couch said.

HHS’ ability to effectively carry out its duties is “grossly diminished,” Couch said, considering “colossal” funding cuts along with the staff reductions.

Congress is floating $880 billion in cuts to Medicaid over 10 years, which nursing home advocates believe will jeopardize the care of vulnerable populations served by the industry.

On Monday, 12 House Republicans voiced concerns over cuts to the Medicaid program, while the reconciliation budget is still being discussed on the Hill.

“We cannot and will not support a final reconciliation bill that includes any reduction in Medicaid coverage for vulnerable populations,” House Republicans said in the letter, a move applauded by nursing home associations including the American Health Care Association and National Center for Assisted Living (AHCA/NCAL).

“Reducing Medicaid financing programs like provider taxes threatens to reduce Medicaid coverage for nursing home residents and should be a dealbreaker for all lawmakers,” Michael Bassett, senior vice president of government relations for AHCA/NCAL, said in a statement.