GUIDE Model Update: Why Assisted Housing Providers May Be Contacted About New Partnership Agreements

• By: Maureen Carland
• On: 07/27/2026 07:25:08
• In: Quality/Regulatory

As the Centers for Medicare & Medicaid Services (CMS) rolls out updates to the Guiding an Improved Dementia Experience (GUIDE) Model, assisted housing (RC and AL)  providers may start hearing from GUIDE Participants about new or updated partnership agreements. These agreements are meant to bring existing partnerships into compliance with new CMS requirements that took effect July 1, 2026.
For many assisted housing providers, it's worth understanding up front: this request comes from CMS, not from the GUIDE Participant itself. The updated agreements exist to keep GUIDE Participants in compliance with the Model's revised requirements for residential care communities (RCCs) — so if your organization is contacted, it's part of a broader regulatory change, not a change your GUIDE Participant partner chose to make on their own.
What Is the GUIDE Model?
GUIDE is an eight-year, voluntary Medicare model that was launched in July 2025 to improve care coordination and quality of life for people living with dementia and their caregivers. GUIDE Participants — Medicare Part B-enrolled providers and suppliers selected by CMS — may partner with RCCs, including assisted housing communities, to deliver certain GUIDE services through a written partnership agreement.
What Changed on July 1, 2026
CMS established a new regulatory framework for assisted housing participate in the GUIDE Model. Under the revised rules, GUIDE Participants that currently partner with assisted housing communities — or want to in the future — must:

• Obtain CMS approval before adding them as a partner
• Execute partnership agreements that meet CMS's new compliance standards
• Submit additional information about their Partner Organizations

As part of this process, assisted housing providers may be asked to share information about ownership and controlling interests, related organizations, governance, and general organizational structure, so that GUIDE Participants can satisfy CMS's reporting and oversight requirements.
Other Operational Changes to Know
Along with the new partnership framework, CMS made several other changes that affect assisted housing providers:

• Memory care exclusion: Residents of dedicated memory care communities or units are no longer eligible to participate in GUIDE.
• Respite services: GUIDE respite services are no longer available to residents of assisted housing communities, regardless of whether they have a primary caregiver.
• New payment category: CMS established a separate payment category specifically for GUIDE Participants.

What assisted housing Providers Should Do Now
If your community currently participates in GUIDE — or is considering it — take time to:

• Carefully review any partnership agreement a GUIDE Participant sends you
• Understand what disclosures you may be asked to provide
• Prepare the organizational and governance information CMS now requires
• Evaluate how the memory care exclusion, respite changes, and new payment structure may affect your residents and operations

Resources

• CMS GUIDE Model FAQs
• GUIDE Payment Methodology Paper
• List of GUIDE Participant organizations (several serve Maine)

Questions?
Contact AHCA's Population Health Policy Analyst Rohini Achal or Nisha Hammel, Vice President, Reimbursement Policy & Population Health.
 
Staff contact: mcarland[at]mehca.org