Washington, D.C. — A new federal grant program is quietly opening doors for nursing homes — but only those willing to back up their lifestyle care programs with hard evidence.
The Centers for Medicare and Medicaid Services has launched a competitive grant program called ELEVATE — short for Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence — offering $100 million in funding to just 30 organizations nationwide. Nursing homes are eligible, but so are academic medical centers, community organizations, and multi-site senior living operators. The competition will be stiff.
The Notice of Funding Opportunity was posted in March, with the first application deadline set for May 15 and a letter of intent that was due April 10. The program’s first cohort is expected to launch in October 2026, with a second cohort beginning in October 2027.
What CMS Is Actually Testing
ELEVATE isn’t a new payment model in the traditional CMS sense. It’s a grant program run through cooperative agreements — meaning recipients have to understand how to accept, manage, and report on federal funding. That’s a meaningful barrier for many nursing home operators who have no prior experience with federal grant administration.
“Do you know what it means to accept a federal grant, what those agreements look like, what the reporting requirements are, what the auditing procedures are?” said Brian Fuller, managing director for value-based care design and delivery at ATI Advisory. “All of the mechanics and administrative operations of accepting and then running and reporting out on a grant program is very important.”
The program targets lifestyle and functional medicine interventions — things like nutrition counseling, structured physical activity, sleep support, stress management, and social connection programs. CMS wants to test whether these approaches, typically not covered under traditional Medicare fee-for-service, can actually reduce hospitalizations and cut costs over time.
Three of the 30 awards will be reserved specifically for dementia care programs.
Which Nursing Homes Have the Best Shot
According to Fuller, operators best positioned for ELEVATE share a few traits: a robust dementia program, documented outcomes data, an aligned clinical model with physicians and nurse practitioners, and experienced dieticians or activities coordinators with measurable results.
Critically, the program isn’t designed to fund new ideas. CMS wants programs that already exist and already show results — ready to scale, not still being built.
“That’s another important caveat and threshold for success in the program,” Fuller said. “It’s not designed to fund programs that don’t exist yet.”
Operators with a presence across multiple care settings — skilled nursing, assisted living, home health — are also seen as strong candidates, since those settings naturally lend themselves to the kind of integrated, lifestyle-focused care the program envisions.
Why This Matters Beyond the Grant
ELEVATE is part of a broader CMS push to bring nursing homes into value-based care arrangements that reward outcomes rather than volume. It arrives alongside other new federal programs with fast-approaching deadlines — including the LEAD model, which closes applications on May 17 and represents a separate 10-year value-based care opportunity for skilled nursing facilities.
Taken together, these programs signal that CMS is serious about rewarding nursing homes that can demonstrate genuine clinical and lifestyle improvements — not just check compliance boxes.
For operators who’ve invested in strong activities, dietary, and dementia programming, ELEVATE is a rare chance to be compensated for work they’re already doing. Whether the industry has the grant-writing muscle to compete for it is a different question.
