The Centers for Medicare & Medicaid Services (CMS) released the Fiscal Year 2027 (FY 27) Skilled Nursing Facility (SNF) Prospective Payment System (PPS) proposed rule late on April 2, 2026.
The rule proposes a 2.4% payment update for SNFs in FY 27 based on a 3.2% market basket update, less a 0.8% productivity adjustment.
In an April 3 press statement, Linda Couch, SVP Policy, LeadingAge, said, “Given today’s uncertain economic environment, and the increased costs in critical categories including food, energy and wages, the modest 2.4% proposed payment rate boost announced late yesterday by CMS is cause for concern. Our nonprofit and mission-driven nursing home members strive to provide the highest quality care—and adequate payment is critical.”
The rule does not propose any ICD-10 code mappings changes in the Patient-Driven Payment Model (PDPM) this year but does request information on addressing what CMS calls “case-mix creep,” the observed pattern of changes in coding or classification of residents that does not appear related to an actual changes in case mix.
In a win for LeadingAge, CMS proposes to remove two measures from the SNF Quality Reporting Program (QRP): COVID-19 Vaccination Coverage Among Healthcare Personnel and COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date. LeadingAge has consistently advocated for removal of these measures since their introduction and if finalized, SNFs would no longer be required to report COVID vaccination status of healthcare personnel through the National Healthcare Safety Network (NHSN) and the COVID vaccination item would be removed from the Minimum Data Set (MDS) for FY 27. “Our opposition to these is longstanding: both reflect personal choice and do not reflect or measure quality of nursing home care. That’s even more true now, with the Centers for Disease Control and Prevention recommendations having changed to shared clinical decision-making. Measuring uptake just doesn’t make sense,” said Couch in the statement.
CMS additionally proposes to revise SNF QRP data submission guidelines and to expand SNF QRP to include data on all SNF patients regardless of payer, both proposals on which CMS has previously sought feedback. As anticipated, CMS is requesting feedback on Advance Care Planning as a future measure concept for SNF QRP. An Advance Care Planning measure was initially included in the December 2026 Measures Under Consideration (MUC) List but removed before the measure could be voted on for long-term care. CMS proposes to update “snapshot dates” for MDS measures in the SNF Value-Based Purchasing (VBP) program to be consistent with data submission guidelines proposed under the SNF QRP.
The proposed rule is expected to be published in the Federal Register on April 7.
Read the unpublished version here.
Read the CMS Fact Sheet here. LeadingAge will provide further analysis of this rule in the coming days. Comments on this proposed rule are due by June 1. LeadingAge will host a call in the coming weeks to solicit feedback from members to inform our comments.
