In LeadingAge’s June 1, 2026 comments filed to the Centers for Medicare and Medicaid Services (CMS) regarding the Fiscal Year 2027 (FY27) Skilled Nursing Facilities (SNF) Prospective Payment System (PPS) proposed rule, we explain our ongoing concerns about the inadequacy of long-term care reimbursement and urge the agency to reconsider payment update policies and work toward policies that support nursing homes with the financial and physical resources needed to meet residents’ needs in real-time. In addition, among other issues, we offer feedback on the development of a SNF-specific wage index and respond to a request for information (RFI) on Methodology for Quantifying and Addressing Case-Mix Creep Under the Patient-Driven Payment Model.