April 6, 2026
The Centers for Medicare & Medicaid Services (CMS) has released the Fiscal Year (FY) 2027 Skilled Nursing Facility Prospective Payment System (SNF PPS) Proposed Rule, outlining several proposed updates to Medicare payment rates, quality programs, and data reporting requirements for skilled nursing facilities.
Key Proposals in the Rule
Among the most notable proposals, CMS estimates a 2.4% net increase in SNF PPS payment rates for FY 2027.
The agency also proposes continued refinements to the Patient-Driven Payment Model (PDPM) aimed at improving payment accuracy. As part of this effort, it is seeking stakeholder input through a Request for Information (RFI) on potential methodologies to quantify and address case-mix creep under PDPM.
Updates to Quality Programs
The proposed rule includes several changes to the Skilled Nursing Facility Quality Reporting Program (QRP) and the SNF Value-Based Purchasing (VBP) Program:
- QRP: CMS proposes removing two COVID-19–related measures and revising data submission deadlines.
- VBP: CMS outlines updates to estimated performance standards and proposes revisions to the review and correction policy for measures calculated using Minimum Data Set (MDS) assessment data.
Expanding the Focus on Health Equity
CMS continues to emphasize health equity and social risk factors across Medicare programs. Under the proposed rule, SNFs would be required to submit MDS data for every resident receiving covered skilled care, regardless of payer source. CMS indicates that broader data collection will support more comprehensive quality measurement and equity analyses.
The CMS fact sheet for the proposed rule is available here.
PALTmed is currently reviewing the proposed rule and will be preparing comments as appropriate. As always, please reach out with any questions or feedback.