The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule to update the Medicare fee-for-service prospective payment system for skilled nursing facilities (SNFs) for fiscal year (FY) 2026.
Key provisions of the proposed rule include:
- Increasing the per-diem federal rate by a net 3% after the market basket update, productivity adjustment and other adjustments. SNFs that fail to satisfy Quality Reporting Program requirements will be subject to a 2-percentage point reduction.
- Updating the labor-related share of the per diem rate from 72% to 71.9%.
- Making technical changes to the Patient-Driven Payment Model ICD-10 code mapping that assigns patients to clinical categories.
- Removing items recently adopted as standardized patient assessment data elements under the social determinants of health category.
- Issuing three Requests for Information regarding future measure concepts, potential revisions to submission deadlines for assessment data collected and advancing digital quality measurement.
- Removing the health equity adjustment from the SNF Value-Based Purchasing program.
The CMS is seeking comments on opportunities to streamline regulations and reduce administrative burdens on providers, suppliers, beneficiaries and other interested parties participating in the Medicare program.
The MHA will provide SNFs with a facility-specific impact analysis and additional details on the proposed rule in the near future. The MHA also encourages members to submit comments to the CMS by June 10 and to contact Vickie Kunz at the MHA with questions and issues identified by May 27.