The Centers for Medicare & Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service prospective payment system (PPS) for skilled nursing facilities (SNF) for fiscal year (FY) 2027.
Key provisions include:
- Increasing the per diem federal rate by a net 2.3% 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 to the market basket update.
- Increasing the labor-related share of the per diem rate slightly from 71.9% to 72%.
- Continuing to use the pre-reclassification and pre-floor hospital inpatient PPS wage indexes.
- Removing two measures focused on COVID-19 vaccination for both SNF residents and healthcare personnel.
- Shortening the time frame for quarterly submission of SNF Minimum Data Set and National Healthcare Safety Network data from 4.5 months to 45 days, beginning with the FY 2029 SNF Quality Reporting Program. For example, data for the quarter ending March 31, 2027, would be due to the CMS by May 17, 2027.
- Requiring submission of Minimum Data Set data on all SNF residents receiving skilled care in a SNF, regardless of payer, starting with patients admitted on or after Oct. 1, 2029, for purposes of the FY 2031 SNF Quality Reporting Program. The CMS modified one Minimum Data Set item in the Type of Assessment section to indicate when an assessment is being completed at admission for a non-Medicare fee-for-service resident receiving covered skilled services. The CMS added three new items to the Minimum Data Set, with a draft of the modified and new items available in the downloads section of the SNF Quality Reporting Program Measures and Technical Information webpage. The new items will:
- Collecting information on the resident’s primary payer for the skilled stay at admission and at discharge from covered skilled services.
- Capturing the start and end dates of a covered skilled stay for a non-Medicare fee-for-service resident.
- Indicating whether the assessment is being completed for a non-Medicare fee-for-service resident at the time of discharge from covered skilled services.
- Updating the “snapshot date” used for two measures — Discharge Function and Falls with Major Injury (Long-Stay) — calculated from Minimum Data Set assessment data to align with the newly finalized SNF Quality Reporting Program submission deadlines for Minimum Data Set assessment data, beginning with FY 2027 data..
The MHA will provide SNFs with an updated facility-specific impact analysis and additional details on the final rule in the coming weeks. Members with questions should contact the MHA health finance team.
The Centers for Medicare & Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service prospective payment system (PPS) for skilled nursing facilities (SNF) for fiscal year (FY) 2027.
