2027 PROPOSED RULES SKILLED NURSING
An Analysis and Commentary on Federal Health Care Issues by Larry Goldberg
Proposed FY 2027 Skilled Nursing Facility PPS Update Issued
The Centers for Medicare and Medicaid Services (CMS) are issuing a proposed rule that would update the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for fiscal year (FY) 2027, as required under section 1888(e)(4)(E) of the Social Security Act (the Act).
CMS is proposing to continue to use the concurrent pre-floor, pre-reclassified Inpatient Prospective Payment System (IPPS) hospital wage index as the basis for the SNF wage index.
CMS is not proposing any substantive changes to the Patient Driven Payment Model (PDPM) ICD-10 code mappings.
The proposal updates the SNF Quality Reporting Program (QRP) including removing two measures from the program, specifically the COVID-19 Vaccination Coverage Among Healthcare Personnel (HCP) Measure and the COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date Measure.
CMS is proposing the revision of the SNF QRP data submission deadlines. In addition, CMS is proposing to require the submission of the minimum data set (MDS) on each resident receiving covered skilled care in a SNF, regardless of payer. Finally, CMS is requesting comment on future measure concepts for the SNF QRP.
CMS is proposing updates to the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program, including estimating performance standards and updating the review and correction policy for measures calculated with MDS assessment data.
This proposed rule also includes a Request for Information (RFI) on the methodology for quantifying and addressing case-mix creep under PDPM.
The proposal is scheduled for publication in the Federal Register on April 6. A copy is currently available at: https://public-inspection.federalregister.gov/2026-06674.pdf.
A 60-day comment period ending June 1 is provided.
The wage index tables can be accessed at: https://www.cms.gov/files/zip/cms-1843-p-wage-index-tables-fy-2027-proposed.zip.