Skilled Nursing Facility PPS

May 15, 2024

At A Glance

The Centers for Medicare & Medicaid Services (CMS) April 11 issued its fiscal year (FY) 2026 proposed rule for the skilled nursing facility (SNF) prospective payment system (PPS). This rule proposes to update SNF payments and modify the SNF quality reporting program (QRP) measures and reporting requirements.

Key Highlights

The proposed rule would:

  • Increase aggregate SNF payments by an estimated 2.8% ($997 million) in
    FY 2026 relative to FY 2025. This includes a 3.0% market basket update
    reduced by a 0.8% productivity cut and a 0.6% increase due to a FY 2024
    market basket forecast error.
  • For the SNF QRP, remove four patient assessment data elements.
  • For the SNF value-based purchasing program (VBP), remove the program’s health equity adjustment.
  • Solicit comments on approaches and opportunities to streamline regulations and reduce administrative burdens on hospitals and other providers.

View the entire AHA Regulatory Advisory.
 

Key Resources


 

Related Resources

 

CMS, OIG, and Other Agency Resources

Public
  Adverse Events in Skilled Nursing Facilities: National Incidence Among Medicare Beneficiaries, Office of the Inspector General (March 3, 2014)