04/09/2026

CMS Proposes 2.4% FY27 SNF Payment Update, Removal of COVID Vaccination Measures

CMS has issued the fiscal year 2027 Skilled Nursing Facility Prospective Payment System proposed rule. The proposal includes a 2.4% payment update, based on a 3.2% market basket update minus a 0.8% productivity adjustment. CMS also proposes to remove two COVID-19 vaccination measures from the SNF Quality Reporting Program, revise QRP submission timelines, require MDS submission for all residents receiving covered skilled care regardless of payer, and seek feedback on future policy changes tied to PDPM coding and advance care planning. Comments are due June 1, 2026.

What You Need To Know

• CMS proposes a 2.4% Medicare payment update for SNFs in FY 2027. LeadingAge called the increase a concern given continued pressure from wages, food, and energy costs.
• CMS does not propose ICD-10 mapping changes to PDPM this year, but it is asking for feedback on how to address so-called case-mix creep, which CMS describes as coding or classification changes not tied to actual resident acuity changes.
• In a significant change for providers, CMS proposes to remove two SNF QRP measures: COVID-19 Vaccination Coverage Among Healthcare Personnel and COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date. If finalized, this would end related NHSN staff reporting and remove the resident COVID vaccination item from the MDS.
• CMS also proposes to shorten QRP data submission deadlines and to expand MDS reporting to all SNF residents receiving covered skilled care, regardless of payer.
• For SNF Value-Based Purchasing, CMS proposes updated snapshot dates for MDS-based measures so they align with the new QRP submission timeline.
• CMS is also requesting feedback on advance care planning as a future SNF QRP measure concept.

What Happens Next

• The proposed rule was published in the Federal Register on April 7, 2026.
• Comments are due June 1, 2026.
• LeadingAge is reviewing the proposal in more detail and plans to gather member feedback to inform national comments.

What to Do

• Review the proposed payment update and consider how far a 2.4% increase goes in covering your organization’s current cost pressures.
• Ask your clinical, reimbursement, and MDS leaders to review the proposals on QRP reporting, all-payer MDS submission, and VBP snapshot dates for operational impact.
• Flag any concerns or examples related to PDPM coding, administrative burden, or quality reporting changes so they can help inform advocacy comments.
• Watch for LeadingAge and LeadingAge Ohio follow-up analysis and opportunities to provide member feedback before the June 1 deadline.

For more details, review the CMS fact sheet and the Federal Register proposed rule.