CMS FY 2026 Skilled Nursing Facility Compliance & Readiness Check Are You Prepared for the CMS FY 2026 SNF PPS Final Rule? The CMS FY 2026 SNF PPS Final Rule updates reimbursement and PDPM mappings, and it signals future quality program requirements that will impact skilled nursing operations. Evaluate how well your organization is positioned to meet new regulatory and performance expectations that began on October 1, 2025, with this readiness check. Scheduling EfficiencyHow prepared is your team to implement the ICD-10-CM code mapping changes that affect PDPM classification and reimbursement accuracy? Fully prepared: We’ve done staff education, reviewed and updated workflows, and ensured our vendors have made updates in their systems. Partially prepared: We’re aware of the changes but haven’t done all the needed education and updates. Not prepared: We haven’t done any preparation activities. Given the FY 2026 updates to the SNF Quality Reporting Program (QRP) and removal of certain Social Determinants of Health (SDOH) items, how confident are you that your MDS coding and submission process is compliant? Very confident: We’ve aligned our processes with updated MDS data elements and validation rules. Somewhat confident: We’re not sure if everything is in place. Not confident: We have limited visibility into the impacts of MDS coding. Multi-Location CoordinationThe FY 2026 Final Rule updates performance standards and measures for upcoming VBP program years (FY 2028–FY 2029). How ready is your facility to adapt to these evolving requirements? Fully ready: We’re tracking current and future VBP measures and performance thresholds. Somewhat ready: We’re aware but haven’t yet aligned reporting and tracking. Not ready: We’re not sure about the new VBP measures and methodology. CMS removed the Health Equity Adjustment from VBP scoring but continues to evaluate equity in outcomes. How is your organization integrating health equity metrics into care quality and reporting? Integrated: We monitor and consider resident demographics, outcomes, and access equity. Partial: We collect limited SDOH data but lack structured review or utilization processes. None: We haven’t built equity monitoring into QAPI or quality reporting. Patient CommunicationHow prepared is your organization for CMS’s push toward digital quality measures (dQMs) and interoperability under the QRP? Well-prepared: Our systems support electronic data exchange and standardized reporting today. In progress: Our systems are capable, but we haven’t enabled or are not using the functionality. Not prepared: We rely mostly on manual or paper-based methods. Have you evaluated the financial impact of the FY 2026 wage index updates and labor-related share adjustment (71.9%) on your facility’s Medicare rates? Yes: We’ve modeled the impact and updated financial forecasts. No: We haven’t assessed how these adjustments will affect our reimbursement. Revenue & Staff ImpactCMS added a formal reconsideration process for the SNF VBP program beginning FY 2027. How confident are you in your ability to manage data accuracy and appeals if your facility receives a low performance score? Confident: We have established documentation, data audit protocols, and workflows. Somewhat confident: We have some processes but lack a formal review framework. Not confident: We’re unfamiliar with the VBP appeals or reconsideration process. How effectively does your team use outcomes data (e.g., readmissions, function scores, infection rates) to improve performance on QRP and VBP measures? Highly effective: Data drives care planning and improvement initiatives at multiple levels. Moderately effective: We track data but struggle to understand it or take action. Not effective: We lack systems or resources to translate data into action. Have your key staff (MDS coordinators, DONs, administrators, and therapists) been trained on the specific updates in the FY 2026 Final Rule? Yes: We’ve completed or scheduled targeted training. Partial: We’ve communicated updates but haven’t conducted formal training. No: Staff are not aware of the upcoming rule changes. What best describes your organization’s readiness strategy for the October 1, 2025 implementation? Proactive: We’ve completed a readiness plan and timeline for all major provisions and feel confident in our readiness. Reactive: We understand the changes and will address them as they start to impact our operations. Unprepared: We don’t have good awareness or a defined approach. Assessment Complete! Your Results Are Ready. Congratulations, you’ve finished the assessment! Your readiness score and an analysis of your clinical, compliance, and reimbursement gaps are calculated. Unlock your analysis now to see where you stand for CMS 2026. Email(Required) Title(Required)Company(Required)Number of Sites(Required)This field is hidden when viewing the formAssessment Score
