8/20/2026:

McKnight’s Long-Term Care News: SNF AUDIT ENVIRONMENT ESCALATES: FORMER PROSECUTOR WARNS ‘NOBODY’S SAFE’

Long-term care operators are facing an unprecendented, aggressive regulatory environment where minor documentation oversights can rapidly escalate into multimillion-dollar liabilities, according to healthcare defense attorney Alyssa Friedman.

“What used to be a little problem that was to be solved with $10,000 or $20,000 in takebacks - they’re now taking the molehill and making it into the mountain,” she said at Zimmet Healthcare Services Group conference last week. “The minute you get the records request, it could go from a request for 10 charts to a $30 million problem.”

A central driver of this inflated financial risk is the expanding reliance on statistical extrapolation the CMS and the HHS Office of Inspector General.

Article can be found at https://lnkd.in/gmtidS43 (REPOSTED FROM INDEED WEBSITE 8/20/26)

8/10/2026:

QIPP Year 10

Texas Health and Human Services/(HHS) and TMHP published the State Fiscal Year (SFY) 2027 Quality Incentive Payment Program (QIPP Year 10) facility-level baselines, program-wide benchmarks, and quarterly targets on August 10, 2026. QIPP 10 officially begins on September 1,2026.

8/10/2026: Component 2 Workforce Metrics

Quality metrics remain unchanged from QIPP 9, but the three Component 2 workforce metrics will now be divided evenly instead of previous allocations.

8/10/2026: Quarter 1 Data Window

Performance data tracking for Quarter 1 covers July through September 2026, coinciding with the program launch.

9/3/2026 Why falls may be the best bellwether for staffing, operational performance

As federal regulators put more emphasis on #falls — even using them to help determine the worst nursing homes in the nation — industry insiders are revealing what those fall-related injuries and even near misses indicate about quality of care.

Increasingly, they’re seen as a window into #staff coverage, communication, and care planning and delivery. And not just by patients.

Insights from AAPACN's Quality Virtual Conference and a new data analysis from Covr are revealing why falls matter not just to individual residents, but to the overall performance of skilled nursing and long-term care organizations.

Jessie McGillLauren Stenson, RN, DNP, CNDLTC, QCP, DNS-CT#skillednursing#nursinghomes#LTC#postacutecare#workforce#fallrisl#seniors

https://lnkd.in/g-s3KAjD

FY 2027 SNF Reimbursement & MDS Industry Updates

CMS finalized its FY 2027 SNF Prospective Payment System (PPS) rule on July 30, 2026, with a 2.4% Medicare payment increase, QRP reforms, and a long-term all-payer MDS mandate. The rule takes effect October 1, 2026

• 2.4% increase in SNF Medicare Part A payment rates for FY 2027, based on a 3.3% market basket increase minus a 0.9% statutory productivity adjustment

• Aggregate increase: ~$882–$888 million in Medicare Part A payments 

• Impact varies by facility type: hospital-based SNFs ~+2.9%, rural ~+2.7%, freestanding urban ~+2.3% 

• SNF Value-Based Purchasing (VBP) will reduce aggregate payments by ~$203.6M in FY 2027 

Quality Reporting Program (QRP) Changes

• Removal of two COVID-19 measures starting FY 2028:

  1. COVID-19 Vaccination Coverage Among Healthcare Personnel

  2. COVID-19 Vaccine: Percent of Patients/Residents Up to Date

• Estimated annual cost savings: ~$8.3M 

• Tighter data submission window for QRP data starting FY 2029 

MDS & All-Payer Data Requirements

• All-payer MDS mandate: Facilities must submit MDS assessments for all covered skilled residents regardless of payer starting with the FY 2031 SNF QRP 

• This will expand MDS reporting beyond current Medicare-only requirements, affecting staffing, software, and annual cost reporting

• CMS is signaling increased focus on MDS accuracy, PDPM coding, and documentation to support reimbursement and compliance. 

Patient Driven Payment Model (PDPM)

• CMS solicited stakeholder input on measuring and addressing case-mix growth; no immediate changes to PDPM CMI values, but future adjustments may be considered

Practical Implications for SNFs

• Finance & Reimbursement: Model the 2.4% rate update at the facility level, factoring in case mix, occupancy, and payer mix. Monitor VBP performance for potential payment reductions

• Clinical & MDS Teams: Prepare for expanded MDS reporting timelines and accuracy requirements; ensure documentation supports both care and reimbursement

• Quality Teams: Update workflows to remove COVID-19 measures from FY 2028 reporting cycles

• Operations: Plan for increased administrative and IT capacity to handle all-payer MDS submissions starting FY 2031 

Bottom line: While the 2.4% payment increase is modest, the long-term MDS and QRP changes will significantly impact SNF operations, compliance, and revenue. Facilities should start preparing now for the expanded data requirements and quality reporting reforms.

Texas State RAI Coordinator Information:

TX Holly Sanchez RAI_MDS@hhs.texas.gov‍ ‍

TX MDS Coding/Clinical Questions RAI_MDS@hhs.texas.gov

9/3/26 Supportive documentation for MDS coding focus!!!

Expanding MDS reporting changes coming for 2029!!!

With greater scrutiny of case-mix growth and coding, nursing homes should be strengthening documentation. Moreover, operators should also prepare now for expanded MDS reporting requirements beginning in 2029.

https://lnkd.in/p/gaRqQ_uR

8/25/2026: RISK BASED SURVEY (RBS)

The RBS (Risk Based) survey will be implemented nationwide beginning September 8, 2026. CMS is providing SAs and CMS Locations information related to training and implementation to prepare for the RBS launch in August and September 2026. High Performing Facility Icon: 🏆CMS will place an icon on Nursing Home Care Compare website identifying facilities that qualify for the RBS which indicates a higher level of performance. The icon will remain on the nursing home’s profile page until the facility is no longer eligible for the RBS.

Reference: QSO-26-14-NH https://cstu.io/19e18d‍ ‍(Reposted from MDS Consultants 8/4/2026 post on LinkedIn website)

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8/20/2026:

MDS CONSULTANTS ARTICLE- PBJ PROVIDERS AND VENDORS:

CMS has posted Payroll-Based Journal (PBJ) resources for the internet Quality Improvement and Evaluation System (iQIES) on the QIES Technical Support Office (QTSO) website. You can find the iQIES Staffing Data Submission PBJ User Manual and the PBJ Error Message Reference Guide in the iQIES Payroll-Based Journal (PBJ) Manuals topic under the Reference & Manuals section. Provider link: https://cstu.io/7a466a iQIES Manuals: https://cstu.io/81767b

For additional assistance email the iQIES Service Center at iqies@cms.https://cstu.io/38f017 or contact the iQIES Service Center at (800) 339-9313, Monday through Friday, 8:00 AM - 8:00 PM ET.

You may also request assistance via secure chat or schedule a call through CCSQ Support Central, Monday - Friday 9:00 AM - 5:00 PM ET

(Reposted from Indeed on 8/14/26 - Published by MDS Consultants)

8/20/2026:

MDS CONSULTANTS ARTICLE- PBJ REPORTS AVAILABLE IN IQIES

The reports guide provides detailed inforamtion on user-requested Payroll-Based Journal (PBJ) reports available in iQIES was posted on 8/14/26. The reports are organized in alphabetical order by report name. Each report is set up as follows:

• Report Name and Purpose

• Run Report Criteria

• Sample Report

• Report Details

Details at https://lnkd.in/gzGF4Rkv and https://lnkd.in/gpSf9cFVtem description

8/4/2026: FY 2027 SNF VBP Program August 2026 Performance Score Reports Now Available

The August 2026 Performance Score Reports (PSRs) for the fiscal year (FY) 2027 Skilled Nursing Facility Value-Based Purchasing (SNF VBP) are now available to download via the Internet Quality Improvement and Evaluation SNF System (iQIES). SNFs may submit requests for corrections to their performance score and ranking up to 30 days following the date of report release.

8/21/2026: IS YOUR SNF READY FOR DATA VALIDATION AUDITS?

CMS recently updated its Skilled Nursing Facility Data Validation Process FAQs, providing additional guidance on what providers can expect if selected for review.

Although selection is random, every SNF should understand the process and be prepared to respond if chosen.

The purpose of this audit is to verify the accuracy of the MDS data behind SNF QRP and VBP quality measures.

Validation results themselves are informational only, but failing to submit the requested records triggers a 2% Annual Payment Update reduction under the SNF QRP.

Three changes stand out:

1. Quarterly selection is now explicit. CMS will notify selected SNFs in Feb, May, Aug and Nov.

2. The 45-day clock remains the critical operational requirement. Selected SNFs have 45 calendar days to submit requested medical record documentation supporting up to 10 MDS assessments. The submission deadline is 11:59 pm on day 45, subject to the business-day exception outlined by CMS.

3. CMS is formalizing the feedback process. Data Validation Summary Reports will now be released annually, and CMS states that the validation team cannot provide case=specific explanations for findings. The reports are informational, and SNFs are not penalized based on the validation results themselves. The penalty is tied to failure to comply with the submission requirements, which can result in a 2% SNF QRP Annual Payment Update reduction.

4. CMS has moved the Help Desk to a CMS email address, added same-day email notification when selection letters are posted in iQIES, and explicitly addresses what happens when PHI is inadvertently sent by email.

   For SNFs, this is increasingly less about waiting for a selection notification and more about being ready when it arrives.

   8/2026 FAQ Update found at Skilled Nursing Facility Validation Program: Frequently Asked Questions