The annual update to Medicare Part A reimbursement rates for skilled nursing facilities proposes to increase Medicare rates by 2.8%. Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2025, CMS-1827-P, 90 Fed. Reg. 18590 (Apr. 30, 2025); Centers for Medicare & Medicaid Services (CMS), “Fiscal Year 2026 Skilled Nursing Facility Prospective Payment System Proposed Rule CMS 1827-P Fact Sheet” (Apr. 11, 2025). Comments are due by June 30, 2025.
The Fact Sheet includes a link to a Request for Information, “Unleashing Prosperity Through Deregulation of the Medicare Program (Executive Order 14192) – Request for Information.”
The Center for Medicare Advocacy is drafting comments, which will
- Urge CMS to use the Bureau of Labor Statistics’ wage data for nursing homes, not higher hospital wage data.
- Urge CMS to audit Medicare cost reports, citing extensive research showing that facilities hide substantial profits in related party transactions. See, e.g., “Tunneling and Hidden Profits in Health Care,” discussed in “Residents’ Advocates Reject Industry Complaints About Nursing Home Staffing Rule” (CMA Alert, May 9, 2024).
- Reiterate the Center’s opposition to CMS’s using self-reported resident assessment-based quality measures, citing research about the inaccuracy of these measures. See, e.g “Assessment of nursing home reporting of major injury falls for quality measurement on nursing home compare,” Health Services Research, 2019;00:1-10.
- Oppose deletion of equity-based measures in the Skilled Nursing Facility Quality Reporting Program and the Skilled Nursing Facility Value-Based Purchasing Program.
- Support development of a new measure on nutrition that ensures that the measure is meaningful and based on actual facility spending per resident for food, malnutrition and dehydration among residents, and outbreaks of foodborne illnesses. See “Serious Food Problems in Nursing Facilities” (CMA Alert, May 1, 2025).
May 15, 2025 – T. Edelman