CareCompli
Compliance news
Increasing costs top concern for retirees, yet most report financially stabilityDitching demographic assumptions could enhance care quality, resident satisfactionNew Illinois law aligns assisted living standards with modern clinical practice, experts sayEmployer healthcare costs projected to increase 10 percent again in 20275 consumer trends reshaping the senior living dining experience‘Surge of advocacy’ seeks to secure work authorization for former senior living and care employeesA very good week for skilled nursing’s unsung heroes — and the operators wise enough to keep themMedicaid managed care denies prior authorizations at higher rate than Medicare Advantage: analysis
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DeadlineFederalBilling

CMS finalizes the FY 2027 payment rule: a modest raise, a much bigger reporting future

At the end of July, CMS issued its final Medicare payment rule for skilled nursing facilities for fiscal year 2027, effective October 1, 2026. The headline number is a 2.4 percent net payment update, roughly 883 million dollars across the industry, built from a 3.3 percent market basket increase reduced by a 0.9 percent productivity adjustment. A modest raise, and smaller than last year's.

Bottom line for operators:

The 2.4 percent update is the headline, but the reporting expansion is the story. Start assessing your MDS workflows, documentation, and software now, before the deadlines shorten.

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DeadlineFederalSurveys

MDS data validation is live: what to do if your facility is selected

As of January 2026, CMS is running its Skilled Nursing Facility Value-Based Purchasing Data Validation Process. Facilities are selected at random, and selection notices arrive through the MDS 3.0 Provider Preview Reports folders in iQIES. If nobody at your facility checks those folders regularly, you can be selected and not know it, and the response window runs whether you are watching or not.

Bottom line for operators:

Assign one named person to check your iQIES provider folders every week, and treat a selection notice like an audit with a clock, because that is what it is.

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FederalEnforcement

The OIG is quietly reading your medical director's hours

The OIG has added medical director engagement to its work plan, and the method is telling: comparing the medical director hours facilities report through Payroll Based Journal against what the regulations require the role to actually do. Under CMS requirements, a medical director must be actively involved in policy development, provider oversight, QAPI activities, and the facility assessment process.

Bottom line for operators:

Check that your PBJ-reported medical director hours are accurate, and that the medical director's involvement in policies, QAPI, and the facility assessment is documented somewhere a reviewer can find it.

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