Nursing Home News 2026Apr9

CMS Clarifies Nurse Aide Training Requirements

The Centers for Medicare & Medicaid Services (CMS) released a memo on April 8 clarifying certain federal requirements for nurse aide training programs. Recall that while CMS sets federal standards, each state is responsible for approving or disallowing nurse aide training and competency evaluation programs (NATCEPs) and competency evaluation programs (CEPs). While the April 8 memo does not contain new policy, the clarifications will be useful to providers interesting in applying for a NATCEP or in states that are considering changing current NATCEP policies. CMS provides clarification on many topics including fees, supervision, instructor qualifications, the use of remote technologies in competency evaluations, and state and CMS location authorities to waive NATCEP disapprovals. Read more about these important clarifications here.

CMS Releases Further Updates to Complaint Investigation Guidance

The Centers for Medicare & Medicaid Services (CMS) previously released significant updates to Chapters 5 and 7 of the State Operations Manual in January 2026. The updates were not changes to policy but rather updated the manual to be consistent with current policies and practices. On April 3, CMS made additional clarifications to Chapter 7 Survey and Enforcement Process for Skilled Nursing Facilities and Nursing Facilities. Note that the revised memo still shows the original January updates highlighted by red text, making it difficult to identify the April 3 changes. In the revised memo, CMS clarified that abbreviated surveys must be completed on two consecutive calendar days beginning with the date of survey entrance. CMS also provided examples for enforcing per day and per instance civil money penalties (CMPs) and clarified that CMP amounts are hypothetical only, based on original amounts not adjusted for inflation, and that actual CMP amounts will be determined based on instructions in the CMP Analytic Tool, required for surveyors and available to providers and the public. The revisions will be applicable to all enforcement cycles starting on and/or after March 31, 2026. CMS further announced that per instance CMPs will be displayed on Nursing Home Care Compare beginning June 24, 2026. LeadingAge has asked CMS for more information on what this will look like.

Advocacy Win: CMS Proposes Removal of COVID Vaccination Measures in FY 2027 SNF PPS Rule

The Centers for Medicare & Medicaid Services (CMS) released the Fiscal Year 2027 (FY 27) Skilled Nursing Facility (SNF) Prospective Payment System (PPS) proposed rule late on April 2. The rule proposes a 2.4% payment update for SNFs in FY 27 based on a 3.2% market basket update, less a 0.8% productivity adjustment. The rule does not propose any ICD-10 code mappings changes in the Patient-Driven Payment Model (PDPM) this year but does request information on addressing what CMS calls “case-mix creep,” the observed pattern of changes in coding or classification of residents that does not appear related to an actual changes in case mix.

In a win for LeadingAge, CMS proposes to remove two measures from the SNF Quality Reporting Program (QRP): COVID-19 Vaccination Coverage Among Healthcare Personnel and COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date. LeadingAge has consistently advocated for removal of these measures since their introduction and if finalized, SNFs would no longer be required to report COVID vaccination status of healthcare personnel through the National Healthcare Safety Network (NHSN) and the COVID vaccination item would be removed from the Minimum Data Set (MDS) for FY 27.

CMS additionally proposes to revise SNF QRP data submission guidelines and to expand SNF QRP to include data on all SNF patients regardless of payer, both proposals on which CMS has previously sought feedback. As anticipated, CMS is requesting feedback on Advance Care Planning as a future measure concept for SNF QRP. An Advance Care Planning measure was initially included in the December 2026 Measures Under Consideration (MUC) List but removed before the measure could be voted on for long-term care. CMS proposes to update “snapshot dates” for MDS measures in the SNF Value-Based Purchasing (VBP) program to be consistent with data submission guidelines proposed under the SNF QRP.



The proposed rule is expected to be published in the Federal Register on April 7. Read the unpublished version here. Read the CMS Fact Sheet here. LeadingAge will provide further analysis of this rule in the coming days. Comments on this proposed rule are due by June 1. LeadingAge will host a call in the coming weeks to solicit feedback from members to inform our comments.

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