CMS Issues Final Rule for Long Term Care Hospital Prospective Payment System and Quality Reporting Program for FY 2026

Strategic Insights -

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule (CMS-1833-F) that updates the Long Term Care Hospital (LTCH) Prospective Payment System (PPS) and the Quality Reporting Program (QRP) for fiscal year (FY) 2026. The rule makes several changes to the LTCH Quality Reporting Program, including the removal of a COVID-19 vaccine item from the Continuity Assessment Record and Evaluation (CARE) Data Set and the amendment of the LTCH QRP reconsideration policy and process. The rule also summarizes feedback on three Requests for Information, including future quality measure concepts for the LTCH QRP.

Key Takeaways:

  • The final rule removes the COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date vaccine item (O0350) from the LTCH CARE Data Set as it pertains to patients who expire in an LTCH.
  • Four assessment items in the Social Determinants of Health (SDOH) category are being removed: one item for Living Situation, two items for Food, and one item for Utilities.
  • The LTCH QRP reconsideration policy and process is being amended.
  • The final rule summarizes feedback on three Requests for Information, including future quality measure concepts for the LTCH QRP.
  • Potential revisions to the data submission deadlines for assessment data collected for the LTCH QRP are being considered.
  • Advancing digital quality measurement in LTCHs is a priority, as discussed in the proposed rule.

Statistics:

  • 1 COVID-19 vaccine item is being removed from the LTCH CARE Data Set.
  • 4 assessment items in the SDOH category are being removed.
  • The final rule is effective as of July 31, 2025.

Sources:

Washington: Centers for Medicare & Medicaid Services has issued the following news release.

Centers for Medicare & Medicaid Services (CMS). (2025, July 31). Long Term Care Hospital (LTCH) Prospective Payment system (PPS) and Updates to the Quality Reporting Program (QRP) for FY 2026 LTCH PPS Final Rule (CMS-1833-F).