Ever get the feeling that hospital policy changes happen quietly, until suddenly, they don’t feel so quiet anymore? That’s exactly what’s happening now with CMS hospital payment changes and SNF coverage, and it’s a shift every senior living community should be watching.
The Centers for Medicare & Medicaid Services (CMS) recently finalized a rule that removes nearly 300 procedures from the inpatient-only list. That list has long dictated which surgeries require hospital stays. Now, many of these procedures, including spine, joint, and fracture repairs, can be done in outpatient settings. According to CMS’s own fact sheet, this change is part of the 2026 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center final rule. It aims to promote flexibility and reduce costs. You can find the full CMS breakdown here.
But there’s a ripple effect. As McKnight’s reports, this shift means fewer hospital admissions. And that matters, because Medicare coverage for skilled nursing typically requires a three-day inpatient stay. Without it, many residents may not qualify for post-acute rehab in a SNF setting, even after surgery.
In practical terms, this could leave older adults recovering from serious procedures without access to the care they expected. And for communities, it adds more pressure to support residents who may be discharged “quicker and sicker” from outpatient centers.
According to another McKnight’s article, providers worry that hospitals and SNFs could see “decreased volumes and lower reimbursement” as a result. That’s a financial hit, but it’s also a care gap that may fall to senior living communities to help bridge.
So, what now? Start talking. Connect with discharge planners. Revisit agreements with hospitals and SNFs. And make sure your community understands which services can support residents who may no longer qualify for a post-acute rehab stay.
CMS hospital payment changes and SNF coverage rules may seem like administrative talk. But the outcome hits real people. Better to prepare now than react later.
Stay well and stay informed!
