The Centers for Medicare & Medicaid Services (CMS) is proposing targeted changes to the Long-Term Care Hospital (LTCH) Quality Reporting Program (QRP) in the fiscal year (FY) 2026 Inpatient Prospective Payment System (IPPS) Proposed Rule.
These updates are designed to reduce reporting burden, eliminate outdated or redundant measures, and pave the way for future digital innovation in post-acute care quality reporting.
While more modest than inpatient updates, these proposals are significant for LTCH administrators, health information management (HIM) leaders, and quality professionals who manage standardized assessment data and ensure compliance with the CMS evolving quality framework.
CMS proposes to remove five data items from the LTCH Continuity Assessment Record and Evaluation (CARE) Data Set, particularly in cases in which the patient has expired during their LTCH stay. These items were deemed duplicative or of limited analytical value.
In addition, four Social Determinants of Health (SDOH) standardized patient assessment data elements are proposed for removal. CMS noted that these data points, while important for equity analysis, are either collected inconsistently across settings or lack the standardization required for actionable use in the LTCH QRP context.
Key takeaway: This effort reflects the CMS intent to streamline data requirements and reduce reporting fatigue for LTCHs without compromising quality tracking.
CMS is proposing updates to the reconsideration request process for the LTCH QRP. This policy clarifies how LTCHs can appeal determinations of non-compliance with quality reporting requirements, ensuring a more structured and equitable process.
While only expected to add four administrative hours across all LTCHs nationwide, the proposed change ensures greater transparency and standardization in how reconsiderations are reviewed and resolved.
CMS is also using the proposed rule to solicit stakeholder feedback through three key Requests for Information (RFIs):
Industry Implication: Providers are encouraged to share their input on these RFIs, which will likely shape the next phase of QRP modernization.
This reflects the CMS aim to streamline quality reporting without sacrificing outcome measurement integrity.
The FY 2026 IPPS Proposed Rule demonstrates the CMS continued effort to align the LTCH QRP with national quality goals while reducing administrative burden on post-acute providers. These changes combined with strategic RFIs signal that digital transformation and data simplification are front and center for long-term care quality oversight.
LTCHs are encouraged to undertake the following:
Submit comments by June 10, 2025, referencing file code CMS-1833-P
To read the full proposed rule or submit feedback, visit https://www.regulations.gov and search for CMS-1833-P.
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