Jessie McGill, RN, BSN, RAC-MT, RAC-MT, is a regular contributor to Park Place Live, and is the curriculum development specialist for the American Association of Post-Acute Care Nursing (AAPACN).

The fiscal year 2026 Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) data tells a story that will sound familiar to many long-term care leaders.

On paper, performance looks acceptable with about 80 percent of facilities meeting compliance requirements. But just beneath the surface, the gaps are harder to ignore. Nearly 15 percent of facilities lost 2 percent of their Annual Payment Update (APU) due to noncompliance. The remaining facilities were excluded from the SNF QRP program due to either certification status or no Medicare assessments.

However, it is the noncompliance where leadership attention matters most. The SNF QRP program is a pay-for-reporting program, only penalizing facilities if they fail to report the required data. Thus, it’s not critical to understand all the nuances of the QRP requirements, but it is essential to ensure the interdisciplinary team has a system in place to assess and report data consistently.

Focus on Reliability

When you step back and examine the national- and state-level data, a pattern emerges. No state meaningfully surpasses the high-80 percent range for facilities in compliance. Most fall somewhere in the middle.

In practice, these numbers often indicate that a team knows what to do but struggles with follow-through. For example, an assessment is missed during a busy week. A dash is left unresolved. The National Healthcare Safety Network (NHSN) data submission falls behind during staffing changes. None of these are intentional failures. But collectively, they create risk. From a leadership perspective, a critical shift in thinking is needed. Compliance is often not a knowledge deficit but rather a product of an unreliable system.

Trends in High/Low Performers

One of the most essential insights from the data is the lack of similarities among the top 10 performing states that differ widely in number of facilities, geography, and facility mix. The top 10 include states with more than a thousand facilities, as well as those with less than a hundred facilities, states with mostly urban facilities and those with a majority rural facilities. However, the data does not provide insights into why these facilities performed well, only showing that it’s possible to succeed in various settings.

Lower performing states also varied widely in number of facilities, geography, and facility mix. Noncompliance with the SNF QRP program clearly does not stem from a single failure point.

Review System Breakdowns

MDS completion requires accurate documentation and coding from the entire interdisciplinary team. To be successful, compliance needs to be integrated into team practice, with shared accountability and clear leadership support.

Leaders in noncompliant facilities should do a root-cause analysis to review system breakdowns like staff turnover, inconsistent training, unclear workflows, ineffective transitions of care, or lack of real-time oversight to see which areas require improvement.

Leaders don’t need to manage every detail, but they must ask the right questions:

• Which system breakdowns lead to dashing the required MDS items?

  
  

• How do we identify issues before submission deadlines?

  
  

• How are dashes monitored and audited?

Once system breakdowns are identified, leaders can redesign their systems for effective, reliable, and lasting positive performance.

Leadership Opportunity

Every QRP data point reflects the clinical assessments completed and ultimately the care delivered. When reporting is incomplete, it is not just a compliance issue; it is a gap in how the resident’s story is told through the data. For leadership, this is the inflection point. SNF QRP compliance does not increase through reminders or last-minute corrections. It improves when systems are designed to perform reliably despite challenging real-world conditions, such as busy shifts, staffing changes, and competing priorities.

This shift requires more than oversight. It demands intentional structure, clear accountability, and consistent reinforcement that accurate reporting is a shared responsibility across the interdisciplinary team. Facilities that succeed are not chasing compliance at the deadline. They are building processes that make compliance the natural outcome of everyday work.

Questions or comments? Contact Patrick Connole at pconnole@parkplacelive.com.