A new proposed rule from the Centers for Medicare & Medicaid Services (CMS) would update prospective payment rates for skilled nursing facilities (SNF) for the fiscal year 2023. To maintain the accuracy, increase the predictability and mitigate instability and significant negative impacts to providers resulting from any future changes to the wage index, CMS is proposing to apply a permanent five percent cap on any decrease to a provider’s wage index from its wage index in the prior year, regardless of the circumstances causing the decline. CMS also proposes requirements for the Skilled Nursing Facility Quality Reporting Program and Skilled Nursing Facility Value-Based Purchasing, including a proposal to adopt influenza vaccination coverage among health care personnel. This proposed rule also requests information from the public on revising the requirements for long-term care facilities to establish mandatory minimum staffing levels.