Nursing Home 2026 Capital Rates Are Out for Review
(Nov. 4, 2025) The Department of Health (DOH) posted January 2026 nursing home Medicaid notice rates on the Health Commerce System (HCS) on Oct. 31st. The primary purpose of the posting is to allow providers to review the Department’s 2026 capital rate calculation and request any needed corrections. The DOH notice is copied at the bottom of this article, and the materials included with the announcement are linked here: Dear Administrator Letter (DAL), Attestation, and Attestation Workbook.
Please note that while the posted operating rates should be the same as those currently in effect (other than for pediatric rates), due to a technical error the case mix for all homes defaulted to 1.0000 and special population add-ons were omitted. DOH issued a note (also copied below) requesting that providers ignore the erroneous operating rates and proceed with the review of their capital rates, which are not impacted by the error.
The capital rates reflect the 2026 capital component calculated by DOH based on 2024 reported costs and reflect a 15% cut enacted in prior State budgets. For homes that reported overall occupancy below 90%, they are calculated based on 90% utilization (i.e., “imputed occupancy”).
This review process provides nursing homes an opportunity to verify the State’s capital rate calculation, identify any errors or discrepancies, and request that DOH modify the rate based on a corrected calculation submitted by the provider (subject to eventual Office of the Medicaid Inspector General (OMIG) audit). Any correction request should be accompanied by a completed Capital Attestation Workbook, as well as supporting documentation.
Please note that DOH asks that ALL providers, whether requesting a correction or verifying the accuracy of the State’s calculation, complete and submit the attestation by email to nfrates@health.ny.gov. Attestations and any correction requests are due by Wed., Dec. 3rd. DOH notes that capital notice rates for Adult Day Health Care (ADHC) programs were also posted, but the Department is not asking that programs attest to them at this time.
Because the 10% capital rate cut enacted in April 2024 is subject to current litigation, we recommend that, after consultation with their counsel, members include restoration of the cut as a correction request.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841
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DOH message regarding error in operating component of notice rates:
From: doh.sm.NF.RATES nfrates@health.ny.gov
Sent: Friday, October 31, 2025 3:20 PM
Subject: 2026 Notice Rates - Operating Rate Issue
Hello,
Good afternoon,
We are looking into a system error that caused the case mix acuity adjustment in the notice rates to default to 1.000. This was not done intentionally, and the case mix adjustments remain frozen at their previous level, per statute.
Please focus on the calculation of your capital reimbursement rates for the time being and we will advise as to whether the operating component can be updated for the notice period.
We apologize for the confusion. Have a good weekend.
Bureau of Nursing Home and Long Term Care Rate Setting
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DOH announcement that 2026 notice rates were posted:
From: doh.sm.NF.RATES nfrates@health.ny.gov
Sent: Friday, October 31, 2025 1:25 PM
Subject: 2026 NH, Specialty & ADHC Notice Rates
Hello,
Please find attached, information regarding the 2026 NH, Specialty and ADHC Medicaid Notice rates and Capital Attestation process.
The notice rates are posted on the Health Commerce System (HCS) application (Healthcare Financial Data Gateway) under the heading of 2026 Notice Rates.
The capital workbook and attestation are attached to this email and posted with the Notice Rates.
The attestation and any applicable workbooks should be emailed in their original file type to NFRates@health.ny.gov by COB Wednesday, December 3, 2025.
If you have questions regarding the rates or the attestation process, please send an email with “2026 NF Notice Rate Inquiry” in the subject line to nfrates@health.ny.gov.