News, Skilled Nursing Facility

Ten things to note about the proposed SNF rule

A proposed rule, titled Proposed Fiscal Year 2020 Payment and Policy Changes for Medicare Skilled Nursing Facilities (CMS-1718-P), was published in the Federal Register on April 25. Here are ten things you need to know.

  1. The proposed rule suggests that SNFs be paid at an increase of $887 million, or 2.5%, for FY2020 compared to FY2019. The increased payment amount is a result of a 3.0% market basket increase with a 0.5%-point reduction.
  2. Minor revisions to the regulation text are being suggested to reflect the revised assessment schedule under Patient Driven Payment Model (PDPM).
  3. A revised definition of group therapy under the SNF PPS was provided, defining group therapy as one therapist working with two to six patients doing the same or similar activities.
  4. Implementation of a subregulatory process for updating the code lists (International Classification of Diseases, Tenth Version (ICD-10) codes) used under PDPM is being suggested, similar to the one currently used for consolidated billing.
  5. CMS is seeking comments on stakeholder concerns regarding the appropriateness of the wage index used to adjust SNF payments.
  6. Two  measures under SNF QRP were proposed, Transfer of Health Information from the SNF to another Provider and Transfer of Health Information from the SNF to the Patient, to specifically assess that the SNF provided the patient’s reconciled medication list at the time of transfer or discharge from the SNF.
  7. CMS proposes to adopt a number of standardized patient assessment data elements that assess either cognitive function and mental status, special services, treatments and interventions, medical conditions and comorbidities, impairments, or social determinants of health (race and ethnicity, preferred language and interpreter services, health literacy, transportation, or social isolation).
  8. The FY2022 SNF Value-Based Purchasing (VBP) Program performance period will be FY2020 and the baseline period will be FY2018.
  9. VBP scoring and operational updates include updated public reporting requirements for SNFs with less than 25 eligible stays during the baseline period or performance period for a Program year, and SNFs with zero eligible cases during the performance period for a Program year.
  10. A 30-day deadline for SNF VBP Phase One Review and Corrections requests was also proposed.

A CMS fact sheet on the proposed rule can be downloaded here.

The unpublished proposed rule can be downloaded here.

Comments on the proposed rule will be accepted until June 18.