Skilled Nursing Facility

CMS issues new SNF PPS Final Rule for 2020

On July 30 CMS issued a final rule updating the payment rates under the prospective payment system (PPS) for SNFs. The rule, designed to increase aggregate payments to SNFs by $851 million in 2020 compared to 2019, will go into effect on October 1.

This rule includes three main revisions:

  1. The rule includes minor changes to the regulation text to reflect the revised assessment schedule under PDPM. Rates have been lowered 0.4% for the multiproductivity factor, reducing costs for SNFs.
  2. The rule revises the definition of group therapy under SNF PPS. Currently, group therapy is defined as four patients, but under the new rule will be defined as between two and six residents.
  3. The rule adds two new measures to the SNF QRP which are designed to assess whether certain health information is provided by the SNF at the time of transfer or discharge:
    • Transfer of Health Information to the Provider-Post-Acute Care
    • Transfer of Health Information to the Patient-Post-Acute Care

In addition, CMS will update the specifications for the Discharge to Community PAC SNF QRP measure to exclude long-term residents, and only consider short-term resident discharges. It will also update the public reporting requirements from SNFs and give a 30-day deadline for Phase One Review and Corrections requests.

While the final rule will go into effect on the same day as PDPM, it does not include any changes to the new payment model.