The Centers for Medicare & Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service (FFS) prospective payment system (PPS) for skilled nursing facilities (SNF) for fiscal year (FY) 2024, which begins Oct. 1, 2023. The rule includes:
- Continuation of the negative 2.3% parity adjustment to the Patient Driven Payment Model (PDPM) case mix indices following implementation of the PDPM to maintain budget neutrality with the prior RUG-IV case-mix system. The CMS finalized a two-year phase-in of the proposed 4.6% negative adjustment for FYs 2023 and 2024, despite opposition from the MHA, the American Hospital Association and others.
- A 6.4% net increase to the SNF federal per diem base rate for providers that comply with the CMS IPF quality reporting program requirements. Facilities should note that the 6.4% net increase will be offset by the negative 2.3% parity adjustment described above.
- A slight increase in the labor-related share from the current 70.8% to 71.1%.
- Updating the SNF QRP to adopt two new measures, modify the COVID-19 Vaccination Coverage Among Health Care Personnel measure and remove two measures. The CMS did not finalize the CoreQ:Short Stay Discharge Measure, with the agency noting they intend to propose a resident satisfaction or experience measure in the future.
- Updating the SNF Value-based Purchasing program for future years by
-
- Adding the following new measures:
-
-
- Nursing Staff Turnover Measure.
- Falls with Major Injury (Long-term) Measure.
- Discharge Function Measure.
- Long Stay Hospitalization Measure.
- Replacing the 30-Day All Cause Readmission Measure with the Within Stay Potentially Preventable Readmissions Measure.
-
-
- Adopting a Health Equity Adjustment.
- Increasing the data completion thresholds to require SNFs to report 100% of the required quality measure data and standardized assessment data collected using the Minimum Data Set tool to at least 90% (instead of 80%) of assessment submitted to the CMS. SNFs that do not meet this requirement will be subject to a two percentage point reduction to their applicable annual payment update.
The MHA will provide SNFs with a facility-specific impact analysis and additional details on the final rule in the near future.
Members with questions should contact Vickie Kunz at the MHA.