The Centers for Medicare & Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service prospective payment system (PPS) for skilled nursing facilities (SNFs) for federal fiscal year (FY) 2025.
Key provisions include:
- Increasing the per diem federal rate by a net 4.2% after the market basket update, productivity adjustment and other adjustments.
- Updating the base year data used to determine the SNF market basket from 2018 to 2022.
- Updating the wage index used under the SNF PPS to reflect data from the 2020 decennial census.
- Increasing the labor-related share of the per diem rate from 71.1% to 72%.
- Making technical updates to the code mappings used to classify patients under the Patient Driven Payment Model that assigns patients to clinical categories.
- Revising the regulations to allow the CMS to impose additional financial penalties on facilities with health and safety deficiencies as identified.
- Adopting four new patient assessment items related to health-related social needs, with SNFs required to collect and report specific data elements related to living situation, food and utilities beginning with the FY 2027 SNF quality reporting program (QRP).
- Modifying the transportation item on the patient assessment item to simplify response options while also using a defined 12-month look-back period.
- Adopting a data validation process for the SNF QRP beginning with the FY 2027 program.
- Proposing operational updates to the SNF Value-Based Purchasing program, including policies regarding measure removal and review and corrections.
- Updating the case mix methodology used to calculate the Total Nurse Staffing measure.
The MHA will provide SNFs with an updated facility-specific impact analysis and additional details on the final rule, effective Oct. 1, in the near future. Members with questions should contact Vickie Kunz at the MHA.
The Centers for Medicare & Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service prospective payment system (PPS) for skilled nursing facilities (SNFs) for federal fiscal year (FY) 2025. 
