2024 FINAL RULES SKILLED NURSING
An Analysis and Commentary on Federal Health Care Issues by Larry Goldberg
Final FY 2024 Skilled Nursing Facility PPS Update Issued
The Centers for Medicare and Medicaid Services (CMS) have issued a final rule to update the Medicare Skilled Nursing Facility prospective payment system (SNF) for FY 2024.
The rule includes a forecast error adjustment for FY 2024 and includes the second phase of the Patient Driven Payment Model (PDPM) parity adjustment recalibration (reduction). This rule also updates the diagnosis code mappings used under the PDPM.
Beginning with the FY 2025 SNF Quality Reporting Program (QRP), CMS is modifying the COVID-19 Vaccination Coverage among Healthcare Personnel measure, adopting the Discharge Function Score measure, and removing the (1) Application of Percent of Long-Term Care Hospital Patients with an Admission and Discharge Functional Assessment and a Care Plan that Addresses Function measure, (2) the Application of IRF Functional Outcome measure: Change in Self-Care Score for Medical Rehabilitation Patients measure, and (3) the Application of IRF Functional Outcome Measure: Change in Mobility Score for Medical Rehabilitation Patients measure.
This final rule also contains updates pertaining to the public reporting of the (1) Transfer of Health Information to the Patient-Post-Acute Care (PAC) measure, (2) the Transfer of Health Information to the Provider-PAC measure, (3) the Discharge Function Score measure, and (4) the COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date measure.
CMS is finalizing several updates for the SNF VBP Program. CMS is adopting a Health Equity Adjustment that rewards top tier performing SNFs that serve higher proportions of SNF residents with dual eligibility status, effective with the FY 2027 program year and adopting a variable payback percentage to maintain an estimated payback percentage for all SNFs of no less than 60 percent. CMS is adopting four new quality measures to the SNF VBP Program, one taking effect beginning with the FY 2026 program year and three taking effect beginning with the FY 2027 program year.
The 451-page document is scheduled for publication in the Federal Register on August 8. A copy is currently available at: https://public-inspection.federalregister.gov/2023-16249.pdf
CMS Releases Four Rules – IPPS, Psychiatric, Rehabilitation and Skilled Nursing Containing Corrections to the FY 2024 PPS Programs
The Centers for Medicare and Medicaid (CMS) have issued 4 rules with corrections to the final FY 2024 prospective payment system (PPS) programs. These include Inpatient, Inpatient Psychiatric, Inpatient Rehabilitation and Skilled Nursing. The rules are effective October 1, 2023, the start of Federal Fiscal year 2024.
The rules are scheduled to be published in the Federal Register on October 4. Copies of the display versions are available as follows;
Inpatient PPS – https://public-inspection.federalregister.gov/2023-22060.pdf. (15 Pages)
Inpatient Psychiatric – https://public-inspection.federalregister.gov/2023-22053.pdf. (9 Pages)
Inpatient Rehabilitation – https://public-inspection.federalregister.gov/2023-22051.pdf. (6 Pages)
Skilled Nursing – https://public-inspection.federalregister.gov/2023-22050.pdf. (12 Pages)