CMS releases SNF final rule

Female nurse doing blood pressure measurement of a senior woman patient. Doctor checking blood pressure of an elderly woman at old age home.

The Centers for Medicare & Medicaid Services (CMS) on July 31 issued a final rule (CMS-1696-F) outlining fiscal year (FY) 2019 Medicare payment updates and quality program changes for skilled nursing facilities (SNF). The final rule includes policies that continue a commitment to shift Medicare payments from volume to value, with continued implementation of the SNF value-based purchasing and quality reporting programs.

Effective Oct. 1, 2019, CMS will be using a new case-mix model, the Patient-Driven Payment Model, which focuses on the patient’s condition and resulting care needs rather than on the amount of care provided in order to determine Medicare payment. The final rule also modernizes Medicare through innovation in SNF, meaningful quality measure reporting, reduced paperwork and reduced administrative costs.

The South Dakota Association of Healthcare Organizations (SDAHO) will be working with Leading Age to prepare a summary and analysis of the final rule, which will be shared in the next few weeks.  Additional information and education will be communicated through SDAHO newsletters, the council on post-acute care, via email and on the next long term care conference call.