CMS, OIG, and Other Agency Resources
Adverse Events in Skilled Nursing Facilities: National Incidence Among Medicare Beneficiaries, Office of the Inspector General (March 3, 2014)
Skilled Nursing Facility PPS
August 27, 2024
At A Glance
The Centers for Medicare & Medicaid Services (CMS) July 31 issued its fiscal year (FY) 2025 final rule for the skilled nursing facility (SNF) prospective payment system (PPS). This rule updates SNF payments and modifies CMS’ nursing home enforcement authority and the SNF Quality Reporting Program (QRP) measures and reporting requirements.
Key Highlights
The rule will:
- Increase aggregate SNF payments by an estimated 4.2% ($1.4 billion) in FY 2025 relative to FY 2024. This includes a:
- 3.0% market basket update reduced by a 0.5% productivity cut.
- 1.7% increase due to FY 2023 market basket forecast error.
- Make technical changes to its Patient-Driven Payment Model (PDPM) ICD-10 code mapping that assigns patients to clinical categories.
- Revise CMS nursing home enforcement authority to allow the agency to impose multiple financial penalties on nursing homes with safety deficiencies.
- Adopt and modify patient assessment items addressing social determinants of health (SDOH).
View the entire AHA Regulatory Advisory.
Key Resources
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- Regulatory Advisory: Skilled Nursing Facility PPS Proposed Rule for FY 2023 (5-20-22)
- Regulatory Advisory: Skilled Nursing Facility PPS Final Rule for FY 2022, (8-26-21)
- Special Bulletin: CMS Releases FY 2022 IRF and SNF PPS Final Rules (7-30-21)
- Advisory: Skilled Nursing Facility PPS Proposed Rule for FY 2022 (4-29-21)
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- Letter: Comments to CMS on its CY 2023 Proposed Skilled Nursing Facility PPS (6-16-22)
- Letter: AHA Raises Concerns With Prototype PAC Payment Model (8-24-21)
- Letter: AHA Comments on Skilled Nursing Facility Proposed Rule For FY 2022 - 6-7-2021
- Member Call: Skilled Nursing Facility PPS: Proposed Rule FY2021, May 20, 2020
- Member Call: Skilled Nursing Facility PPS: Final Rule for FY 2020 (August 21, 2019
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