The nation's skilled nursing facilities will receive a windfall as a result of Medicare's final 2016 payment rule: A $430 million increase in payments next year. That represents a 1.2 percent overall increase.
The increase is slightly lower than the 1.4 percent bump the Centers for Medicare & Medicaid Services (CMS) proposed earlier this year.
CMS may have backed off the original increase it proposed due to economic data provided to the agency by Global Insight Inc., sources told Senior Housing News.
Some SNF payments will be tied to specific quality measures, starting in fiscal 2018. Those measures would be centered on patient skin integrity; incidence of major falls; functional status and cognitive function, along with discernible changes in both categories. According to CMS' original proposal issued last spring, SNFs that fail to adhere to the quality program would see their future updates to their payments automatically reduced by 2 percent.
SNFs have come under pressure to keep readmissions to acute care hospitals down, particularly as they play an ever-larger role in care delivery for an aging population.
Studies have shown SNFs play a significant role in hospital readmissions. A study published last year concluded nearly a quarter of SNF patients wind up in a hospital emergency department within 30 days of their discharge. Nearly 38 percent have to go to a hospital within 90 days.
The final payment rule creates what CMS considers is an acceptable unplanned readmission rate for SNF patients that takes every driver under consideration.