CMS Will Cut Skilled Nursing Facility Reimbursement

[w8liftinglady]

CMS announced in a final rule that it will cut Medicare skilled-nursing facility pay by 11.1%, or $3.87 billion, in fiscal 2012, a move strongly opposed by the SNF industry.

The CMS cut the payments to claw back estimated increased reimbursement in the current fiscal year that resulted from unintended changes in SNF Medicare billing for therapy, which had followed changes in how Medicare paid for therapy. The CMS in the rule said that it has recalibrated its payment structure, enacted through what it calls resource utilization groups, or RUGs, to correct the incentives that led to billing for higher-cost therapies.

CMS also tightened the rules for SNFs in the timing of allocating group therapy, to also reduce future overbilling.

“We are appalled that the (CMS) chose to implement an 11.1% across-the-board rate cut for skilled-nursing facilities in one year,” said a statement from not-for-profit nursing home association LeadingAge. “We believe that any across the board cut is unwarranted and problematic, and one of this magnitude is unprecedented.”

The fiscal 2012 recalibration reduced payments by $4.47 billion or 12.6%, but that change was partially offset by the update of 1.7%, or $600 million, according to the CMS. The update reflects a 2.7% inflation increase and was reduced by 1 percentage point through a productivity adjustment mandated by last year's Patient Protection and Affordable Care Act


Read more: CMS to cut skilled-nursing facility pay - Healthcare business news, research, information and opinions | Modern Healthcare http://www.modernhealthcare.com/article/20110729/NEWS/307299952#ixzz1TXJB0miI
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[William769]

1. I have a gut feeling CMS will be cutting alot more, thanks to our fearless leader.

[Mimosa]

2. Sounds disastrous.

But I can't access the article without being a subscriber. :(

[Tuesday Afternoon]

3. direct patient care is already cut to the bone

my god, does this mean management and administration of these facilities might have to take a hit?

:sarcasm: (kind of)

[enough]

4. The people taking the hit will be people who need the care, largely elderly.

Damn, I meant to reply to comment #3 above.

[Divernan]

5. CMS means Centers for Medicare & Medicaid Services

We get so used to whatever acronyms are common in our own industry/profession, that we forget others don't know what they are. I looked up CMS and SNF. (Skilled Nursing Facility)


Centers for Medicare & Medicaid Services (CMS)
www.cms.gov/ -
US federal agency which administers Medicare, Medicaid, and the Children's Health Insurance Program. Provides information for health professionals, ...
_________________________________________________________

When Obama's supporters sanctimoniously instruct others of us that Obama would NEVER cut SS/Medicare payments or services to recipients, but ONLY would cut funding to providers - THIS is how that translates. An 11 percent cut, in one year, to skilled nursing facilities? Well, I guess they could leave the patients totally unattended for 3 hours each day. As long as we can keep extending those Bush tax cuts and throwing trillions away on drone attacking assorted Muslim 3rd world countries w/oil.

[texanwitch]

6. I visit a nursing home, so this is close to home.

It is a skilled nursing home, many very sick people of mixed ages.

The people get excellent care.

This is beyound sick to take away care from very ill people who can't take care of themselves.

I lot of people will be taking their loved one's home for care.

The people who work in the homes will loose their jobs.

[w8liftinglady]

7. This translates to my work

I do wound care on patients...many who are residents of long-term care facilities.I can only imagine decreased funding equals decreased care for fragile patients...which equals increased bedsores and nutritional deficiencies.

...and no place to send the patients when they heal.

[madrchsod]

8. my god..... can`t we die with a shred of decency?

i thought death panels were a figment of the teabager`s imagination but once again i have been proven wrong.

i suppose we should hope the hell that we go quietly and quickly to spare our children the burden of deciding if they can afford to put us in a home.

i also feel sorry for those who take care of the elderly knowing that the cut will effect the people they care for.

i could say more but i`d be ......