CMS' Final Rule Release – Impacting FY 2022 (CMS-1746-F)

Thursday, July 29th, CMS released their FY 2022 Final Rule. A few of the highlights impacting skilled nursing facilities include:

Payment update

  • Estimated 1.2% increase in payment rates (not including SNF VBP reductions or Wage Index adjustments)

PDPM Rate Parity Adjustment

  • Delayed PDPM pay rate adjustments until next year – a welcome relief after CMS had disclosed the increased spend under PDPM in 2020 vs. 2019’s RUGs based model on an intended budget-neutral program change

Updated Base Rates for PDPM Components for FY 2022

Wage Index adjustment

ICD-10 Mapping

QRP Measures

2 new QRP measures which impact the annual payment updates in FY 2023 include:

  • Reporting requirements surrounding healthcare-associated infections (HAI’s) like pneumonia, urinary tract infections, and sepsis

  • VBP Healthcare Personnel (HCP) Measure requires SNFs to report COVID-19 HCP vaccination of their staff beginning 10/1/21 through the CDC’s National Healthcare Safety Network

Value-Based Purchasing (VBP)

  • VBP suppression of the 30-Day All-Cause Readmission Measure (SNFRM) for the FY 2022 VBP program year due to COVID-10 PHE circumstances – all SNFs will receive a score of 0 irrespective of how they perform using the previously finalized scoring methods

Let's Get to the Point:

While the impact of this final rule provided a sigh of relief to many regarding the anticipated PDPM parity adjustments, there are many changes included, which are impactors of FY 2022 as well as FY 2023, to share with both our clinical and reimbursement team members.

The FY 2022 SNF PPS Final Rule will be published in the August 4th edition of the Federal Register.