RehabVisions

What the Fiscal Year 2025 Final Rule Means for Skilled Nursing Facilities

On July 31, 2024, the Centers for Medicare & Medicaid Services (CMS) announced important changes for skilled nursing facilities (SNFs) that will take effect on October 1, 2024. These changes include a 4.2% increase in Medicare spending, new enforcement rules for nursing homes and several updates to quality reporting and value-based purchasing programs. Here’s a summary of what these updates mean for us.

Understanding the 4.2% Payment Increase

CMS will increase Medicare spending for SNFs by 4.2%, which amounts to an additional $1.4 billion compared to fiscal year (FY) 2024. This increase is made up of:

  • A 3% market basket update,
  • A 1.7% increase forecast error adjustment,
  • A 0.5% cut for productivity.

This increase means there is more funding available to help us continue delivering high-quality care for our residents.

Updates to PDPM ICD-10 Mapping

CMS finalized several changes to the PDPM ICD-10 code mapping.  This is intended to provide more accurate, consistent, and appropriate primary diagnoses that meet the criteria for skilled intervention during a Part A SNF stay.  Knowledge of these changes allows us to plan for and allocate appropriate resources to those needing our services.

Stricter Enforcement Policies

CMS is introducing tougher enforcement rules for nursing homes, including additional financial penalties for facilities with health and safety violations. This emphasizes the importance of maintaining high standards of care and compliance. Our therapy team will work closely with our partner facilities to ensure all therapy services meet these standards, reducing the risk of citations.

Changes to Quality Reporting Program (QRP)

Starting in FY 2025, SNFs will need to collect data on social needs, such as living situations, food and utilities for FY 2027 QRP. These changes highlight the importance of social aspects in patient care. RehabVisions is committed to including these Social Determinants of Health in our therapy plans to provide comprehensive care.

Updates to the Value-based Purchasing Program (VBP)

CMS has made several updates to the SNF VBP, this includes adopting a measure selection, retention, and removal policy for the program. There is also an update to the method used to calculate the Total Nurse Staffing measure. These updates aim to improve care outcomes and efficiency. At RehabVisions, we are committed to providing high quality therapy services with measurable outcomes that add value to our facility partners.

Looking Ahead

The CMS FY 2025 updates bring both opportunities and challenges. With increased funding, stricter enforcement and new reporting requirements, it’s crucial to stay informed and proactive. RehabVisions is here to help our SNF partners navigate these changes. By providing high-quality therapy services, staying updated on regulations and working together, our goal is to help you not only comply with CMS requirements, but also thrive.

For more detailed information on the SNF FY 2025 Final Rule and how the changes might affect your facility, view the CMS Fact Sheet or the Final Rule in its entirety.  As always, our team is here to support you every step of the way.

 

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