CMS postpones PDPM pay cuts, shaves 2022 PPS pay rates to 1.2%
- By: Danielle Watford
- On: 08/09/2021 12:58:56
- In: Quality/Regulatory
Industry stakeholders had widely feared that PDPM pay rates would be cut starting Oct. 1 after CMS had surprised many by asking for comments in April. At the time, the agency stated that the new pay system had disbursed 5%, or $1.7 billion, more than intended after its onset Oct. 1, 2019 — a figure contested by many operators as overly inflated, given ensuing pandemic conditions.
The comment period, however, wound up buying fearful providers more time, as CMS acknowledged that its original analysis might not have accounted for pandemic factors appropriately.
Additionally the new rule established new quality reporting measures within the SNF Quality Reporting Program. SNFs that do not meet reporting requirements for any of the metrics can be subject to a 2% reduction in their annual update.
Starting in Fiscal Year 2023, facilities will have to report healthcare-associated infections, or HAIs, requiring hospitalization. Sepsis, urinary tract infection, and pneumonia are among the kinds of infections CMS will track, noting that HAIs often result from “inadequate patient management following a medical intervention, such as surgery or device implementation, or poor adherence to protocol and antibiotic stewardship guidelines.” CMS said it wants to be able to monitor characteristics associated with facilities that have notably higher HAI rates to encourage “improved quality of care.”
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