Harmony Healthcare Blog

Is Your Skilled Nursing Facility Ready for the 2014 PEPPER?

Posted by The Harmony Team on Tue, Apr 14, 2015

Edited by Kris Mastrangelo

2014 PEPPER is just about here. 
What lessons have we learned from the first two?

PEPPERLogo-738492-editedThe 2014 PEPPER report will be available to Skilled Nursing Facilities on April 20th.  To say that it is eagerly awaited is quite an understatement.

When the first report was released in September 2013, as an industry our reactions were “What’s a PEPPER report?”, “I’ve never heard of it.” and “How do I get a copy?”  During the months following the PEPPER release, our learning curve was vast as we collectively struggled to interpret the robust, yet complicated, data collection and analysis tool and use it to manage our business.

The next PEPPER was released in the Spring of 2014.  Many SNFs, now more familiar with the format, were better prepared to use the data as part of their compliance program to mitigate risk and ensure accurate and appropriate Medicare reimbursement.  With that said, 3 months after the release date of the report, 51% of Skilled Nursing Facilities nationwide had not yet accessed their PEPPER.  Why? Is it because we:

Now that PEPPER is a little more “mainstream,” are we more prepared to take the report and run with it? Does everyone know how to access it from the www.pepperresources.org website?  Are we ready to have flashbacks to college statistics classes with percents and percentile rankings?  The vast number of Skilled Nursing Facility owners and operators whom I encounter understand that PEPPER has valuable information, but they are still unsure of how to use the data as a compliance tool.

Among some of the more common questions are: Will the 6 Targeted Areas Remain the Same? Will we see any additions? 

In the first two iterations of PEPPER, the 6 targeted areas have been:
  • Therapy RUGs with High ADLs
  • Non-Therapy RUGs with High ADLs
  • Change of Therapy Assessment Utilization
  • Ultra High Therapy RUGs
  • Therapy RUGs compared to overall Medicare days
  • 90 Plus Day Episode of Care

Will the 20th and 80th percentile remain the key benchmarks?  Will those figures move?  If the figures change, by how much will they change?

To illustrate, let’s use the example of Ultra High Therapy.

Ultra High Therapy RUGs
   FY 2012  FY2013
20th Percentile  21.6% 69.2%
80th Percentile  28.1% 73.1%

From looking at this data, it is clear that significantly more Ultra High therapy was delivered across the country in 2013 than in 2012.  Will the trend continue?  If so, by how much will it change?  What does that mean?

No one knows the answers to these questions just yet, but we will on or around April 20th. Harmony Healthcare International (HHI) recommends having a detailed medical record review to examine any outliers (either below the 20th percentile or above the 80th percentile) that might appear on your PEPPER

HHI has helped SNF providers manage and use this tool since the inception and we will be providing assistance and analysis of the FY 2014 PEPPER beginning on April 20th.

If you have any questions or would like to receive our PEPPER analysis, please click here to contact Harmony Healthcare International or call us at (800) 530-4413. 

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