Harmony Healthcare Blog

CMS SNF Payment Rates for FY 2010
 
As of October 1, 2009 the SNF PPS payment rates quoted in the Final Rule went into affect. The Final Rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs), for fiscal year (FY) 2010.
 
Harmony notes a significant change to the assignment of the RMX and RVL RUG score.  For facilities who reside in RURAL areas  the RUG will now assign RVL, not RMX when the ADL score is 15. Nothing has changed with the Urban RUGs. Facilities in designated URBAN areas will continue to get an RMX vs an RVL.
 
In addition, Harmony reminds facilities that the new RUGs IV classifications posted in the August 11, 2009 Final Rule do not go into affect until October 1, 2010.
 
Please contact Harmony Healthcare for more information on Final Rule.

RUGs IV Upate:  The LTC industry eagerly awaits the passing of the American Jobs and Closing Tax Loopholes Act.  Last week the House and Senate reached agreement on the "extenders package", also known as  American Jobs and Closing Tax Loopholes Act. This ensures that RUG IV and MDS 3.0 will be implemented together on October 1, 2010. The House will take up the bill early in the week with the Senate to follow later in the week.  Majority Leader Harry Reid (D-NV) has said he "hopes to finish the spending bill and the so-called extenders bill before the scheduled start of the Memorial Day recess at week's end." 
 
CMS released a statement that SNF's will recieve interim payment rates, effective October 1, 2010, that reflect not only the use of MDS 3.0, but also the new RUG IV system.  If the bill does not pass, then CMS plans to retroactively adjust the rates to reflect a hybrid RUG-III (HR-III) system which incorporates RUG-IV's specific revisions on concurrent therapy and the look-back period within the framework of the existing 53-group RUG-III system, along with the use of MDS 3.0.  Harmony is closely monitoring the progress on this "Package" and will update the newsletter with any new information.  Please feel free to contact us with any questions.