Feds Propose Rule to Promote Safety and Quality in Nursing Homes
On Monday, the U.S. Centers for Medicare and Medicaid Services (CMS) issued its FY 2023 Skilled Nursing Facilities Prospective Payment System (SNF PPS) proposed rule seeking public feedback on how staffing in nursing homes and health equity improvements could lead to better health outcomes. According to CMS, the proposed rule builds upon the Biden-Harris Administration’s commitment to advance health equity, drive high-quality person-centered care, and promote sustainability of its programs.
The SNF PPS providers Medicare payments to over 15,000 nursing homes serving more than 1.5 million people. Through its proposed rule, CMS is continuing to transform the SNF payment system to a more patient-centered model by making payments based on the needs of the whole patient rather than focusing on the volume of certain services the patient receives.
In the proposed rule, CMS is soliciting input to help the agency establish minimum staffing requirements that nursing homes will need to meet to ensure all residents are provided safe, high-quality care, and nursing home workers have the support they need. The input will be used in conjunction with a new research study being conducted by CMS to determine the optimal level and type of nursing home staffing needs. The agency intends to issue proposed rules on a minimum staffing level requirement for nursing homes within one year.
Additionally, CMS is requesting stakeholder input on a measure to examine staff turnover levels in nursing homes for possible inclusion in CMS’ SNF Value-Based Purchasing (VBP) Program, which rewards facilities with incentive payments based on the quality of care they provide to people with Medicare. The proposed rule also considers the adoption of three new measures into the SNF VBP Program, including infection prevention and management, total nursing hours per resident day, and successful community discharge.
Last, CMS is proposing a 3.9 percent, or $1.4 billion, update to payment rates for nursing homes and a proposed adjustment to payment rates as the result of the transition to SNF payment case-mix classification model.
Additional information from CMS is available here.