Final SNF rule could arrive in September, experts forecast

Phillips estimates the final rule for SNFs will arrive in September, and include elements on QAPI and compliance
Phillips estimates the final rule for SNFs will arrive in September, and include elements on QAPI and compliance

The final version of the Centers for Medicare & Medicaid's massive proposed rule for skilled nursing facilities is estimated to be released in September 2016, a long-term care policy expert shared on Wednesday.

Elements of that final rule, which was first released as a massive 403-page proposal last July, are “guaranteed” to include Quality Assurance Performance Improvement, ethics, compliance and infection control said Cheryl Phillips, M.D., senior vice president of LeadingAge.

The organization is pushing back against certain portions of the proposal, Phillips said during a LeadingAge Illinois session, including new requirements for construction and the “crazy” provision that would require a physician to see a resident before the resident was transferred to a hospital.

Also high among the group's regulatory priorities is MedPAC's aim to create a site-neutral payment model for post-acute care, which Phillips said “all sounds theoretically good,” but should cause some concern among providers for its lack of attention to residents' individual needs and characteristics. The latter may include co-morbidities.

“The analogy that I use is if you buy a cookie in a package. Whether you go to Starbucks, or you go to 7-Eleven, or you go to Safeway, it's the same cookie in the same package. You should pay the same price,” Phillips told conference attendees. “But we're not cookies, and the people we take care of are so much more complex than that.”

LeadingAge will also turn its regulatory focus to legislation like the Rural Health Care Connectivity Act, and the Improve Access to Medicare Coverage Act, which targets hospital observation stays. (The NOTICE Act “doesn't solve the observation days problem,” Phillips noted.)

Phillips also encouraged providers to begin preparations for payroll-based journaling, which will go live on July 1, 2016, as well as the new Five-Star Quality Measures released by CMS last month.

Those sentiments were echoed earlier in the day by McKnight's Payment Expert Patricia Boyer, MSN, NHA, RN, during a session on Medicare updates in 2016. Among the top issues tackled by Boyer during the session include the new quality measures, bundled payments, changes to MDS 3.0, and tools such as INTERACT.

“There's going to be more changes in the next five years than there's been in the past 15 years,” Boyer warned providers. “Get ready to put on your running shoes.”

The LeadingAge Illinois conference concludes Thursday at the Renaissance Schaumburg Convention Center.