What is the outlook for 2019 reimbursement for SNFs?

Expect more changes that  affect reimbursement in one way or the other.

Some facilities have experienced notification of payment reductions that began in October 2018 due to not submitting their information for the Quality Reporting Program. All SNFs have received their annual SNF Value Based Program reports and adjustments to their reimbursement rates for the FY 2019.

You have seen the PBJ staffing results as part of the Five Star Rating and now you are hearing more information on the new payment system, the Patient-driven Payment Model, which goes into effect on October 1.

At the same time, we still seem to be getting more Additional Development Requests (ADRs) and Recovery Audit Contractor (RAC) reviews on Medicare and Medicaid claims.

It’s a lot to digest as each program looks at different items, uses different information and different time frames. Yet each facility is still expected to meet the requirements of each program.

Over the next few months we will explore in more detail each of these programs. We’ll explore the content of each, time frames, reports and correction dates. We will give your staff the information they need to meet each program’s requirements so that you receive the reimbursement you deserve for the care you are providing.

I also need to announce to all of you who have been reading this column for the last 10-plus years that I am retiring June 1. As a result, I am transitioning this column to my assistant and successor, Caryn Adams. Caryn has been in the industry for more than 20 years and has a wealth of knowledge of our industry, so I feel I’m leaving you in good hands. Please support Caryn the same way you have supported me! Best regards, Pat

Please send your payment-related questions to ltcnews@mcknights.com.