CMS FY 2022 Final Rule for Skilled Nursing Facilities

Annually, the Centers for Medicare and Medicaid Services update regulations to Medicare payment policies for Skilled Nursing Facilities (SNFs). Reviews and updates of the regulations account for patient-care-related payment adjustments, inflation factors, and wage index adjustments.

The CMS FY 2022 final rule included updates for Medicare payment policies and rates, SNF quality reporting, and the SNF Value-Based program. This final rule allows SNFs to continue to focus on their response to the COVID-19 pandemic with streamlined requirements and regulations. 

Many of the changes made in the CMS rule have a minimal impact on many organizations. But, it is important to be aware of any changes that are impacting an organization and its fiscal health. 

Below you will find our key observations from the CMS final rule for skilled nursing facilities. 

Key Observations

• CMS confirmed payment increases by 1.2% for SNFs. This will result in an estimated $410 million increase in payments compared to last year. 

• The SNF quality program had minor changes. Changes included the introduction of two new quality measures. 

• The Patient-Driven Payment Model (PDPM) did not have any changes. 

• SNF readmission rates will still be calculated but will not be used to score facility performance for the FY 2022 Value-Based Purchasing program. 

• Introduced Part A billing exemption for blood clotting factors and related services and items.

Need help understanding how the CMS final rule might impact your skilled nursing facility?

The team at MCA is here to help!

Schedule a Call

For more detailed information on the Centers for Medicare and Medicaid FY 2022 final rule for skilled nursing facilities, you can download the full rule from the Federal Register. Or, check out the CMS fact sheet.

Overview of the CMS FY 2022 Final Rule for Skilled Nursing Facilities (SNFs)

Market Basket and Payment Update

CMS has set the market basket rate for FY 2022 at 2.7%. This rate update increases payment by 1.2%. Resulting in an estimated increase of $410 million for Medicare Part A payments to SNFs. The rate increase includes a forecast error adjustment of 0.8% and a productivity adjustment of 0.7%. These are subtracted from the market basket percentage.

Consolidated Billing

To account for the exclusion of certain blood clotting factors, CMS finalized a reduction of the Medicare Part A SNF rates. Additionally, the final rule did include added HCPCS codes that were not included in the proposed rule. These codes are billed separately under Part B when associated with a SNFs Part A resident. CMS finalized a $0.02 in the adjusted urban and rural rates to reflect the exclusion of the blood clotting factors.

Find more information about the excluded codes on the SNF Consolidated Billing website under our resource section below.

Patient-Driven Payment Model (PDPM)

CMS determined that the PDPM had paid approximately 5% more in FY 2020 than it would have under the previous payment model. CMS had noted that a recalibration of the PDPM parity adjustment is needed. They proposed various methodologies in the proposed rule. It was determined that no changes to the PDPM will occur for FY 2022. Instead, CMS intends to propose recalibration methods on the FY 2023 SNF PPS Proposed Rule.

SNF Value-Based Purchasing Program

The final rule acknowledges that COVID-19 has impacted the readmission measure and resulting performance scores. Because of this, CMS will continue to suppress the use of SNF readmission measure data for scoring and payment adjustments in the SNF value-based purchasing (VBP) program. 

CMS confirmed that SNF readmission rates will still be calculated. But, the score would not be used to rank SNFs, score facility performance, or calculate the incentive payment. Instead, all SNFs participating in the VBP program will receive a score of zero regardless of their performance. To compensate for suppressing this score, CMS plans to reduce each eligible SNFs adjusted federal per diem rate by 2% and return 60% of the withhold as their incentive payment. This results in a 1.2% payback to the SNFs.

CMS does plan to report the FY 2022 SNF readmission rates noting the data limitations due to the COVID-19 public health emergency.

Quality Reporting

CMS confirmed that the SNF quality reporting program (QRP) will continue as a pay-for-reporting program. Additionally, any SNFs that do not meet the reporting requirements may be subject to a 2% reduction in their annual update. 

CMS finalized the adoption of two no measures for FY 2023.

• COVID-19 Vaccination Coverage Among Healthcare Personnel Measure –  CMS has determined that it is important to assess whether SNFs are taking steps to reduce COVID-19 transmission. This measure requires facilities to disclose healthcare personnel vaccination data to the CDC and National Healthcare Safety Network. 

• Skilled Nursing Facilities Healthcare-Associated Infections (HAI) Outcomes Measure – This risk-standardized measure is being implemented to help identify facilities that may see higher rates of infection in the event of another pandemic. This is a claims-based measure so no additional data will be required from the SNFs. 

CMS also finalized updates to the Transfer of Health Information to the Patient – Post-Acute Care Measure. For this measure, the denominator will exclude residents discharged home under the care of an organized home health service or hospice. 

How can we help

We recognize that the CMS final rule changes can have a broad impact on your organization. The information and breakdown of the CMS final rule is our summary. It is our goal to ensure that all our clients remain informed of any changes that may impact the financial health of their organization.

Should you have questions about the CMS final rule, we’re always here to help. But, we also encourage all our clients to review the final rule with their legal and compliance teams. This helps to ensure you’re applying these decisions to your organization appropriately.

At the end of the day, we strive to provide you with information and support. So, if there is anything we can do to help, don't hesitate to reach out.

Contact MCA

Resources

FY 2022 Skilled Nursing Facility PPS Final Rule

FY 2022 Skilled Nursing Facility PPS Final Rule Fact Sheet

Skilled Nursing Facility Quality Reporting Program

Skilled Nursing Facility Value-Based Purchasing Program

Patient-Driven Payment Model 

SNF Consolidated Billing  

What Daily Updates Can Do for Your Medical Billing

How often do you (or your billing team) check on the status of all of your claims? If you're like most billers then you're probably checking on them at least weekly. 

In fact, if you're like most billers you probably are checking them right after you post remittance advices.

It's no doubt this process helps you (or your billers) save time by focusing only on what has not been "Paid." 

On the other hand, this follow-up process may be resulting in your claims (and payments) being delayed beyond the 30-day mark.

Additionally, claims take tremendous time to review and re-work.

1. You have to call or check the payer(s) portal
2. Take down the denial reason codes
3. Locate the claim 
4. Make the appropriate correction(s) in order for the claim to be re-processed

This full process can take several hours (if not days) to complete.

No one should have to spend this much time researching denials. 

And, if your billers have other duties they may have to push back working these denied claims until they have more time to review the denials and take the appropriate next steps.

Wouldn't it be great if you had a system that did all of the updates for you and provided the "Next Step" at the same time?

I'd like to introduce our solution - REVEX!

REVEX is an interactive (HYPER AUTOMATED) aging report. Our platform allows billers to work their aging reports without the unnecessary steps of checking claim status with the various payers.

How it works.

REVEX is supported by both professional medical billers and HYPER AUTOMATION technology. With this careful blend of human interaction and technology, we are able to provide daily updates on all of your claims.

You may be asking, "What value would daily updates bring to my billing?"

Daily updates will allow you to make well-informed decisions on your claims.

• For example, if you were a biller who waits until you post a remit to begin your denial management process then you might not start correcting claims until about 7-10 days after the claim was originally submitted.

• With the daily updates, you can identify the claims that were immediately denied and correct these at least 3-4 days earlier than before.

This, in turn, allows you to accomplish 2 things:

1. Reduce claims from rolling over each month.
2. Plan out your follow-ups more effectively.

The claim data is organized using our frameworks so users can easily navigate and address their open claims.

In doing so, your team can now save up to 50% of their work week.

Imagine having 50% of your time freed up to work on more fulfilling duties. Wouldn't this time be useful for you? 

Your next step: Schedule a call with one of our REVEX managers. During the call, we can discuss exactly how REVEX can help you and your organization.

 Please feel free to comment your questions!

Also, don’t forget to subscribe for email updates right above this article!

Thanks so much for reading!

Why Your Office Needs THESE Pickles ASAP!

You would never guess that dill pickles, fried pickles, sweet pickles, homemade pickles, even pickle juice are all crucial to your company, but they are!  Pickles ARE the core of your company.  This variety of pickles will keep your company operating efficiently, boost employee morale, and brings a sense of balance to the office. 

 

Okay, I’ll confess I’m not really talking about pickles here.  Though, I am not opposed to having pickles in the office as they can be quite delicious… It’s a metaphor for how to consider personalities when hiring your team. If you happen to want to bring the pickles into the workplace as well- because lets face it, pickles will probably still boost morale- then so be it!

 

Let’s get down to the juicy stuff! What “pickles” DO you need in the office?

 

The Real “Dill”

 

The Dill pickle is recognized as the most popular pickle you’ll find in a refrigerator, on a sandwich, or in a big glass jar at the gas station.  Why are Dill pickles the most popular? They are reliably good!  The first type of pickles you NEED in your workplace are reliable pickles without a doubt. 

 

The office “dills” are going to be the people you know will get the job done and done well.  They are employees you can turn to for help with tasks that may not even be their responsibility simply because they want to do their best work possible and genuinely care.  This type of person is resourceful, often collaborative, and consistently productive.  The “dill” employees are also generally likely by their coworkers due to their amiability, work ethic, and reliability. 

 

Eatin’ Sweet!

 

Bread and butter pickles, or sweet flavored pickles, are our next necessity in the office.  Though not highly favored like the reliable dill pickles, the sweet pickles soften up what can sometimes be a tense environment.

 

An employee who is considered sweet, sympathetic, and thoughtful can bring a sense of home to the workplace.  This is the person always checking on how your family is doing, bringing baked goods to the workplace, checking to see if anyone needs help, organizing office parties, remembering birthdays, and so on. 

 

Do not let the sweetness fool you, this person does still need to be a hard worker and due to their level of care, likely will be.  Bringing this sense of hospitality and warmth to the workplace does make it a little bit easier for coworkers to come in every day which is why sweet pickles are a necessity in your office!

 

Fried?!

 

If you haven’t tried a fried pickle, let me tell you, you are missing out big time!  Lucky for you, I can draw up a nice comparison for what a fried pickle experience might entail.  Fried pickles have a lovely contrast in textures from first the cream ranch you dip it in, to the soft, greasy crunch of the fried breading encrusting them, and finally the thorough chomp-crunch of the actual pickle itself.  This pickle experience is multifaceted, highly enjoyable, full of smiles, and a solid go-to for a great time!

 

In the office, the fried pickle is going to be somebody known for their light-heartedness, constant smile, and who cannot be serious for 8 straight work hours.  With their complex texture, the fried pickle knows when its time to have fun, be focused, and crack the right joke without compromising professionalism or productivity. 

 

Sometimes, when tensions are high in the office, people may look to this person to lighten things up with some humor or even just a well-timed smile.  The fried pickle brings the belly laughs and leaves the drama at the door which makes them well-liked by coworkers and keeps the air in the office light!

 

Homemade > Store Bought

 

Yes, people home-make pickles.  Homemade is one of the best types of pickles of all for the workplace!  Homemade pickles are fairly simple requiring about 8 ingredients and a jar.  However, this is still more time consuming than just going to the store and buying pre-made pickles, and it may not taste like the mainstream pickles we are used to.  However, on the health and hard work scale, these persevere.

 

Homemade pickles are vital to the workplace because they are a solid foundation of great work ethic, ingenuity, perseverance, self-starting, and punctuality.  As homemade pickles do not come easy, these employees worked their butts off to get where they are and have a solid skills base as well a strong commitment to the company.  These individuals are focused and highly motivated due to their sense of pride in their work.  When employees have pride in their work, the company is going to reap the benefits of high quality and high productivity.

 

Pickle Juice, Pickle Juice, Pickle Juice!

 

Okay, I know this is “technically” not a pickle, but it is the whole soul and essence of the pickle besides the cucumber element itself.  Pickle juice is the entire driving force behind creating, maintaining, and the enjoyment of the pickles.  Pickle juice offer many benefits: it hydrates, relieves muscle cramps, enhances gut health, and even contains antioxidants.  There are so many benefits to pickle juice and even more to having “pickle juice” in your workplace!

 

Regarding the workplace, I consider the culture and core values the “pickle juice” of a company.  Just as pickle juice is the core to creating and maintaining the pickles, the culture and values of a company being in line with employees is especially important to the company’s success.  Take a look at REVEX’s blog post on the 5 Ways to Revamp Communication on Your Workplace which touches on the importance of establishing a company culture and core values.

 

When a company culture and values are embraced by employees, there is a cohesiveness to the workplace which promotes higher levels of productivity and morale.  Setting a company culture of quality, trust, innovation, family, systems, resourcefulness, and so on will guide employees to live out positive values every day in the workplace.  The culture and value “pickle juice” must be present in all employees which makes EVERY employee a pickle!

 

 

To conclude, you NEED this variety of pickles (and pickle juice) in your workplace!  If all of your employees were the same type of people, your company might lack innovation, creativity, collaboration, and fun!  The strategic combination of reliable, nurturing, energetic, hardworking, and cultured employees will help your company and your employees to thrive.

 

 

Also, don’t forget to subscribe for email updates on the left-hand side of this article!

Thanks so much for reading!

 

Dani Barry 

Marketing Manager 

REVEX

REVEX is a Medical Billing Service & Software Company catering  to the Healthcare Industry. 

(Specifically Skilled Nursing Facilities)

5 Ways to Modernize Your Workplace

Have you ever walked into your office after working there for 5, 10, maybe even 15 years and realized not one thing has changed in all that time besides your age?  Have you been grappling with that one pesky printer and walking to the same corner to the water cooler since you can remember?  Do you still work on a 95’ Windows PC equipped with minesweeper and a big box back? 

 Modernizing your workplace can have a significant impact on employee productivity, morale, budget, and the company’s overall success. 

 Moreover, with millennials becoming a growing percentage of the workforce, you need to consider the preferences of different generations to cultivate the optimal workspace so each employee can be as productive as possible.  Check out our blog on 7 Ways to Manage Different Generations to find new ways to support diverse generations in updating your workplace.

 

Keep reading for our five ways to bring the modern world into your workplace:

Enhance Your Aesthetics!

The professional aesthetics of your office directly affect employee productivity, morale, and overall happiness.  Interior design and feng shui will help your employees feel comfortable at work, look forward to coming to work, and even welcome visitors to the space as it sets the tone for your company. 

Overall aesthetic should be a clean design that is free of clutter with wires hidden, open spaces, and room for collaboration.  Natural lighting is known to increase productivity, happiness, calmness, and lead to healthier employees.  Ditch the wood paneling and upgrade your office’s color pallet for a fresh coat of paint your employees can enjoy seeing every day!

Prioritizing communal spaces for employees to co-work, collaborate, and converse benefits the company by allowing relationship and idea building between people who may not have desks close to one another.  When employees can collaborate, concepts can grow through idea and experience sharing which advances opportunities for the company as a whole.

Invest in Technology! 

Technology is crucial when it comes to saving your company time and money.  Yes, initially upgrading your technology is an investment but when you factor in the amount of time it saves, the increased labor output, and the decrease in spending on office supplies (pens, paper, folders, etc.), the upgrade pays for itself in the long run.  Not to mention, technology aides in the “go-green” initiative and keeps your company competitive with others.

Technology aides in saving on labor costs because little adjustments like switching to wireless charging, wireless streaming for meetings (no more HDMI struggles), and touchscreens can save small amounts of time throughout the say which add up in the future.

Offering technology training and troubleshooting resources onsite is also a major modern movement of the workforce.  Rather than having an employee try to fix their own computer on the phone with the manufacturer, companies now have an IT specialist to manage the problem and get the employee right back on track with minimal downtime.  The saves the company on bringing in contractors and having to wait for employees to get back online.  It also helps lessen the frustrations of employees who struggle with technology, which leads to happier employees.

Upgrading the technology in your office is also important if you want to remain competitive in the labor market.  Companies want to hire the best, most qualified employees possible and with a shift in generations in the workplace, this means accommodating digital natives.  Digital natives are the younger generations entering the workplace who were raised on today’s technology and are constantly keeping up with new tech.  Offering a workplace competitive in technology upgrades means your company won’t fall behind when it comes to the labor market.

 

Flexibility

 Though flexibility is a broad topic, it is taking charge in the modern workplace.  Employers are beginning to realize the value in allowing employees to work a little more on their terms as long as they maintain and exceed productivity levels. 

 Offering the option for employees to work from home has become a major trend for companies even before Covid-19 struck.  Not only does it save the company on office space, it allows employees to work in a comfortable environment, save time and money on commuting, flexibility in where employees work from, and so much more.  The biggest downfall here is finding ways to ensure your employees are being productive and not distracted by home factors.

 Another way to offer flexibility in the workplace is through scheduling.  Many offices have daily arrival and departure expectations for salary employees (i.e. 9-5 or say 8-4).  If their job is not held to duties that must be done during the standard workday, consider letting your employees shift their schedule a bit.  If an employee knows they are not a morning person, let them come in a bit later and leave later as well (11-7) as long as the position allows it.  Some companies also offer split work schedules where an employee can come in from 8-12 then continue to work from home from say 3-7.  Allowing your employees this bit of flexibility helps them consider needs in their personal lives, work when they’ll be most productive, and they feel heard and cared about at work.  This method will boost productivity and morale by giving your people a voice to tell you what they need which brings me to my next point…

 Listen to your employees.  When you are looking to modernize your workplace, reach out to employees for suggestions on what they need.  You do not have to take every suggestion but work to compromise with your employees, so they feel heard and valued. 

Track and Use Data Wisely!

Modern companies are making huge strides to quantify and track as many factors of productivity in the workplace as they can.  Keeping data on the usage of office amenities, utilities, and spaces will help your company see where they needs to invest and what they can downsize in your physical office.  This is very effective when it comes to budgeting office upgrades and ensuring money is going where it needs.

Data is also crucial in tracking employee productivity and retention.  This responsibility would fall on human resources to learn why certain trends are the way they are and what can be done to improve these numbers in the future.

Encourage a Healthy Work-Life Balance!

Technology plays a major role in this factor of modernization.  With cellphones being a computer on the go, employees feel constantly tied to the workplace and available for any work needs.  This can add constant pressure and stress to your employees.  We recommend encouraging employees to “turn-off” when being available is not crucial to their position.  Now I know some positions, especially in the healthcare field, require people to be on-call or somewhat available incase of crises.  However, giving employees some guaranteed “off the clock” or “off the grid” time will help them to relax and unwind. 

A healthy work-life balance has so many benefits for your employees such as boosting morale, increasing employee retention, but most of all, it lowers burnout rates for employees.  Some people do not know how to balance the two and when an employer recognizes this and cares enough to step in and ensure their employee is giving appropriate time to both, it can save the employees relationship with the company and their career.

In conclusion, if your workplace needs a refresher and you want to upgrade your workplace, consider aesthetic, technology, flexibility, data acquisition, and the importance of work-life balance.  Not only will this bring your company into modern times, it will support your employees’ more than you know!  Please feel free to share any training or certification resources you recommend or ask any questions in the comment section below!

 

 

 

Also, don’t forget to subscribe for email updates on the left-hand side of this article!

 

Thanks so much for reading!

Dani Barry

Marketing Manager

REVEX

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Aihini, Danielle, and Ryan MacInnis. “How Companies Use Workplace Data to Optimize the Office.” Robin, 28 Oct. 2019, robinpowered.com/blog/how-companies-use-analytics-in-the-workplace/.

Davis, Chris. “5 Workplace Design Trends for Boosting Employee Engagement.” ViewSonic Library, 20 Nov. 2019, www.viewsonic.com/library/business/workplace-design-trends/.

Doyle, Alison. “What Is Workplace Flexibility?” The Balance Careers, www.thebalancecareers.com/workplace-flexibility-definition-with-examples-2059699.

Ellis, Christine. “The Modern Workplace Trends You Need to Know About.” IT Lab, www.itlab.com/blog/the-modern-workplace-trends-you-need-to-know-about.

Modern Workplace: Is Your Business Up With the Times? Trends In The, 1 July 2020, instapage.com/blog/modern-workplace-trends.