SNF ALERT - CMS Final Rule

Updated: Oct 9, 2019

On Tuesday CMS issued the FY 2020 SNF Final Rule which will take effect on October 1, 2019 and includes a series of rate, regulatory, definition, and reporting updates that we have summarized for you. An updated payment rate was finalized under the SNF PPS for 2020. It also includes revisions that reflect the revised assessment schedule under PDPM as well as updated requirements for the SNF Value Based Purchasing Program and the SNF Quality Reporting Program (QRP). Here are the latest updates that are most likely to impact your organization:


PDPM Updates

  • An increase in payment to SNF’s $851 million or 2.4% for FY 2020, compared to FY 2019.

  • FY 2020 Urban and Rural rates have been finalized for each PDPM component.


  • Case Mix Components were finalized for each PDPM Category.

  • CMS is changing the definition of Group Therapy for SNF providers to be 2-6 residents in order to align consistency in payment policies across PAC settings. 75% will be individual therapy, and 25% will be combined group and concurrent therapy.

  • CMS approved sub-regulatory process for ICD-10 code revisions.





Value-Based Purchasing Updates

  • The SNFPPR’s name will change to “Skilled Nursing Facility Potentially Preventable Readmissions after Hospital Discharge”.

  • An update to reporting requirements to ensure that CMS publishes accurate performance information for low-volume SNF’s.

  • A 30-day deadline for Phase One Review and Corrections requests.


Quality Reporting Program Updates

  • 11 SNF QRP are currently adopted for the FY 2021.

  • Discharge to Community Post-Acute Care SNF QRP measure will exclude baseline nursing home residents.

  • Two new quality measures will assess whether certain health information is provided by the SNF at the time of transfer or discharge which will begin with FY 2022 SNF QRP.

- Transfer of Health Information to the Provider Post-Acute Care

- Transfer of Health Information to the Patient Post-Acute Care

  • A new program, SPADEs - Standardized Patient Assessment Data Elements - will begin FY 2022 and include 75 assessment data elements of the following categories:

- Functional Status

- Cognitive Function

- Special Services, Treatments and Interventions

- Medical Conditions and Comorbidities

- Impairments

- Other categories deemed necessary and appropriate

  • Data collection of SPADEs will begin October 1, 2020 through December 31, 2020 for the FY 2022 SNF QRP.

  • It’s expected that the MDS form will change October 1, 2020 to support the new SPADEs program.


As the clock ticks down to October 1st, Concept Rehab will continue to provide education, tools and resources to support our customers in a successful transition and implementation. If you’d like to speak to one of our Post-Acute Care specialists please contact Caryn Enderle at 614-570-2404 or by email at caryne@conceptrehab.com.





In order to keep you and your interdisciplinary team up to date, download our revised PDPM Quick Guides that now include the Final

Rule revisions and updates here.



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