CMS has confirmed the 2024 Final Rule for the skilled nursing facility (SNF) prospective payment system (PPS) and as a result, major changes are on the horizon. Beginning October 1, 2023, and continuing through September 2024, and future years, the Final Rule includes updates to the SNF Quality Reporting Program (QRP), along with the addition of two new measures being implemented, one modification, and three being removed.
SNF QRP Data Completion Threshold
Beginning in 2024, SNFs will bear the responsibility to collect data and publicly report to ensure compliance with QRP measures. One of the most pivotal changes will be an increase to the SNF QRP data completion threshold from 80% to 90% within the Minimum Data Set (MDS). Facilities will need to be in line with the specified guidelines provided from the newly established QRP requirements. This will result in SNFs realizing a 10% increase in the requirement of 100% collection of data associated with the required quality measures and standardized patient assessments. Facilities will also go from 99 QRP items currently, to 230 MDS items come October 1, 2023.
In order to ensure compliance, SNFs must use the MDS to gather data on a minimum of 90% of assessments that are submitted to CMS. With the SNF QRP being classified as a pay-for-reporting system, lack of compliance with the updated requirements will result in losses for facilities. The penalty assessed to the SNF will entail a 2% reduction in their annual payment for fiscal year 2026, resulting in decreased reimbursements.
Discharge Function Score Measure
CMS is also adopting the Discharge Function Score Measure, which will begin pulling data on October 1, 2023, and will be implemented along with the 2025 SNF QRP. This measure assesses functional status by evaluating the percentage of SNF residents who meet or exceed an expected discharge function score and uses mobility and self-care items already collected on the MDS. This measure will be replacing the Application of Percentage of Long-Term Care Hospital Patients with an Admission and Discharge Functional Assessment/A Care Plan that addresses function measure. For more details on the new measure and other changes, access the CMS User Manual here.
Ensure Your SNF is in Compliance with Real Time
With the fast-approaching onset of these quality measure modifications, it is critical for SNFs to be proactive in managing their data. With Real Time’s live, data analytics solution, SNFs can better manage patient care and outcomes, while ensuring their facility is in compliance with the QRP measures. By utilizing Real Time’s proprietary AI algorithms, post-acute providers will receive alerts for any of the dashes in the MDS sections that impact the QRP calculation. SNFs can also identify any trends, such as a clinical system breakdown or lack of understanding on how to code a certain MDS question. Early adoption and proper utilization of a real-time data analytics solution will enable SNFs to effortlessly transition to the strict updates that have been announced as a result of the fiscal year 2024 SNF PPS Final Rule.
To learn more about Real Time’s post-acute data analytics solution and the ways we can help, contact us today.