Nursing houses to obtain Medicare pay bump of 4% in 2024


Expert nursing amenities are set to obtain a 4% enhance in Medicare reimbursements in fiscal 2024 beneath a last rule the Facilities for Medicare and Medicaid Providers issued Monday.

CMS proposed a 3.7% enhance in a draft regulation printed in April. The ultimate cost coverage displays a 3% market basket replace plus a 3.6% enhance to appropriate prior forecast errors, and minus a 0.2% productiveness adjustment and a 2.3% discount from clawbacks associated to the implementation of the Affected person Pushed Cost Mannequin.

The ultimate rule additionally contains modifications to high quality reporting for skilling nursing amenities. Nursing houses that don’t meet reporting necessities are topic to a 2-percentage-point cost penalty.

The regulation requires that amenities submit high quality and standardized resident evaluation data utilizing the minimal knowledge set in a minimum of 90% of stories beginning in fiscal 2026, or face cost penalties. As well as, nursing houses will start reporting the Nursing Workers Turnover Measure, with cost penalties beginning in fiscal 2026. The ultimate rule provides measures of hospitalization charges of long-stay residents and falls with main accidents to the standard reporting program.

CMS additionally adopted a well being fairness measure. Nursing houses with resident populations which might be a minimum of 20% dually eligible for Medicare and Medicaid can high quality for cost bonuses based mostly on fairness metrics.

The regulation additionally requires nursing houses to report the proportion of healthcare employees and residents who are up-to-date with COVID-19 vaccinations starting with fiscal 2025 and 2026 high quality reporting applications, respectively, in accordance with Facilities for Illness Management and Prevention steering.

The ultimate rule doesn’t embody the extremely anticipated minimal staffing rule. That proposal, initially promised for this spring and vehemently opposed by business, stays beneath evaluate by the White Home Workplace of Administration and Funds.

Nursing house corporations and commerce associations flooded CMS with feedback for the reason that company launched the proposed rule urging a bigger reimbursement hike, citing inflation, rising labor prices and the anticipated results of the looming staffing mandate.

The American Well being Care Affiliation welcomed the speed enhance whereas describing it as insufficient. “We admire that CMS acknowledges the extreme challenges and growing prices nursing house suppliers face—from an unprecedented workforce scarcity to file inflation in recent times. This Medicare enhance will assist nursing houses improve their providers and help their caregivers,” Senior Vice President of Reimbursement Coverage Martin Allen stated in a information launch.

“Nevertheless, extra have to be carried out to put money into our nation’s nursing houses, particularly if the administration implements a federal staffing mandate, which may price tens of billions of {dollars} annually. It’s vital to fund authorities mandates and to make sure Medicare stays a viable program to make sure our nation’s seniors can entry the care they want,” Allen stated.

LeadingAge, which represents nonprofit nursing houses, made related observations. “The 4% offered on this rule will certainly be offset by the growing prices of care, which is able to most definitely proceed to rise within the coming 12 months—on high of the anticipated staffing requirements,” President and CEO Katie Smith Sloan stated in a information launch. The affiliation additionally expressed concern that the COVID-19 vaccination provisions might violate the rights of staff and residents to decide out.

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