First few Article Sentences
Beginning October 1, 2019, the Centers for Medicare and Medicaid Services ("CMS") will overhaul Medicare Part A payments to skilled nursing facilities ("SNF"), moving from a RUG-based methodology to the new Patient Driven Payment Model ("PDPM"). SNFs will be paid a per diem rate based on how a resident is classified with respect to five different case mix components: physical therapy (based on the resident's primary diagnosis and functional status); occupational therapy (based on the resident's primary diagnosis and functional status); speech language pathology; nursing; and non-therapy ancillary (based on comorbidities or use of extensive services), plus a non-case mix base rate. The per diem rate is variable over time, to account for the presumed decrease in costs and necessary services over time.