Medicare recently finalized and implemented new payment rules that will impact the bottom line for skilled nursing facilities. Many of them are struggling to put the new rules into place in their business, and the regulations are changing the way that nursing homes provide care for their residents. The skilled nursing facility has already been criticized for putting profits first, and the new Medicare program threatens to make this even worse.
Based on the new reimbursement rules, nursing homes have less incentive to give extensive therapy to residents since it will impact the facility’s bottom line. This may lead to an overall deterioration of the condition of the average nursing home resident who depends on therapy to maintain their health and well-being.
On October 1, 2019, Medicare finalized a new program called the Patient Driven Payment Model (PDPM). Previously, Medicare reimbursements were determined based on therapy minutes. Now, the basis for reimbursement is the patient’s condition as well as their anticipated needs during their stay. Under the new rules, nursing homes must determine the level of care that is necessary for a patient and will then have to deliver care in accordance with the resident’s needs. The facility will have to first determine the resident’s needs and then must make sure not to overdeliver care.