In a June 27 letter to the CMS Administrator, LeadingAge joined eleven other organizations including AHCA, AJAS, AAPACN, and LSA to outline significant concerns about, and opposition to, the increased enforcement proposal laid out in CMS’s FY 2025 Medicare PPS Proposed Rule for Skilled Nursing Facilities (SNFs). This proposal, which seeks to layer civil monetary penalties (CMPs) onto nursing homes, will not lead to better resident care. Instead, it will exacerbate the existing workforce crisis and displace more of our nation’s vulnerable residents. There is no evidence that imposing CMPs directly improves the quality of care in nursing homes, the letter says. More CMPs would divert funds from care and services for residents and this would further reduce the number of nursing homes eligible to offer training programs known to help hire and develop nursing staff. In addition, the proposed revisions to the CMP enforcement mechanism are inconsistent with federal statute, congressional intent, and agency authority and should be withdrawn. LeadingAge submitted comments on the SNF PPS rule in May; our comments included similar opposition to the proposed rule’s increased CMPs.

LeadingAge submitted comments on the Fiscal Year (FY) 2025 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) proposed rule on May 23. As explained in this press statement, “LeadingAge to CMS: to Achieve Improvements, Focus on Nursing Homes’ Needs,” the proposed rule includes a provision that would expand the authority of the Centers for Medicare & Medicaid Services (CMS) to enforce civil money penalties (CMPs) against nursing homes for noncompliance with Requirements of Participation. Read more in this LeadingAge bulletin.

The Fiscal Year (FY) 2025 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) proposed rule was published in the Federal Register on April 3. The rule proposes a 4.1% payment update, but also includes a significant expansion of the Centers for Medicare & Medicaid Services (CMS) authority related to civil money penalties.

Comments on the rule are due to the Federal Register on May 28 and we created a new members-only resource that includes tips and assistance for developing and submitting comments.

The Fiscal Year (FY) 2025 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) proposed rule, Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2025, was released to the Federal Register and included a 4.1% payment update and expanded authority to impose civil money penalties.

Read the full LeadingAge article here.

LeadingAge president and CEO Katie Smith Sloan released a statement on the Skilled Nursing Facility (SNF) Prospective Payment System FY2025 proposed rule:

“Our nonprofit, mission-driven skilled nursing provider members welcome any increase in payment rates, and we appreciate the Centers for Medicare and Medicaid’s (CMS) proposed 4.1% increase. At the same time, our members are struggling to stay above water with inflation-induced increased operating costs, including workforce, when there is already a nationwide shortage of direct care workers. There is no issue more pressing for nursing homes than the workforce crisis—and that’s having a direct impact on older adults and families that need care. The bottom line is, without staff, there is no care, and the national caregiver crisis is happening in real time. Policymakers in Congress and the administration must deliver immediate support to expand and enhance the workforce. Every month they wait to confront the growing difficulties in access to care will mean hardships for more older adults and more American families.”

The Fiscal Year (FY) 2025 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) proposed rule was released to the Federal Register on March 28. The rule proposes a 4.1% payment increase, 0.1% greater than what was finalized for FY 2024. The rule also proposes adjustments to the SNF Quality Reporting Program (QRP) and SNF Value-Based Purchasing (VBP) program, though no new measures are proposed for either program.

The rule also proposes strengthening of CMS’s enforcement authority related to civil money penalties (CMPs). Specifically, the rule proposes adjustments that would allow for both per day and per instance CMPs to be imposed on a single survey and allow for multiple CMPs (such as a per day and multiple per instance CMPs) to be enforced for the same type of noncompliance.

LeadingAge will provide more in depth analysis of the proposed rule in the coming days. Read the CMS Fact Sheet on the rule.