July 31, 2023 Washington, DC — Statement from Katie Smith Sloan, president and CEO, LeadingAge, the association of nonprofit, mission-driven providers of aging services, including nursing homes, on the Skilled Nursing Facility Prospective Payment System Final Rule for FY 2024:

“The final rule released today does not address the reality of providers’ operating environments, and will, ultimately, limit older adults’ access to much-needed care and services

Of course, our nonprofit and mission driven members welcome any increase in payment rates, the 4% provided in this rule will surely be offset by the increasing costs of care, which will most certainly continue to rise in the coming year – on top of the expected staffing standards. We encourage Congress and HHS to ensure any proposed standards meet the provisions outlined in LeadingAge’s Get Real on Ratios proposal.

Our policy experts are analyzing the complete rule now, but several measures stand out as concerning on quality reporting and value-based purchasing – which we stated in our submitted comments on the proposed rule. These measures aren’t fair, reasonable or within providers’ control.

• COVID-19 Vaccination Coverage Measures in the Skilled Nursing Facility Quality Reporting Program (SNF QRP): Continuing to include the staff vaccination measure and adding the resident vaccination measure penalizes providers for allowing residents and staff to exercise personal choice. Further, this information is already available to the public in a more meaningful manner.
• Total Nurse Staffing Turnover Measure for the Skilled Nursing Facility Value Based Purchasing Program (SNF VBP): The rule’s focus on staff turnover places inappropriate blame on providers, who are at the mercy of the workforce crisis. Further, we disagree with how CMS is defining gaps in employment (60 day-timeframe) – which is contradictory to the Department of Labor’s guarantee of 12 weeks per year of family/medical leave (FMLA).

One measure not in the rule is the CoreQ: Short Stay Discharge, an effort designed to collect satisfaction data from short-stay residents. While we and our members support this type of reporting, the measure as proposed did not provide adequate funding to ensure its success – so it was rightly excluded in the final rule.

We share CMS’ goal of ensuring quality care, and our members are committed to compliance. This final rule does not move the country closer to that goal.”