On-Demand Webinar: SNF Regulatory Rundown: Final Rule, PEPPER, iQIES, and What’s Next for the RAI-Recording: SNF Regulatory Rundown: Final Rule, PEPPER, iQIES, and What’s Next for the RAI User’s Manual

Recording: SNF Regulatory Rundown: Final Rule, PEPPER, iQIES, and What’s Next for the RAI User’s Manual

Video Transcription

Video Summary

The presentation reviewed major CMS and SNF regulatory updates affecting skilled nursing facilities, reimbursement, and compliance. Key topics included the SNF PPS final rule, which set the Medicare Annual Payment Update at 2.4% for FY 2027, discussed ICD-10 remapping processes, and highlighted CMS’s concerns about PDPM case-mix creep. CMS also finalized removal of COVID-19 vaccination measures from SNF QRP beginning FY 2028 and shortened SNF QRP reporting deadlines from 4.5 months to 45 days after quarter end starting with FY 2029 data.<br /><br />A major upcoming change is SNF QRP All-Payer, finalized for FY 2031, with data collection beginning October 1, 2029. This will require reporting for all residents receiving covered skilled services, regardless of payer, using new “other skilled admission” and “other skilled discharge” assessments plus new MDS items for payer type and skilled stay timing.<br /><br />Other updates included PBJ reporting moving from CASPER to iQIES, the return of PEPPER reports for SNFs, and revisions to the SNF QRP manual, including a note about the future falls with major injury hybrid measure. CMS also clarified OBRA discharge rules: an emergency department visit alone does not trigger a discharge; only hospital admission or observation stays over 24 hours do.<br /><br />A key takeaway was that MDS items must be coded according to CMS instructions, not modified to satisfy state or payer-specific requirements. The presenter urged facilities to begin preparing now by tightening documentation, payer identification, discharge communication, and QAPI monitoring processes.

Keywords

SNF PPS final rule

Medicare Annual Payment Update

ICD-10 remapping

PDPM case-mix creep

SNF QRP

COVID-19 vaccination measures

QRP reporting deadlines

SNF QRP All-Payer

MDS assessments

PBJ reporting

iQIES

PEPPER reports

OBRA discharge rules

CMS regulatory updates

All-Payer reporting

MDS coding instructions

QAPI monitoring