April’s average per diem Medicare rate paid for COVID-19 patients in skilled nursing facilities was $669, according to an analysis of claims submitted by the more than 1,300 SNFs, conducted by Zimmet Healthcare Services Group and CORE Analytics. The number is nearly 9% higher than the comparable rate average from February, the analysis found.
It also only happened as a result of the implementation of the Patient Driven Payment Mode, which took effect Oct. 1, 2019, the analysis noted.
Although the authors caution that the analysis had limitations and cannot be used as a formal reflection of national performance, the data “clearly shows COVID-positive patients generated higher rates than non-COVID patients. Rates were driven higher due to the increased nursing and non-therapy ancillary components of caring for these patients, something that would not have been possible under the therapy-centric RUG-system.
“RUG-IV would have been a fiscal disaster for SNFs dealing with COVID,” the analysis said. “Instead of $669 per day, RUG-IV was so distorted by therapy volume, rates could have been hundreds of dollars lower. PDPM came along just in time.”
This article appeared in the McKnight’s Business Daily, a joint effort of McKnight’s Senior Living and McKnight’s Long-Term Care News.