DataPoint: Rehab Utilization, 2017

Based on a LeadingAge NY analysis of the recently released Centers for Medicare and Medicaid Services (CMS) 2017 Skilled Nursing Facility (SNF) utilization and payment public use files (PUF), Ultra-High rehabilitation categories represented 59.8 percent of all Medicare Fee-for-Service (FFS) Resource Utilization Group (RUG) days nationwide. Ultra-High rehabilitation utilization for New York State providers represented 65.9 percent of RUG days, up from 63.3 percent in 2016. New York State’s Ultra-High rehab utilization ranked fourth nationally, accounting for 7.5 percent of Ultra-High days nationwide. Initial CMS impact modeling of the switch from RUG-IV to the Patient-Driven Payment Model (PDPM) suggested that homes with a high proportion of residents in the Ultra-High rehab RUG categories were less likely to see a revenue increase under the new reimbursement methodology.

The entire 2017 SNF PUF, which includes payment, utilization, and individual provider data, can be downloaded here.

Contact: Ken Allison, kallison@leadingageny.org, 518-867-8820