Skilled Nursing Prospective Payment System Thesis

Open, View, and/or
Download this Document

Total Length: 2035 words ( 7 double-spaced pages)

Total Sources: 6

Page 1 of 7



There are length of stay rules that govern skilled nursing facilities, which are reimbursed for up to 100 days of care per calendar year (Medpac.gov, online). If the patient requires more than 100 days of care, that patient is deemed by the government to be in need of long-term care (LTC), for which Medicare does not reimburse providers for. The patient costs associated with skilled nursing facilities is often offset by a Medicaid component, and if the patient has any financial responsibility, it is minimal. However, to qualify for the Medicaid component, the patient must be indigent, and if the patient owns any property, the state in which the patient receives the skilled nursing or long-term nursing care in, which made payments for the patient shares, can seize the patient's assets at death, and sell the assets (usually property) to offset its losses.

The resource utilization groups by which the government determines the RUG payment to the skilled nursing facility, are classified by 53 groups of diagnoses that are related to skilled nursing levels of care (Medpac.gov, online). The groups are assigned reimbursement levels (refer to diagram above), and are periodically updated by the group as is determined by the government with regards to inflation in the cost of the RUG (Medpac.

Stuck Writing Your "Skilled Nursing Prospective Payment System" Thesis?

View All Our Example Skilled Nursing Prospective Payment System Thesis

Have A Custom Example Essay Written

gov, online). The RUGs are tracked by the government, because the patients who fall within a certain RUG should have similar charges for utilization of care (Medpac.gov, online).

Again, documentation must support the RUG. For instance, when physical therapy or another ancillary service is utilized by the patient, the number of minutes, or hours that the patient receives in service will impact the per diem payment of the RUG. Therefore, the documentation must support the charges submitted for reimbursement, as well as the need for services (Medpac.gov, online).

As is demonstrated, the PPS reimbursement for SNF should be such as to ensure a high quality of care delivered by professionals in the setting. It was what the industry lobbied for, and the improved quality of care was what the beneficiaries expected to see come about. It is too soon for to determine the extent to which the quality of care has improved, but studies are being conducted that should reveal if the efforts to reimburse skilled nursing facilities on a more equitable basis through the PPS has been successful......

Show More ⇣

     Open the full completed essay and source list


OR

     Order a one-of-a-kind custom essay on this topic


sample essay writing service

Cite This Resource:

Latest APA Format (6th edition)

Copy Reference
"Skilled Nursing Prospective Payment System" (2009, February 27) Retrieved June 15, 2026, from
https://www.aceyourpaper.com/essays/skilled-nursing-prospective-payment-system-24449

Latest MLA Format (8th edition)

Copy Reference
"Skilled Nursing Prospective Payment System" 27 February 2009. Web.15 June. 2026. <
https://www.aceyourpaper.com/essays/skilled-nursing-prospective-payment-system-24449>

Latest Chicago Format (16th edition)

Copy Reference
"Skilled Nursing Prospective Payment System", 27 February 2009, Accessed.15 June. 2026,
https://www.aceyourpaper.com/essays/skilled-nursing-prospective-payment-system-24449
   

Open, View, and/or
Download this Document
order custom essay example