The American Health Care Association has developed a Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) rate calculator 
Medicare rate calculator (please maximize screen to view tabs after opening) to assist members in examining and estimating the impact of payment changes to SNF PPS rates. Using information on your distribution of Medicare Part A days by RUG category, the calculator will allow you to simulate and understand the impact of SNF PPS payment policy changes for FY 2010, FY 2011, and FY 2012 on a facility.
The rate calculator has been updated to reflect Medicare payment policy changes found in the SNF PPS final rule for fiscal year 2012 that was issued on July 29, 2011. The final rule and the rate calculator illustrate the net impact of a 2.7% increase in rates for the market basket update, a 1.0% reduction in rates due to the Accountable Care Act (ACA) mandated productivity adjustment, and a 12.6% reduction in rates due to the recalibration of the parity adjustment, for a net 11.1% reduction in SNF PPS rates for FY 2012. (Please note that the individual adjustments may not add to the total adjustment due to rounding.)
Please note that rate calculator does not take into account (simulate) the impact of non-rate related payment policy changes in the FY 2012 SNF PPS final rule such as the allocation of group therapy minutes, implementation of the Change of Therapy Other Medicare Required Assessment (COT-OMRA), changes to End of Therapy OMRAs, assessment reference date changes, etc. These non-rate related payment policy changes could have the effect of dropping patients into lower RUG categories for payment purposes. Please consider these policy changes in simulating and interpreting results from the rate calculator. To prepare the rate estimates, please take the following steps on the “Inputs and Results” tab of this Excel spreadsheet:
1. Enter your facility name.
2. Select your facility location in the drop-down menu on the line “Facility Location (CBSA)”.
3. Enter the time period that covers the Medicare patient days by RUG category for your facility.
4. Enter the Medicare patient days by RUG category for the period of October 1, 2009 through September 30, 2010 (RUG-53/RUG-III); and October 1, 2010 through a recent period (RUG-66/RUG-IV).
The difference between the average Medicare rate for fiscal year 2012, effective October 1, 2011, the average Medicare rate for fiscal year 2011, effective October 1, 2010, and the average Medicare rate for fiscal year 2010, effective October 1, 2009, will be expressed in dollar and percentage amounts. You will be able to estimate the impact of RUG-IV effective October 1, 2010, and the proposed per diem payment changes effective October 1, 2011.
Please note that the rates provided in this calculator are the same as those published in the Federal Register. It has been determined that discrepancies exist between the rates in this calculator and the SNF PPS PC Pricer. Once the SNF PPS PC Pricer is provided by CMS for fiscal year 2012, the rates for each geographic area will be provided on the AHCA website.
For assistance or questions, please contact Bill Hartung at (202) 898-2841, or whartung@ahca.org.