This week the Centers for Medicare and Medicaid Services (CMS) released a public data set on utilization, payments and submitted changes organized by provider, state and resource utilization group (RUG) for skilled nursing facilities. In addition to information on payments and charges, the SNF Utilization and Payment Public Use File (SNF PUF) contains information on two categories of RUGs for patients who receive a significant amount of therapy: Ultra-High (RU) and Very High (RV) Rehabilitation RUGs.

Consistent with prior CMS findings, the SNF PUF shows that for these two RUGs, the amount of therapy provided is often very close to the minimum amount of minutes needed to qualify a patient for these categories. Medicare SNF per diem payment amounts for rehabilitation RUGs are primarily based on therapy minutes and payment amounts for these two RUGs can exceed payments for comparable RUGs with fewer therapy minutes by more than 25 percent.

The SNF PUF was created from CMS administrative claims data for Medicare beneficiaries enrolled in the fee-for-service program available from the CMS Chronic Condition Data Warehouse (www.ccwdata.org). The data cover calendar year 2013 and is based on SNF Part A institutional claims.

Click here to view a fact sheet on the Skilled Nursing Facility data set.