Skilled nursing facilities reform. 1998


The Medicare prospective payment system for skilled nursing facilities will take effect with cost reporting years beginning on or after July 1, 1998. HCFA is working on the implementation details. While final details are not expected to be published until Summer 1998, the following information has been provided through HCFA and/or the Nursing Home Case-Mix and Quality (NHCMQ) Demonstration project (RUGs-III) procedures.

UI MeSH Term Description Entries
D011445 Prospective Payment System A system wherein reimbursement rates are set, for a given period of time, prior to the circumstances giving rise to actual reimbursement claims. Discretionary Adjustment Factor,Prospective Pricing,Prospective Reimbursement,Reimbursement, Prospective,Adjustment, Discretionary,Adjustment Factor, Discretionary,Adjustment Factors, Discretionary,Adjustments, Discretionary,Discretionary Adjustment,Discretionary Adjustment Factors,Discretionary Adjustments,Factor, Discretionary Adjustment,Factors, Discretionary Adjustment,Payment System, Prospective,Payment Systems, Prospective,Pricing, Prospective,Prospective Payment Systems,Prospective Reimbursements,Reimbursements, Prospective,System, Prospective Payment,Systems, Prospective Payment
D011907 Rate Setting and Review A method of examining and setting levels of payments. Rate Setting, Review,Review and Rate Setting,Rate Settings, Review,Review Rate Setting,Review Rate Settings,Setting, Review Rate,Settings, Review Rate
D006278 Medicare Federal program, created by Public Law 89-97, Title XVIII-Health Insurance for the Aged, a 1965 amendment to the Social Security Act, that provides health insurance benefits to persons over the age of 65 and others eligible for Social Security benefits. It consists of two separate but coordinated programs: hospital insurance (MEDICARE PART A) and supplementary medical insurance (MEDICARE PART B). (Hospital Administration Terminology, AHA, 2d ed and A Discursive Dictionary of Health Care, US House of Representatives, 1976) Health Insurance for Aged and Disabled, Title 18,Insurance, Health, for Aged and Disabled,Health Insurance for Aged, Disabled, Title 18,Health Insurance for Aged, Title 18
D012866 Skilled Nursing Facilities Extended care facilities which provide skilled nursing care or rehabilitation services for inpatients on a daily basis. Extended Care Facilities,Facilities, Skilled Nursing,Nursing Facilities, Skilled,Care Facilities, Extended,Care Facility, Extended,Extended Care Facility,Facilities, Extended Care,Facility, Extended Care,Facility, Skilled Nursing,Nursing Facility, Skilled,Skilled Nursing Facility
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D014487 Centers for Medicare and Medicaid Services, U.S. A component of the Department of Health and Human Services to oversee and direct the Medicare and Medicaid programs and related Federal medical care quality control staffs. Name was changed effective June 14, 2001. Centers for Medicare and Medicaid Services,United States Centers for Medicare and Medicaid Services,United States Health Care Financing Administration,Centers for Medicare and Medicaid Services (U.S.),HCFA,Health Care Financing Administration,Health Care Financing Administration (U.S.),Health Care Financing Administration, U.S.
D016134 Organizational Policy A course or method of action selected, usually by an organization, institution, university, society, etc., from among alternatives to guide and determine present and future decisions and positions on matters of public interest or social concern. It does not include internal policy relating to organization and administration within the corporate body, for which ORGANIZATION AND ADMINISTRATION is available. Institutional Policy,Institutional Policies,Organizational Policies,Policies, Institutional,Policies, Organizational,Policy, Institutional,Policy, Organizational
D018166 Health Care Reform Innovation and improvement of the health care system by reappraisal, amendment of services, and removal of faults and abuses in providing and distributing health services to patients. It includes a re-alignment of health services and health insurance to maximum demographic elements (the unemployed, indigent, uninsured, elderly, inner cities, rural areas) with reference to coverage, hospitalization, pricing and cost containment, insurers' and employers' costs, pre-existing medical conditions, prescribed drugs, equipment, and services. Healthcare Reform,Health Care Reforms,Healthcare Reforms,Reform, Health Care,Reform, Healthcare,Reforms, Health Care,Reforms, Healthcare
D019467 Subacute Care Medical and skilled nursing services provided to patients who are not in an acute phase of an illness but who require a level of care higher than that provided in a long-term care setting. (JCAHO, Lexikon, 1994) Post-acute Care,Postacute Care,Sub-Acute Care,Care, Post-acute,Care, Postacute,Care, Sub-Acute,Care, Subacute,Post acute Care,Sub Acute Care

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