McKnight’s Articles

Payment Reform: Ready! Set! Don’t go! No, I mean go!

Old News. On April 27, 2017, CMS released an Advance Notice of Proposed Rulemaking (ANPRM) that solicited comments on potential revisions to the SNF payment system. This system is called RCS-1, which stands for Resident Classification System.

This was a bit of a bombshell, but a bombshell that was long foretold (which, therefore, by definition is not a bombshell at all, but don’t let that stop me).

RCS-1 has three goals: (1) more accurately compensate SNFs; (2) reduce incentives for SNFs to deliver therapy based on financial considerations, rather than resident need; and (3) maintain simplicity. RCS-1 represented the greatest example of “moving the cheese,” that the SNF industry has seen for quite some time.

Well, perhaps you think that bombshell turned out to be a dud. I hope to make the point that it was not.

Continue reading Steven Littlehale’s guest column on