Skilled nursing facilities (SNFs) will see a slight increase of 1.8 percent to their Medicare payments under new guidelines published recently by the Centers for Medicare & Medicaid Services (CMS).

The agency estimates that net Medicare Part A payments to SNFs will increase by about $670 million over the year.

The notice, issued on July 27, updates the SNF Prospective Payment System (PPS) for fiscal year (FY) 2013. The complicated math boils down to a 2.5 percent increase for the market basket and a 0.7 percent decrease for a productivity adjustment.

The update, which takes effect Oct. 1, was expected, but was “still welcome news,” American Health Care Association President and Chief Executive Officer Gov. Mark Parkinson said in a statement.

“Skilled nursing facilities have already been hit too many times over recent years through government reductions, including last year’s devastating SNF PPS rule,” Parkinson said. “Any additional cuts could be devastating to many facilities all over the country and threaten our ability to provide quality care to our residents.”

Additional highlights of the rule include:
■ The per diem rate for SNF patients with AIDS had been increased by 128 percent as of Oct.1, 2004, and under the CMS notice, this add-on will remain in effect for FY 2013.
■ All rates and wage indexes outlined in the notice for FY 2013 apply to all swing-bed rural hospitals, but not to critical access hospitals that would continue to be paid on a reasonable cost basis for SNF services furnished under a swing-bed agreement.
■ The labor-related weight for FY 2013 is 68.383 percent, down from 68.693 percent for FY 2012.
Also in the notice, CMS expressed concerns about SNFs that are requiring patients to sign binding arbitration agreements at admission. CMS plans “to monitor this closely and take action consistent with current rules and guidelines,” the rule says, “and consider rulemaking or any additional steps that may be appropriate.”

For all of the good news, the future of the long term and post-acute care profession “remains at risk,” Parkinson said.

“While CMS appears to have understood the current state of the profession, Congress will continue to indiscriminately hunt for pay-fors, and we, like all other providers, are in its sights,” Parkinson said. “We must remain vigilant that any additional reductions to skilled nursing facilities are not the answer.”

Earlier this year, House Republicans briefly flirted with the idea of slashing provider assessments to help pay for student loans. They backed off after an uproar from the long term care industry.

In 2010, some 1.7 million Medicare patients were treated in the nation’s 15,000 SNFs. Medicare spent almost $32 billion on SNF care in 2011 alone.