United States

Senior Living Health Care Connection: Public Use File

INSIGHT ARTICLE  | 

The Centers for Medicare & Medicaid Services (CMS) has prepared a public data set, the Skilled Nursing Facility Utilization and Payment Public Use File (herein referred to as the “Skilled Nursing Facility PUF”). This file contains specific information on Medicare beneficiaries utilizing Medicare benefits in skilled nursing facilities (SNFs). While this information looks back to 2013, it is another example of the type of information that is available to consumers and CMS.

The Skilled Nursing Facility PUF contains information on utilization, payment (allowed amount, Medicare payment and standard payment) and submitted charges organized by CMS certification number (six-digit provider identification number), Resource Utilization Group (RUG) and state of service. SNFs need to be aware of the information and continue to watch their own utilization patterns. If SNFs consistently provide therapy services at the ultrahigh levels, then the documentation supporting the need should be reflected in both the therapy and the clinical documentation. Also, be aware that providing therapy minutes at the minimal amount to attain the therapy RUG will raise flags.

The data is available on the CMS website.

For more information, contact Joan McCarthy at 1.312.634.3479.

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