2025 National Nurse Practitioner Week Is November 9–15

Louisville, Ky. (Nov. 9, 2025) — As health care continues to evolve, one constant remains: the trusted presence of nurse practitioners (NPs) in communities across the United States. During National Nurse Practitioner Week, November 9–15, 2025, we celebrate these health care professionals whose compassion, advanced training and commitment to personalized care help millions of Americans lead healthier lives.

Sixty years after the first NP program launched in 1965, the profession has grown to include more than 461,000 licensed NPs nationwide. Each year, NPs conduct nearly 1 billion patient visits, providing high-quality health services in hospitals, clinics, private practices, urgent care centers and long-term care facilities.

In communities all across Kentucky, NPs are making a daily difference - serving individuals and families through preventive care, routine checkups, chronic condition management and so much more. They take the time to listen, answer questions and tailor care to each patient’s needs - qualities that have earned them one of the highest favorability ratings among all health care providers.

“APRNs across our Commonwealth play a vital role in improving community health,” said Jill York, Executive Director of the Kentucky Association of Nurse Practitioners and Nurse-Midwives. “Their clinical expertise, combined with their ability to truly listen and connect with patients, ensures that individuals feel seen, heard, and valued throughout their care journey.”

NPs are board-certified, clinically trained health professionals who hold graduate-level degrees and complete rigorous education and certification requirements. They are trusted to diagnose illnesses, prescribe medications, order and interpret diagnostic tests, and coordinate care alongside other members of the health care team.

This year’s NP Week theme - “NPs: Trusted Voices, Proven Care” - reflects both the deep relationships NPs form with patients and the proven outcomes associated with their care. As more people choose NPs for their health needs, local communities are recognizing the value of these compassionate, skilled professionals.

About National Nurse Practitioner Week

National NP Week is held annually during the second week of November to raise awareness of the NP role and honor the exceptional care NPs provide.

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Software developer ranks No. 1; health care jobs remain prominent.

Jan. 10, 2023, at 12:01 a.m.

Washington, D.C. – U.S. News & World Report, the global authority in rankings and consumer advice, today announced the 2023 Best Jobs. The rankings offer a look at the best jobs across 17 categories – from sectors such as business, health care and technology – to help job seekers at every level achieve their career goals. Outcomes take into account the most important aspects of a job, including growth potential, work-life balance and salary.

While nearly 40% of the top 100 Best Jobs are in health care or health care support roles, a technology job – software developer – captured the No. 1 spot this year.

“Software developers are becoming increasingly critical for the growth and sustained success of businesses across industries,” says Janica Ingram, careers editor at U.S. News. “The 10-year outlook for the occupation is strong and expected to grow at an above-average rate. It is predicted to be in high demand, because of the rising number of products and services that leverage software. Low unemployment and a high median salary also contribute to the appeal of this career.”

Following software developer in the overall rankings is nurse practitioner at No. 2, medical and health services manager at No. 3 and physician assistant at No. 4. In addition, pilot debuted in the top 50 this year at No. 47 due to its higher scoring in work-life balance, salary and future prospects.

“It is unsurprising that jobs in health care continue to dominate the Best Jobs rankings. This year’s cold and flu season reiterates the everpresent human need for health care practitioners,” says Ingram. “The higher-than-average salaries, low unemployment rates and strong future prospects for many of these roles certainly reflect that.”

Health care jobs also continue to rank high among the Careers With the Most Job Security, with the industry capturing 13 of that list’s top 20 jobs. Nurse practitioner captured No. 1, while dentist took the No. 3 spot, physician assistant landed at No. 4 and orthodontist came in at No. 5.

The 2023 Best Jobs rankings offer job seekers detailed information on training and education requirements, median salary, and job satisfaction across diverse sectors, including social services, education, construction, and creative and media. For individuals interested in pursuing science, technology, engineering and math, also known as the STEM fields, U.S. News compiles the Best STEM Jobs. Best Jobs Without a College Degree and Highest Paying Jobs Without a Degree are also offered for those who did not attend or finish college.

To calculate Best Jobs, U.S. News draws data from the U.S. Bureau of Labor Statistics to identify jobs with the greatest hiring demand. Jobs are then scored using seven component measures: 10-year growth volume, 10-year growth percentage, median salary, employment rate, future job prospects, stress level and work-life balance. For further details on how the rankings were calculated, see the methodology.

For more information, visit Best Jobs and share the rankings on Facebook and Twitter using #BestJobs.

2023 U.S. News Best Jobs Rankings

*See the full list of the Best Jobs here.

100 Best Jobs

1. Software Developer
2. Nurse Practitioner
3. Medical and Health Services Manager
4. Physician Assistant
5. Information Security Analyst

Best Technology Jobs

1. Software Developer
2. Information Security Analyst
3. IT Manager
4. Web Developer
5. Computer Systems Analyst

Best Health Care Jobs

1. Nurse Practitioner
2. Physician Assistant
3. Physical Therapist 
4. Dentist
5. Veterinarian

Best Business Jobs

1. Medical and Health Services Manager 
2. Financial Manager
3. Market Research Analyst 
4. Logistician
5. Management Analyst
   

Media Contact: Santierra Hutson; shutson@usnews.com; 614-704-3292.

About U.S. News & World Report

U.S. News & World Report is the global leader in quality rankings that empower consumers, business leaders and policy officials to make better, more informed decisions about important issues affecting their lives and communities. A multifaceted digital media company with Education, Health, Money, Travel, Cars, News, Real Estate and 360 Reviews platforms, U.S. News provides rankings, independent reporting, data journalism, consumer advice and U.S. News Live events. More than 40 million people visit USNews.com each month for research and guidance. Founded in 1933, U.S. News is headquartered in Washington, D.C.

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"I'm sorry to wake you up so early this morning again," says Gandhi over the phone. "But I thought that you would want to know what your results are."

It's unlikely the woman will mind the early morning wake-up. That's because it's good news.

In Urdu, Gandhi explains to the woman that her mammogram came back clean: the mass in her breast isn't cancerous.

Gandhi hangs up the phone, but she doesn't miss a beat: time now to read up on her next patient, who's been M.I.A. for months.

"Looks like he has diabetes," she says, reading off a computer screen. "I had asked for him to get an appointment six weeks thereafter. That was back in September. That was cancelled, and then he didn't come back for two appointments that were rescheduled. And now he's finally back."

The role of non-doctor medical staff in community clinics

Gandhi is what's known as a mid-level provider, a category that includes registered nurses, physician assistants and nurse practitioners like her. But at a clinic like UMMA – located just west of the 110 freeway on Florence Avenue – she might as well have the letters "MD" after her name.

Here, it's nurse practitioners like Gandhi who dispense medicine here.

"A community like this has less resources," she said. "A lot of the folks that live here have less education. As I'm sure everybody's aware, our educational system is stressed, so the basic education people get around their bodies – [health literacy] – is low."

That means a lot of patients have chronic conditions – most commonly, diabetes and high blood pressure – but don't know how to deal with them.

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Casperson has struggled with homelessness and drug addiction, Now, she's at Glide Health Services, a clinic in San Francisco's Tenderloin district.  

Clark uses the visit as an opportunity to ask about other health matters - like her efforts to quit smoking. After a half hour visit, Casperson left with a prescription. She says she's been coming to this clinic for a few years.

"They have compassion for a client. They have understanding for a client," Casperson says. "I like the nurses here. Because they're like one big family, and they all work together.

This clinic is run by nurses with advanced training. Nurse practitioners - or NPs - in California have at least a masters' level education.

A physician visits 12 hours a week, to sign forms and consult on difficult cases. A bill in the California legislature would allow nurse practitioners to provide primary care independently. Supporters say that would enable more people to get care in inner cities and rural areas.

"It's difficult to get primary care physicians to work in a place here because the pay is low often times and there's more money in specialty practice," says clinic manager Karen Hill. "The Housing is incredibly expensive here if you want to raise a family. And the population is difficult."

It’s a step up that Gourley figures would increase her current salary of $55,000 by as much as $30,000, while giving her more freedom to pursue the kind of health care work she loves.

She’s putting that dream on hold, for now.

Gourley, 36, is worried that interest rates on the subsidized Stafford loans that she had planned to rely on for her bachelor’s degree in nursing will double unless Congress intervenes. That would add to the already daunting cost of going back to school.

"I’m going to wait until they decide what they’re going to do,” said Gourley, who currently works with lung cancer patients at a hospital in Oklahoma City.

The news this week that interest rates on newly issued government-subsidized Stafford loans could rise to 6.8 percent, from 3.4 percent, is just the latest worry for many Americans who are already weighing the burden of debt against the expected payoff of a higher education.

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According to a report from Irving, Texas-based physician staffing company, Staff Care, a shortage of physicians in the United States, coupled with the approaching implementation of the Affordable Care Act, is prompting healthcare facilities to expand the role of primary care providers. The report states two groups of professionals in the field are chief among the expansion -- nurse practitioners and physician assistants. 

Chance-Peeler, who works full time at Baptist Memorial Hospital-Golden Triangle and part-time at a family practice, says she saw the growing need for people in her field, especially at smaller clinics. 

"I think it's definitely true, because you have less physicians wanting to do family practice," she said. "That's a role nurse practitioners function well in." 

A recently announced collaboration between Mississippi University for Women and North Mississippi Health Services is designed to address the growing needs by bringing aspiring professionals in each of those fields together in an integrated residency training program, according to Karen Hughes, North Mississippi Medical Center Family Medicine Residency Center associate director.  

Have you tried making an appointment with a primary care doctor recently? Good luck to you. Most primary care physicians are not accepting new patients. If you are one of the fortunate existing patients, then you will most likely experience lengthy wait times for an appointment.

The majority of Americans do not realize that there is a critical shortage of primary health care physicians. It is estimated that by the year 2015, there will be a shortage of 63,000 primary care physicians, and this shortage will continue to increase to 130,000 by 2025. Further compounding the situation is an aging baby boomer population of 78 million who began turning 65 in 2011 and many are expected to have chronic medical conditions.

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Pitt nursing faculty member Catherine Grant is one of the first nurse practitioners with her own practice in the state. There are a variety of nurse practitioner specialties, such as acute-care nurse practitioners who work in hospitals and critical care units, pediatric nurse practitioners and others. Grant and her colleagues are family nurse practitioners, taking care of patients throughout their lives, from infancy to old age. Her practice provides everything from well-patient visits and physical exams to HIV prevention services and laboratory tests.

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The data in this news release are from the Occupational Employment Statistics (OES) program, which provides employment and wage estimates by area and by industry for wage and salary workers in 22 major occupational groups and 821 detailed occupations. In addition, national employment and wage estimates for 94 minor occupational groups and 458 broad occupations are available for the first time.

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Partly driving this change is The Affordable Care Act, known as Obamacare, which will extend health care coverage to approximately 30 million more individuals, most of whom have not been able to afford health insurance in the past.

Predictions for a shortage of family practice doctors are adding to the impetus for a broader role for nurse practitioners, who are already the main non-physician providers of primary care. NPs have more advanced training than registered nurses (RNs), typically acquired through completion of a Master of Nursing or other graduate degree.

The effort to expand the scope of nurse practitioners' authority to treat patients, however, has been opposed by a number of physician groups, including the American Medical Association (AMA), the American Academy of Family Physicians, the American Academy of Pediatrics and the American Osteopathic Association, all of which support direct supervision of NPs by physicians. Some doctors -- concerned about the ability of NPs to diagnose complex illnesses -- have fought legislation on the state level that would allow these changes. Those in favor of giving NPs more authority say physicians are also worried about the loss of income they will face if too many patients opt to see an NP rather than an MD.

Physicians may be facing a losing battle. "That horse has already left the barn," says Linda Aiken, professor of nursing at the University of Pennsylvania School of Nursing and director of the Center for Health Outcomes and Policy Research. "With Obamacare coming in and millions of people getting insurance, there is no other way to provide them with reasonable access in the short term except to expand the role of NPs and physician assistants (PAs). It takes 20 years to train a doctor, so there isn't any alternative." According to an article titled, "Broadening the Scope of Nursing Practice," published in 2011 in The New England Journal of Medicine, "between three and 12 nurse practitioners can be educated for the price of educating one physician, and more quickly."

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By May 21, 2014, all certified medical examiners must be on the National Registry database, and drivers must obtain a medical examination from a certified examiner.  

Health care professionals who perform medical examinations for interstate truck and bus drivers must be trained, tested, and certified on the specific physical qualifications that affect a driver’s ability to safely operate the vehicle.

The National Registry of Certified Medical Examiners (National Registry) is a new Federal Motor Carrier Safety Administration (FMCSA) program. It requires all medical examiners (MEs) who wish to perform physical examinations for interstate commercial motor vehicle (CMV) drivers to be trained and certified in FMCSA physical qualification standards. Medical examiners who have completed the training and successfully passed the test are included in an online directory on the National Registry website.

The National Academy of DOT Medical Examiners is one organization offering training online.

• The eligible professional is not a physician (MD, DO, or podiatrist), nurse practitioner, or physician assistant as of June 30, 2011 (This determination is based on the primary taxonomy code in the National Plan and Provider Enumeration System (NPPES)) and does not generally have prescribing privileges, and reports g-code G8644 (defined as not having prescribing privileges) at least one time on an eligible claim prior to June 30, 2011;

• The eligible professional does not have at least 100 cases containing an encounter code in the electronic prescribing measure’s denominator;
  

• The eligible professional’s allowed charges for covered professional services submitted for the electronic prescribing measure’s denominator codes is less than 10 percent of the eligible professional’s total 2011 Medicare Part B PFS allowed charges;

• The eligible professional reports a significant hardship code and CMS determines that the hardship code applies (see "Significant Hardship Exemptions” section below) and is granted an exemption; OR

• The eligible professional becomes a successful electronic prescriber for purposes of the 2012 payment adjustment by reporting the electronic prescribing measure via claims for at least 10 unique electronic prescribing events for patients in the denominator of the measure between January 1, 2011 and June 30, 2011.

• The group practice reports a significant hardship in its 2011 self-nomination letter for participation in the eRx Incentive Program group practice reporting option (see "Significant Hardship Exemptions” section below) and is granted an exemption; OR

• The group practice becomes a successful electronic prescriber. The group practice becomes a successful electronic prescriber for purposes of the 2012 payment adjustment by reporting the electronic prescribing measure via claims for between 75-2,500 unique electronic prescribing events (depending on the group practice size) for patients in the denominator of the measure between January 1, 2011 and June 30, 2011.

• The eligible professional practices in a rural area without sufficient high speed internet access (report code G8642)

• The eligible professional practices in an area without sufficient available pharmacies for electronic prescribing (report code G8643)

• Eligible professionals who register to participate in the Medicare or Medicaid EHR Incentive Programs and adopt certified EHR technology;

• Inability to electronically prescribe due to local, state, or federal law or regulation;

•  Limited prescribing activity; or

•  Insufficient opportunities to report the electronic prescribing measure.

With the exception of dually-eligible hospitals, providers can only participate in one of the EHR Incentive Programs—Medicare or Medicaid—each year. This message outlines key differences between the Medicare and Medicaid EHR Incentive Programs to help you determine which EHR Incentive Program is right for you.

Who is eligible?

Dually-Eligible Hospitals
If you represent a hospital that meets all of the following qualifications, you are dually-eligible for the Medicare and Medicaid EHR Incentive Programs:

· You are a subsection(d) hospital in the 50 U.S. States or the District of Columbia, or you are a CAH; and

· You have a CMS Certification Number ending in 0001-0879 or 1300-1399; and

· You have 10% of your patient volume derived from Medicaid encounters.

We encourage potential participants to review CMS' comparison chart to learn more about the differences between the two EHR Incentive Programs, and use the Eligibility Wizard to determine for which program they may be eligible.

Final rule adopts measures for new IRF Quality Reporting Program

The Centers for Medicare & Medicaid Services (CMS) today issued a final rule that updates Medicare payment policies and rates for more than 1,200 freestanding and hospital-based inpatient rehabilitation facilities (IRFs) in Fiscal Year (FY) 2012. The final rule increases IRF payment rates under the IRF Prospective Payment System (PPS) by 2.2 percent and establishes a new quality reporting system authorized by the Affordable Care Act. CMS projects that total payments under the IRF PPS will increase by $150 million in FY 2012.

"The final rule extends to the Inpatient Rehabilitation Facility payment system a quality reporting program designed to encourage these facilities to adopt practices that will better protect patient safety and prevent hospital-acquired conditions, which is an essential part of providing well-coordinated patient-and-family-centered care,” said CMS Administrator Dr. Donald Berwick.”

Initially, IRFs will submit data on two quality measures, a urinary catheter-associated urinary tract infection measure and a measure for new or worsening pressure ulcers, with a third measure—"30-day Comprehensive All Cause Risk Standardized Readmission”--under development. IRFs that do not submit performance data will see their payments reduced by two percentage points beginning in FY 2014. CMS anticipates adding measures for reporting in the future through rulemaking and establishing a process for making the data available to the public. As with other data on the CMS website, the IRFs would have an opportunity to review the data for accuracy before it becomes public.

The final rule will affect payments to more than 200 freestanding rehabilitation hospitals and more than 1,000 IRF units in acute care hospitals and critical access hospitals, beginning with discharges on or after Oct. 1, 2011. Under the IRF PPS, the Medicare payment to an IRF increases after the IRF’s costs for treating a beneficiary exceed an outlier threshold amount. The threshold is set for FY 2012 at an amount that is projected to maintain outlier payments at three percent of total payments under the IRF PPS.

The final rule also:

· Updates the case-mix group (CMG) relative weights using FY 2010 IRF claims and FY 2009 IRF cost report data;

· Uses the final FY 2011 pre-reclassified and pre-floor hospital wage data to determine the FY 2012 rates;

· Freezes the facility-level adjustment factors for FY 2012 at FY 2011 levels for one additional year while the agency explores ways to improve upon the accuracy and consistency of the current methodology used to calculate the facility-level adjustment factors;

· Allows IRFs to receive temporary adjustments to their FTE intern and resident caps if they take on interns and residents who are unable to complete their training because the IRF that had originally been their assigned training site either closed or ended its resident training program; and

· Allows IRF and inpatient psychiatric facility units to expand in the middle of a cost reporting period, rather than restricting such expansions to the start of a cost reporting period.

"The final rule we are announcing today will help ensure that Medicare beneficiaries who require rehabilitation in an inpatient setting, continue to have access to high quality care that will help them meet their rehabilitation goals during the difficult work of recovery,” said Dr. Berwick.

The final rule went on display on July 29, 2011 at the Office of the Federal Register’s Public Inspection Desk and will be available under "Special Filings” at: http://www.ofr.gov/OFRUpload/OFRData/2011-19516_PI.pdf and http://www.ofr.gov/inspection.aspx?AspxAutoDetectCookieSupport=1

It will appear in the Aug. 5, 2011 Federal Register.

For more information, please see: www.cms.hhs.gov/InpatientRehabFacPPS/

Final rule aims to improve patient access, quality of care

Hospices serving people with Medicare will see a 2.5 percent increase in their Medicare payments for fiscal year (FY) 2012, according to a final regulation released today by the Centers for Medicare & Medicaid Services (CMS). Hospices are also called upon to begin reporting on the quality of care received by Medicare patients, as a result of this final regulation.

The estimated hospice payments are the net result of a 3.0 percent increase in the "hospital market basket,” an indicator of industry-related price increases, offset by an estimated 0.5 percent decrease in payments to hospices due to updated wage index data and the third year of CMS’ seven-year phase-out of a wage index budget neutrality adjustment factor (BNAF).

The final rule also implements Affordable Care Act requirements, including a hospice quality reporting program, and clarifies previously adopted policies on hospice face-to-face certifications, said Jonathan Blum, deputy administrator and director of CMS’ Center for Medicare. "These payment and policy changes and additional attention to quality will work to encourage better coordination of hospice benefits and fair payments to Medicare hospice providers.”

Final Rule Details

This final rule continues the BNAF phase-out, now in its third year. The BNAF was implemented in 1997, when the former Health Care Financing Administration (HCFA), now CMS, moved from an outdated wage index to a more current and accurate method for determining hospice payments. To minimize disruption to services during the transition, a special budget neutrality adjustment was applied. In FY 2010 rulemaking, CMS adopted a schedule to phase out the BNAF over seven years, reducing it by 10 percent in FY 2010, 15 percent in FY 2011, and successive 15 percent reductions from FY 2012 through FY 2016.

The final rule revises how CMS calculates each hospice’s yearly aggregate cap. Federal law requires that CMS impose a limit on the aggregate Medicare payments a hospice provider receives annually. CMS calculates each hospice’s aggregate cap by multiplying the number of patients served by the hospice in a cap year by a cap amount. Medicare payments made to a hospice during the cap year that exceed the hospice’s aggregate cap must be refunded to Medicare.

In this final rule, CMS will:

• Change the way it counts hospice patients for the 2012 cap accounting year and beyond. The final policy for counting the number of Medicare hospice beneficiaries in care for a given cap year calculates the cap based on the number of days of care the patient received in that cap year for each hospice. This rule also finalized that the new counting method be applied to past cap years in certain instances.

• Allow hospice providers who do not want a change in their patient counting method to elect to continue using the current method.

• Allow any hospice physician to perform the face-to-face encounter regardless of whether that same physician recertifies the patient’s terminal illness and composes the recertification narrative.

• Implement a hospice quality reporting program, which includes a timeframe for reporting, as required by section 3004 of the Affordable Care Act. The measures that are being adopted in this final rule for the FY 2014 program are one measure endorsed by the National Quality Forum related to pain management and one structural measure that assesses whether a hospice administers a Quality Assessment and Performance Improvement (QAPI) program that contains at least three indicators related to patient care.

As finalized, hospices will be required to begin collecting quality data in October 2012, and will submit the data in 2013; hospices may also voluntarily begin collecting data on the QAPI measure in October 2011 for submission in 2012. Hospices failing to report quality data in 2013 will have their market basket update reduced by two (2) percentage points in FY 2014.

Also requires a new assessment to capture changes in therapy services, and allocation of group therapy time to ensure payment accuracy

The Centers for Medicare & Medicaid Services (CMS) today announced a final rule reducing Medicare skilled nursing facility (SNF) Prospective Payment System (PPS) payments in FY 2012 by $3.87 billion, or 11.1 percent lower than payments for FY 2011. The FY 2012 rates correct for an unintended spike in payment levels and better align Medicare payments with costs.

"CMS is committed to providing high quality care to those in skilled nursing facilities and to pay those facilities properly for that care,” said CMS Administrator Donald M. Berwick, M.D. "The adjustments to the payment rates for next year reflect that policy.”

CMS is now recalibrating the case-mix indexes (CMIs) for FY 2012 to restore overall payments to their intended levels on a prospective basis.The SNF PPS uses a resource classification system known as Resource Utilization Groups Version 4 (RUG-IV), which assigns a patient to a RUG group to determine a daily payment rate. Each RUG group consists of CMIs that reflects a patient’s severity of illness and the services that a patient requires in the skilled nursing facility (SNF). In transitioning from the previous classification system to the new RUG-IV, CMS adjusted the CMIs for FY 2011 based on forecasted utilization under this new classification system to establish parity in overall payments. SNFs have been paid under RUG-IV since Oct. 1, 2010.

CMS found that the parity adjustment made in FY 2011, which was intended to ensure that the new RUG-IV system would not change overall spending levels from the prior year, instead resulted in a significant increase in Medicare expenditures during FY 2011. This increase in spending was primarily due to shifts in the utilization of therapy modes under the new classification system differing significantly from the projections on which the original parity adjustment was based.

"Additional data analyzed by CMS since publication of the proposed rule confirmed the extent of the overpayments that have occurred since implementation of the RUG-IV system,” said Jonathan Blum, deputy administrator and director of the Center for Medicare. "We are also making several improvements to our payment system to strengthen its integrity.”

TheFY 2012 recalibration of the CMIs will result in a reduction to skilled nursing facility payments of $4.47 billion or 12.6 percent. However, this reduction would be partially offset by the FY 2012 update to Medicare payments to skilled nursing facilities. The update — an increase of 1.7 percent or $600 million for FY 2012 — reflects a 2.7 percent increase in the prices of a "market basket” of goods and services reduced by a 1.0 percent multi-factor productivity (MFP) adjustment mandated by the Affordable Care Act. The combined MFP-adjusted market basket increase and the FY 2012 recalibration will yield a net reduction of $3.87 billion, or 11.1 percent.

For FY 2012, the recalibration will reflect the intent of the new RUG-IV system to pay SNF providers more accurately based on the service needs of Medicare beneficiaries in their care. The adjustment was determined using claims and assessment data from the first eight months of FY 2011. It will ensure that payments more accurately reflect the resources required to provide care for the range of SNF patients, including those requiring more medically complex care.

It is important to note that this recalibration removes an unintended spike in payments that occurred in FY 2011 rather than decreasing an otherwise appropriate payment amount. Even with the recalibration, the FY 2012 payment rates will be 3.4 percent higher than the rates established for FY 2010, the period immediately preceding the unintended spike in payment levels.

Along with recalibrating and updating the SNF PPS payment rates for FY 2012, this final rule makes a number of additional revisions aimed at enhancing SNF PPS accuracy and integrity. The rule modifies the patient assessment windows and grace days to minimize duplication and overlap in observation periods between assessments. The final rule also:

Clarifies circumstances when SNFs must report breaks of three or more days of therapy.

• Eliminates the distinction between facilities regularly furnishing therapy services on a 5- or 7-day basis for purposes of setting the date for the End of Therapy (EOT) Other Medicare Required Assessment (OMRA).
• Streamlines procedures for documenting situations involving a brief interruption in therapy, where therapy resumes without any change in the patient’s RUG-IV classification level.
• Introduces a new Change of Therapy (COT) OMRA to capture those changes in a patient’s therapy status that would be sufficient to affect the patient’s RUG-IV classification and payment, even though they may not increase to the level of a significant change in clinical status.
• Provides for the allocation of a therapist’s time for group therapy (defined in the rule as a single therapist leading four patients in a common activity) to ensure that Medicare payments better reflect resource utilization and cost for these services, and specifically that the therapist’s time is being appropriately counted and reimbursed.
• Discusses the impact of certain provisions of the Affordable Care Act, and announces that proposed provisions regarding ownership disclosure requirements set forth in the Affordable Care Act will be finalized at a later date.

More information on this SNF PPS final rule and other health care related news can be found at www.healthcare.gov, a new web portal made available by the U.S. Department of Health and Human Services.

. A copy of the final rule is available on the Federal Register website at: http://www.ofr.gov/OFRUpload/OFRData/2011-19544_PI.pdf