Changes in Patient Medical Complexity After Skilled Nursing Facility Payment Reform: A Qualitative Study

The skilled nursing facility (SNF) patient-driven payment model (PDPM) is intended to align payment with patient clinical characteristics to more accurately compensate complex and resource intensive care. However, it is unclear whether and how SNFs shifted their admission practices to align PDPM's financial incentives. This study examined SNF leaders’ perspectives on changes in admission practices and patient case mix in order to understand variation in responses to PDPM implementation.