The SNF proposed final rule (See link on resources page) has changes to some wage indexes. Some areas have changed from urban to rural and vice versa. The CMI for RUG-IV is different for urban and rural facilities. It is worth looking your area up (I download the file as an adobe document then use "search") to see if you are getting an additional break or additional hit in your rates for FY14. For example, my home, Virginia Beach, VA had a wage index last year (FY13) of 0.9208 and this year the wage index is 0.8928. So, the 1.4% increase will be mitigated somewhat by the lower wage index adjustment. The wage index adjustment is explained in the final rule, but basically, they take about 70% of the per diem rate and apply the wage index adjustment to it. That means the base urban or rural rate will be adjusted upwards or downwards. (Accountants, forgive me for the oversimplification & number rounding). Let's say the daily rate is $400.00. They take roughly 70% of that, which would be about $280, then apply your wage index adjustment: 280 x .8928 = $250. That $280 becomes $250, and they add the $250 to the 30% of the rate that was not labor costs, so: 250 + 120 = $370.
Summary: The $400 daily rate becomes, for my facility, $370.
Now, let's use Virginia Beach again to show what adjusting your wage index does for you:
RUC in FY13: $569 (after labor cost adjustment $538)
RUC in FY14: $577 (after labor cost adjustment $534)
RUC with FY13 labor cost adjustment for Virginia Beach:(roughly) 70% of 569 = $398 x .9208 = $367 + 171 = 538
RUC with FY14 labor cost adjustment for Virginia beach (roughly) 70% of 577 = 403 x .8928 = 360 + 174 = 534
So, the 1.4% increase becomes roughly a four dollar decrease.
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