Washington Here's the word from the Office of Inspector General: The prospective payment system has not shut the doors of skilled nursing facilities to Medicare beneficiaries. Many feared the opposite would be true when the payment system went into effect July 1, 1998. But according to the OIG's new report, Early Effects of the Prospective Payment System on Access to Skilled Nursing Facilities, 94 percent of SNF administrators polled believe their facilities have not refused any residents because of the new reimbursement system. Still, 70 percent say their admission practices have changed because of PPS, with the patient's medical condition becoming a key deciding factor. About 53 percent of administrators said they are less likely to admit patients who require expensive supplies or services, the report says.