Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Spotlights and Announcements
Updates
September 24, 2026
NOW AVAILABLE: Skilled Nursing Facility Healthcare-Associated Infections (HAI) Requiring Hospitalization Measure Technical Specification Report
The Skilled Nursing Facility (SNF) Healthcare-Associated Infections (HAI) Requiring Hospitalization Measure Technical Specification Report is now available. The report presents the technical specifications for the refined SNF HAI measure, including updates to incorporate Medicare Advantage (MA) encounter records as a data source in addition to Medicare Fee-for-Service (FFS) claims.
The report describes the measure overview and rationale, data sources, SNF stay construction and inclusion and exclusion criteria, denominator and numerator specifications, risk adjustment methodology, measure calculation algorithm, measure results, and measure testing findings. Additional updates related to the public reporting timeline for the refined measure will be provided at a future date.
The report can be found in the Downloads section on the SNF Quality Reporting Program (QRP) Measures and Technical Information webpage.
September 17, 2026
NOW AVAILABLE: Final MDS 3.0 RAI User’s Manual version 1.20.11
The final Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.20.11 is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS 3.0 RAI User’s Manual v1.20.11 will be effective beginning October 1, 2026.
September 11, 2026
NOW AVAILABLE: SNF QRP Measure Calculations and Reporting User’s Manual V8.0 and Associated User's Manual Files
The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Measure Calculations and Reporting User's Manual v8.0 and accompanying files are now available. The accompanying documents include a V7.0 to V8.0 Change Table, Risk Adjustment Appendix File, Imputation Appendix File, and HCC ICD-10 Crosswalks.These documents serve as an update to the specifications used to calculate quality measures that are included in the SNF QRP effective October 1, 2026.
The manual and associated files can be found in the Downloads section on the SNF Quality Reporting Program (QRP) Measures and Technical Information webpage.
August 28, 2026
NEW RESOURCE AVAILABLE: Chapter 2: Assessment Types and Timing for the Resident Assessment Instrument (RAI)
The Centers for Medicare & Medicaid Services (CMS) is offering a web-based training that provides an overview of Chapter 2 of the Resident Assessment Instrument (RAI). The course reviews RAI requirements for OBRA and PPS assessments, including assessment types, timing and scheduling requirements, discharge assessment determination, interrupted stay considerations, and combined assessments.
This training can be accessed through the SNF QRP Training webpage.
August 26, 2026
NEW RESOURCE AVAILABLE: SNF QRP: APU Compliance Essentials Course
The Centers for Medicare & Medicaid Services (CMS) is offering an updated web-based training that provides an overview of the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP), including its purpose, structure, and the SNF QRP Life Cycle.
This training can be accessed through the SNF QRP Training webpage.
August 14, 2026
NEW RESOURCE AVAILABLE: Section K: Assessment and Coding Essentials Course
The Centers for Medicare & Medicaid Services (CMS) is offering a web-based training that provides an overview of Section K of the Minimum Data Set (MDS), including its purpose and key assessment and coding requirements.
This training can be accessed through the SNF QRP Training webpage.
August 5, 2026
SNF Quality Reporting Program: Non-Compliance Notifications
The Centers for Medicare & Medicaid Services (CMS) is providing notifications to Skilled Nursing Facilities (SNFs) and non-Critical Access Hospital (CAH) Swing Beds (SBs) that were determined to be out of compliance with SNF Quality Reporting Program (QRP) requirements for calendar year (CY) 2025 which will affect their fiscal year (FY) 2027 Annual Payment Update (APU). Non-compliance notifications will be placed in the facilities’ My Reports folders in the Internet Quality Improvement Evaluation System (iQIES) on August 5, 2026. Additionally, letters will be distributed by the Medicare Administrative Contractors (MACs). Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 pm, September 4, 2026. If you receive a notice of non-compliance and would like to request a reconsideration, see the instructions in your notification letter and on the SNF Quality Reporting Reconsideration and Exception & Extension webpage.
Please note: Any reconsideration containing protected health information (PHI) will not be processed. All PHI must be removed in order for a reconsideration to be reviewed.
Additionally, all submissions must be less than 20 MB overall (email message and attachments). Submissions that are greater than 20 MB in size cannot be processed.
July 29, 2026
Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2026 (CMS-1843-F)
On July 29, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1843-F) that provides updates to the fiscal year (FY) 2026 Skilled Nursing Facility Quality Reporting Program (SNF QRP). In this final rule, CMS finalized the removal of two COVID-19 measures and revised the data submission deadline. Additionally, CMS finalized the requirement to submit Minimum Data Set data on all SNF residents receiving covered skilled care in a SNF, regardless of payer.
The final rule went on display at the Federal Register and will be available at: https://www.federalregister.gov/public-inspection
July 29, 2026
Public Reporting July 2026 Refresh of SNF QRP Data – Now Available
The July 2026 refresh of the SNF QRP data is now available on the compare tool on Medicare.gov and Provider Data Catalog (PDC).
For more information, please visit the SNF QRP Public Reporting website.
July 15, 2026
SNF Provider Preview Reports – Now Available
The SNF Provider Preview Reports have been updated and are now available. These reports contain provider performance scores for quality measures, which will be published on the compare tool on Medicare.gov and the Provider Data Catalog (PDC) during the October 2026 refresh.
For more information, please visit the CMS SNF QRP Public Reporting website.
June 4, 2026
NEW RESOURCE AVAILABLE: SNF QRP: OBRA Discharge Assessment Determination Fact Sheet
The Centers for Medicare & Medicaid Services (CMS) is offering a one-page resource that clarifies when an OBRA Discharge assessment is required under the MDS 3.0 RAI User’s Manual (Chapter 2). This resource outlines the primary discharge criteria, including hospital admissions, observation stays greater than 24 hours, and discharges to other care settings or private residences.
This one-page resource can be accessed through the SNF QRP Training Page.
April 20, 2026
NEW RESOURCE AVAILABLE: Cross-Setting: Falls with Major Injury (FMI) Quality Measure (QM) Respecification
The Centers for Medicare & Medicaid Services (CMS) is offering a Web-Based Training that provides the latest information about the respecification of the Falls with Major Injury (FMI) Quality Measure (QM) for the Post-Acute Care (PAC) Settings. The training provides an overview of the legacy and respecified FMI Measure, discusses how the respecified measure includes both assessment and claims/encounter data in the respecified measure specifications. It also reviews key changes in PAC data collection guidance related to falls and injuries.
This resource can be accessed through the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Training webpage
January 26, 2026
Impact of Combined Assessments on SNF APU: How Medicare 5-Day and PPS Discharge Combined Assessments Affect Your Facility’s APU Calculation
The Centers for Medicare & Medicaid Services (CMS) has released a one-page resource for SNF providers that illustrates how Medicare 5-Day and PPS Discharge combined assessments can impact the APU calculation. Providers should anticipate more in-depth training focused on the criteria for success for the SNF QRP APU in the near future.
This resource can be found in the downloads section at the bottom of the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Training webpage.
If you have questions about accessing resources or feedback regarding the trainings, please email the PAC Training Mailbox. If you would like to receive email notifications related to future training resources or events, please register to be added to our Notification List. Content-related questions should be submitted to the SNF QRP Help Desk.
December 23, 2025
Overview of the Data Validation Process for the SNF Assessment-Based Measures
The Centers for Medicare & Medicaid Services (CMS) is offering a recorded presentation which describes the new data validation process.
This training can be accessed through the Data Validation Process webpage.
November 26, 2025
Falls with Major Injury (FMI) SNF Technical Specification Report
The Centers for Medicare & Medicaid Services (CMS) has released the official Technical Specification Report for the Falls with Major Injury (FMI) measure. This report incorporates feedback received during the cross-setting Technical Expert Panel (TEP) held on May 12 and 14, 2025. The report provides an overview of the measure, a high-level summary of the key features of the re-specified measure, a description of the methodology used to construct the FMI measure, and an overview of measure testing results. Additional guidance and related updates to the Quality Measure Calculations and Reporting User’s Manual and public reporting timelines will be provided at a future date.
The report is available in the Downloads section on the SNF QRP Measures and Technical Information webpage.
September 24, 2025
Final MDS 3.0 RAI User’s Manual version 1.20.1
The posted final Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.20.1 has been updated to align with the revisions to item J1900 in the release of the MDS item sets v1.20.1v4. The updated version is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual webpage. The MDS 3.0 RAI User’s Manual v1.20.1 is effective as of October 1, 2025.
September 23, 2025
Final MDS 3.0 Item Sets version 1.20.1v4
The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.20.1v4 and Item Matrix v1.20.1v4 are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual webpage. This revised final version (1.20.1v4) includes updates to the language in item J1900, which have been made in response to provider concerns; these are the only changes from the previous version. The MDS Item Sets v1.20.1v4 will be effective beginning October 1, 2025.
September 19, 2025
SNF QRP Measure Calculations and Reporting User’s Manual V7.0 and Associated User's Manual Files
The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Measure Calculations and Reporting User's Manual v7.0 and accompanying files are now available. The accompanying documents include a V6.0 to V7.0 Change Table, Risk Adjustment Appendix File, Imputation Appendix File, and HCC ICD-10 Crosswalks. These documents serve as an update to the specifications used to calculate quality measures that are included in the SNF QRP effective October 1, 2025.
The manual and associated files can be found in the Downloads section on the SNF Quality Reporting Program (QRP) Measures and Technical Information webpage.
August 11, 2025
May 2025 Falls with Major Injury Technical Expert Panel (TEP) Summary Report
The Centers for Medicare & Medicaid Services (CMS) convened a Technical Expert Panel (TEP) on May 12 and 14, 2025, to obtain input on potential cross-setting updates to the Falls with Major Injury (FMI) measure. The TEP was held in response to concerns regarding potential underreporting on the current measure and recommendations from the U.S. Department of Health and Human Services Office of Inspector General (OIG) in its 2023 report. The OIG report recommended that CMS pursue measure respecification, including consideration of alternative data sources, such as claims-based data, and transitioning the measure to a hybrid model. CMS has released the official TEP Summary Report, which provides an overview of the panel’s discussion and feedback on proposed updates to the measure.
CMS intends to move forward with updates to the FMI measure based on input received during the TEP. Additional guidance related to updates to the Quality Measures User’s Manual, clinical guidance manuals, technical specifications, and public reporting timelines will be provided at a future date. In the interim, stakeholders are encouraged to review the TEP Summary Report for additional detail on the proposed updates and the rationale discussed by the TEP.
The TEP Summary Report can be found in the Downloads section on the SNF QRP Measures and Technical Information webpage.