Measures
Measures
The SNF VBP Program’s Hospital Readmission Measure
For the FY 2024 Program year, the SNF VBP Program will award incentive payments to SNFs based on their performance on the SNF 30-Day All-Cause Readmission Measure (SNFRM). The SNFRM measures the rate of all-cause, unplanned hospital readmissions for SNF residents within 30 days of discharge from a prior hospital stay. The SNFRM is risk adjusted for patient demographics, comorbidities, and other health status variables that affect the probability of a hospital readmission, including diagnoses of COVID-19. Each SNF receives a SNFRM result (i.e., a risk-standardized readmission rate) for a baseline period and a performance period. The following table provides the baseline and performance periods for the Fiscal Year (FY) 2019 through FY 2027 Program years, as finalized through the federal rulemaking process.
|
Program Year |
Baseline Period |
Performance Period |
|---|---|---|
|
FY 2019* |
CY 2015 (1/1/2015-12/31/2015) |
CY 2017 (1/1/2017-12/31/2017) |
| FY 2020 | FY 2016 (10/1/2015-9/30/2016) | FY 2018 (10/1/2017-9/30/2018) |
|
FY 2021 |
FY 2017 (10/1/2016-9/30/2017) |
FY 2019 (10/1/2018-9/30/2019) |
|
FY 2022 |
FY 2018 (10/1/2017-9/30/2018) |
4/1/2019-12/1/2019** |
| FY 2023 | FY 2019 (10/1/2018-9/30/2019) | FY 2021 (10/1/2020-9/30/2021) |
| FY 2024*** | FY 2019 (10/1/2018-9/30/2019) | FY 2022 (10/1/2021-9/30/2022) |
| FY 2025*** | FY 2019 (10/1/2018-9/30/2019) | FY 2023 (10/1/2022-9/30/2023) |
| FY 2026 | FY 2022 (10/1/2021-9/30/2022) | FY 2024 (10/1/2023-9/30/2024) |
| FY 2027 | FY 2023 (10/1/2022-9/30/2023) | FY 2025 (10/1/2024-9/30/2025) |
CY = Calendar Year; FY = Fiscal Year.
*The SNF VBP Program shifted from calendar year to fiscal year measurement periods beginning in the FY 2020 Program year to mitigate logistical calculations concerns.
** In response to the COVID-19 public health emergency (PHE), CMS excluded qualifying claims in the first two quarters of Calendar Year (CY) 2020 (January 1, 2020 – June 30, 2020) from use in the SNF VBP Program. Thus, the FY 2022 SNF VBP performance period originally specified in the interim final rule with comment was restricted to April 1, 2019 through December 1, 2019. For further information please see the interim final rule with comment (pages 54835–54837) and the FY 2022 SNF PPS final rule (pages 42503–42516).
*** In response to the COVID-19 PHE, CMS excluded qualifying claims in the first two quarters of CY 2020 (January 1, 2020 – June 30, 2020) from use in the SNF VBP Program. Thus, the baseline periods for the FY 2024 and FY 2025 Program years remained FY 2019 and were not advanced by one year to avoid any use of the excluded qualifying claims.
Future Expansion of the SNF VBP Program
In Section 111 of the Consolidated Appropriations Act, 2021, Congress amended Section 1888(h) of the Social Security Act to allow the HHS Secretary to apply up to nine additional measures to the SNF VBP Program.
In the FY 2023 SNF PPS final rule (pages 47564–47580), CMS adopted three additional measures. In the FY 2024 SNF PPS final rule, CMS adopted four additional measures, and finalized one measure replacement. The following table lists the measures currently adopted for the FY 2024 through FY 2028 Program years, as finalized through the federal rulemaking process.
| Measure and Link to Technical Report |
FY 2024 Program Year |
FY 2025 Program Year |
FY 2026 Program Year |
FY 2027 Program Year |
FY 2028 Program Year |
|---|---|---|---|---|---|
| SNFRM | Yes | Yes | Yes | Yes | - |
| Skilled Nursing Facility Healthcare-Associated Infections (SNF HAI) Requiring Hospitalization | - | - | Yes | Yes | Yes |
| Total Nurse Staffing Hours per Resident Day (including Registered Nurse [RN], Licensed Practical Nurse[LPN],and Nurse Aide hours | - | - | Yes | Yes | Yes |
| Total Nursing Staff Turnover | - | - | Yes | Yes | Yes |
| Discharge to Community—Post-Acute Care (DTC-PAC) Measure for SNFs | - | - | - | Yes | Yes |
| Percent of Residents Experiencing One or More Falls with Major Injury (Long-Stay) | - | - | - | Yes | Yes |
| Discharge Function Score for SNFs | - | - | - | Yes | Yes |
| Number of Hospitalizations per 1,000 Long Stay Resident Days | - | - | - | Yes | Yes |
|
Skilled Nursing Facility Within-Stay Potentially Preventable Readmission (SNF WS PPR) Measure |
- | - | - | - | Yes |
Resources
- Original SNFRM Technical Report (PDF) and 2023 Measure Updates and Specifications Report: Skilled Nursing Facility 30-Day All-Cause Readmission Measure (PDF)
- SNFRM Reliability Testing Memo (PDF)
- Specifications for the Skilled Nursing Facility Healthcare-Associated Infections (SNF HAI) Requiring Hospitalization Measure (PDF)
- Specifications for the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program: Total Nursing Hours per Resident Day Measure (PDF)
- Specifications for the Total Nursing Staff Turnover Measure (PDF)
- Specifications for the Discharge to Community—Post-Acute Care (DTC-PAC) Measure for SNFs (PDF)
- Specifications for the Percent of Residents Experiencing One or More Falls with Major Injury (Long-Stay) Measure
- Specifications for the Discharge Function Score for SNFs Measure (PDF)
- Specifications for the Number of Hospitalizations per 1,000 Long Stay Resident Days Measure (PDF)
- Specifications for the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program: SNF Within-Stay Potentially Preventable Readmission Measure (PDF)
Page Last Modified:
09/15/2023 07:52 AM