Measures

Measures

The SNF VBP Program’s Hospital Readmission Measure

For the FY 2025 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) 2025 through FY 2027 Program years, as finalized through the federal rulemaking process.

Program YearBaseline PeriodPerformance Period
FY 2025*FY 2019 (10/1/2018-9/30/2019)FY 2023 (10/1/2022-9/30/2023)
FY 2026FY 2022 (10/1/2021-9/30/2022)FY 2024 (10/1/2023-9/30/2024)
FY 2027FY 2023 (10/1/2022-9/30/2023)FY 2025 (10/1/2024-9/30/2025)

CY = Calendar Year; FY = Fiscal Year.

* 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 period for the FY 2025 Program year remained FY 2019 and was not advanced by one year to avoid any use of the excluded qualifying claims.

Future Expansion of the SNF VBP Program

Beginning in the FY 2026 Program year, the SNF VBP Program is expanding to assess performance on multiple quality measures rather than a single measure. 

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 (pages 53276-53304), CMS adopted four additional measures, and finalized one measure replacement. 

The following table lists the measures currently adopted for the FY 2025 through FY 2028 Program years, as finalized through the federal rulemaking process.

 

Measure and Link to Technical Report

FY 2025 

Program Year

FY 2026

 Program Year

FY 2027

 Program Year

FY 2028

Program Year

SNFRM (PDF)YesYesYes-
Skilled Nursing Facility Healthcare-Associated Infections (SNF HAI) Requiring Hospitalization (PDF)-YesYesYes
Total Nurse Staffing Hours per Resident Day (including Registered Nurse [RN], Licensed Practical Nurse [LPN], and Nurse Aide hours) (PDF)-YesYesYes 
Total Nursing Staff Turnover (PDF)-YesYesYes
Discharge to Community—Post-Acute Care (DTC-PAC) Measure for SNFs (PDF) --YesYes
Percent of Residents Experiencing One or More Falls with Major Injury (Long-Stay) (PDF)--YesYes
Discharge Function Score for SNFs (PDF)--YesYes
Number of Hospitalizations per 1,000 Long Stay Resident Days (PDF)--YesYes
Skilled Nursing Facility Within-Stay Potentially Preventable Readmission (SNF WS PPR) Measure (PDF)---Yes

 

Resources

Page Last Modified:
09/10/2024 06:23 PM