Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Measures and Technical Information

The purpose of this webpage is to provide information on the measures reported by SNFs in accordance with the SNF QRP. On this page, you will find descriptions of each measure, links to measure specifications, measure updates and other measure-related information. This page is updated as measure updates become available.

What are the SNF QRP Measures?

Measures adopted for and removed from the SNF QRP are listed below. Several are endorsed by the consensus-based entity (CBE) contracted by the Secretary to guide the selection of performance measures for federal health programs. Data for the SNF QRP measures are collected and submitted through three methods:

• Minimum Data Set (MDS) 3.0
• Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN)
• Medicare Fee-For-Service Claims

MDS Assessment-Based Measures

Data collected using the MDS 3.0 and submitted to the Centers for Medicare & Medicaid Services (CMS) via the Internet Quality Improvement and Evaluation System (iQIES):

SNF QRP Measure #1: Application of Percent of Residents Experiencing One or More Falls with Major Injury (Long Stay) [CMIT Measure ID #00520 (not endorsed)]

This measure was finalized in the fiscal year (FY) 2016 SNF Prospective Payment System (PPS) Final Rule which was published in the Federal Register on August 4, 2015 (80 FR 46440 through 46444). Data collection for this measure began 10/1/2016. Public reporting began 10/24/2018.

SNF QRP Measure #2: Drug Regimen Review Conducted with Follow-Up for Identified Issues—PAC SNF QRP [CMIT Measure ID #00225 (not endorsed)]

This measure was finalized in the FY 2017 SNF Final Rule which was published in the Federal Register on August 5, 2016 (81 FR 52034 through 52039). Data collection for this measure began 10/1/2018. Public reporting began 10/28/2020.

SNF QRP Measure #3: Changes in Skin Integrity Post-Acute Care: Pressure Ulcer/Injury [CMIT Measure ID #00121 (not endorsed)]

This measure was finalized in the FY 2018 SNF PPS Final Rule which was published in the Federal Register on August 4, 2017 (82 FR 36572 through 36577). Data collection for this measure began 10/1/2018. Public reporting began 10/28/2020.

SNF QRP Measure #4: Application of IRF Functional Outcome Measure: Discharge Self-Care Score for Medical Rehabilitation Patients [CMIT Measure ID #00404 (not endorsed)]

This measure was finalized in the FY 2018 SNF PPS Final Rule which was published in the Federal Register on August 4, 2017 (82 FR 36583 through 36593). Data collection for this measure began 10/1/2018. Public reporting began 10/28/2020.

SNF QRP Measure #5: Application of IRF Functional Outcome Measure: Discharge Mobility Score for Medical Rehabilitation Patients [CMIT Measure ID #00403 (not endorsed)]

This measure was finalized in the FY 2018 SNF PPS Final Rule which was published in the Federal Register on August 4, 2017 (82 FR 36584 through 36593). Data collection for this measure began 10/1/2018. Public reporting began 10/28/2020.

SNF QRP Measure #6: Transfer of Health Information to the Provider-Post-Acute Care (PAC) [CMIT Measure ID #00728 (not endorsed)]

This measure was finalized in the FY 2020 SNF PPS Final Rule which was published in the Federal Register on August 7, 2019 (84 FR 38755 through 38761). Data collection for this measure began on October 1, 2023.

SNF QRP Measure #7: Transfer of Health Information to the Patient-Post-Acute Care (PAC) [CMIT Measure ID #00727 (not endorsed)]

This measure was finalized in the FY 2020 SNF PPS Final Rule which was published in the Federal Register on August 7, 2019 (84 FR 38761 through 38764). Data collection for this measure began on October 1, 2023.

SNF QRP Measure #8: Discharge Function Score [CMIT Measure ID #01698 (not endorsed)]

This measure was finalized in the FY 2024 SNF PPS Final Rule, which was published in the Federal Register on August 7, 2023 (88 FR 21316 through 21422). Data collection for this measure began on October 1, 2023.

SNF QRP Measure #9: COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date [CMIT Measure ID #01699 (not endorsed)]

This measure was finalized in the FY 2024 SNF PPS Final Rule, which was published in the Federal Register on August 7, 2023 (88 FR 21316 through 21422). Data collection for this measure will begin on October 1, 2024.

For more detailed information on data collection and submission deadlines, please refer to the SNF QRP Data Submission Deadlines webpage. For more information on the data sets and guidance related to the collection and reporting of assessment data, please refer to the MDS Resident Assessment Instrument (RAI) manual located on the MDS 3.0 RAI Manual webpage.

CDC NHSN Measures

Data for these measures are submitted via the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN):

SNF QRP Measure #10: COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) [CMIT Measure ID #00180 (not endorsed)]

This measure was finalized in the FY 2022 SNF PPS Final Rule, which was published in the Federal Register on August 4, 2021 (86 FR 42480 through 42489). Data submission for this measure began October 1, 2021. This measure was modified in the FY 2024 SNF PPS Final Rule, which was published in the Federal Register on August 7, 2023 (88 FR 53200 through 53347). Data collection for the modified measure began on October 1, 2023.

SNF QRP Measure #11: Influenza Vaccination Coverage among Healthcare Personnel (HCP) [CMIT Measure ID #00390 (CBE-endorsed)]

This measure was finalized in the FY 2023 SNF PPS Final Rule, which was published in the Federal Register on August 3, 2022 (87 FR 47537 through 47544). Data submission for this measure began October 1, 2022.

Medicare Fee-For-Service Claims-Based Measures

Data for these measures are collected from claims, and no additional data need to be submitted by the SNF.

SNF QRP Measure #12: Medicare Spending Per Beneficiary (MSPB)– Post-Acute Care (PAC) SNF QRP [CMIT Measure ID #00434 (not endorsed)]

This measure was finalized in the FY 2017 SNF PPS Final Rule which was published in the Federal Register on August 5, 2016 (81 FR 52014 through 52021). Public reporting began 10/24/2018.

SNF QRP Measure #13: Discharge to Community - PAC SNF QRP [CMIT Measure ID #00210 (CBE-endorsed)]

This measure was finalized in the FY 2017 SNF PPS Final Rule which was published in the Federal Register on August 5, 2016 (81 FR 52021 through 52029). Public reporting began 10/24/2018.

SNF QRP Measure #14: Potentially Preventable 30-Day Post-Discharge Readmission Measure – SNF QRP [CMIT Measure ID #00575 (not endorsed)]

This measure was finalized in the FY 2017 SNF PPS Final Rule which was published in the Federal Register on August 5, 2016 (81 FR 52030 through 52034). Public reporting began 10/24/2019.

SNF QRP Measure #15: SNF Healthcare-Associated Infections (HAI) Requiring Hospitalization [CMIT Measure ID #00680 (not endorsed)]

This measure was finalized in the FY 2022 SNF PPS Final Rule, which was published in the Federal Register on August 4, 2021 (86 FR.42473 through 42480). Public reporting began 4/29/2022.

Measures Removed from SNF

Percent of Residents or Patients With Pressure Ulcers That Are New or Worsened (Short Stay)

As finalized in the FY 2018 SNF PPS Final Rule published in the Federal Register on 08/04/2017 (82 FR 36572 through 36577), this measure was replaced in the QRP by a modified version of the measure entitled Changes in Skin Integrity Post-Acute Care: Pressure Ulcer/Injury beginning with the FY 2020 SNF QRP.

Application of Percent of Long-Term Care Hospital (LTCH) Patients with an Admission and Discharge Functional Assessment and a Care Plan that Addresses Function

As finalized in the FY2024 SNF PPS Final Rule published on August 7, 2023, this measure was removed from the SNF QRP beginning FY 2024. Data collection for this measure ended on October 1, 2023.

Application of IRF Functional Outcome Measure: Change in Self-Care Score for Medical Rehabilitation Patients

As finalized in the FY2024 SNF PPS Final Rule published on August 7, 2023, this measure was removed from the SNF QRP beginning FY 2024. Data collection for this measure ended on October 1, 2023.

Application of IRF Functional Outcome Measure: Change in Mobility Score for Medical Rehabilitation Patients

As finalized in the FY2024 SNF PPS Final Rule published on August 7, 2023, this measure was removed from the SNF QRP beginning FY 2024. Data collection for this measure ended on October 1, 2023.

Updates

November 22, 2024

SUMMARY REPORT PUBLISHED: SNF QRP Listening Session: Possible Expansion of SNF Data Collection and Submission to All Residents Regardless of Payer

The Centers for Medicare & Medicaid Services (CMS) has published a summary report on the virtual Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Listening Session that was held on October 1, 2024 by RTI International. This session was held to seek feedback from clinical staff, MDS coordinators, administration and management staff, and software vendors on the possible expansion of collection and submission of Minimum Data Set (MDS) assessment data used for the SNF QRP to include all residents receiving short-term skilled care in a SNF regardless of their payer. The report presents a summary of the presentation for each discussion topic, input from interested parties for each of the discussion questions, and key findings. The summary report also includes the feedback received via email in the 30 days following the event. The report can be found in the Downloads section of this webpage.

September 3, 2024

SNF QRP Data Elements Used for Reporting Assessment-Based QMs and Standardized Patient Assessment Data Elements Affecting FY 2027 APU Determination FY 2027

The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Overview of Data Elements Used for Reporting Assessment-Based Quality Measures and Standardized Patient Assessment Data Elements Affecting Fiscal Year (FY) 2027 Annual Payment Update (APU) Determination table has been updated to reflect the data elements that will be required to meet the APU for the FY 2027 SNF QRP.  The FY 2027 SNF QRP APU Table is now available in the Downloads section of this webpage.

August 30, 2024

SNF QRP Quality Measure Calculations and Reporting User’s Manual V6.0, Change Table, Risk Adjustment Appendix File, Imputation Appendix File, and HCC ICD-10 Crosswalks – Now Available

The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Quality Measure Calculations and Reporting User’s Manual Version 6.0 and accompanying documents are now available. 

The SNF QRP Measure Calculations and Reporting User’s Manual Version 6.0 serves as an update to the specifications used to calculate quality measures that are included in the SNF QRP. The accompanying SNF QRP Measure Calculations and Reporting User’s Manual Change Table Version 6.0 provides a summary of changes between Version 6.0 and Version 5.0 of the SNF QRP Quality Measure Calculations and Reporting User’s Manual. Furthermore, the Risk Adjustment Appendix File for the SNF QRP Measure’s Calculations and Reporting User’s Manual Version 6.0 contains risk-adjustment values used to calculate the risk-adjusted quality measures. The Crosswalks of Hierarchical Condition Categories (HCC) to International Classification of Diseases (ICD)-10 codes are used in the risk-adjustment models for the Discharge Self-Care, Discharge Mobility, and Discharge Function Score measures. Lastly, the Imputation Appendix File for the SNF QRP Quality Measure Calculations and Reporting User’s Manual Version 6.0 contains imputed coefficients used to calculate the risk-adjusted Discharge Function Score measure. 

These files are effective October 1, 2024 and can be accessed in the Downloads section of this webpage. 

December 1, 2023

SNF QRP Claims-Based Measure Manual and Accompanying Files – Now Available

The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Claims-Based Measure Manual is now available. The manual serves as a resource used to calculate claims-based measures that are included in the SNF QRP. The Discharge to Community (DTC)–Post Acute Care (PAC) SNF QRP (DTC) measure, Potentially Preventable 30-Day Post-Discharge Readmission Measure for SNF QRP (PPR), and SNF Within-Stay Potentially Preventable Readmission (SNF WS PPR) measure Supplemental Codes file provides both a list of codes used to identify readmission and diagnoses and a list of covariates used in risk adjustment across the DTC, PPR, and SNF WS PPR measures. The Medicare Spending Per Beneficiary (MSPB)-PAC SNF QRP (MSPB SNF) measure Covariates file provides a list of covariates used in risk-adjustment for the MSPB SNF measure. Additionally, the MSPB SNF Clinically Unrelated Services Exclusion file and MSPB SNF First Day Service Exclusions files provide a list of services that are excluded from MSPB SNF measure calculation. Finally, the SNF Healthcare-Associated Infections (HAI) Requiring Hospitalization (SNF HAI) measure Supplemental Codes file provides both International Classification of Diseases (ICD)-10 codes used in the measure numerator and covariates used in risk adjustment for the SNF HAI measure.

These files can be accessed in the Downloads section of this webpage.

SNF Quality Reporting Program Archives