SKILLED NURSING FACILITY (SNF)

VBC/VBP

The information on Care Compare – Nursing homes including rehab services, and Provider Data Catalog comes from these key sources:

  1. CMS's health inspection database - Includes the nursing home characteristics and health deficiencies issued during the 3 most recent standard inspections and any complaint investigations or infection control inspections in the past 3 years. Data about penalties made against nursing homes also come from this database. Additional inspection data may be added to the database at any time because of complaint or facility reported incident investigations, outcomes of revisits, Informal Dispute Resolutions (IDR), or Independent Informal Dispute Resolutions (IIDR). These data may not be added in the same cycle as the standard inspection data. The following measures on Care Compare – Nursing homes including rehab services, and Provider Data Catalog come from this data source:

        1. Health inspections data

        2. Fire Safety inspections data

        3. Penalties

  2. Payroll-Based Journal (PBJ) system - The PBJ system allows nursing homes to electronically submit the number of hours facility staff are paid to work each day. The information is submitted quarterly, and is auditable to ensure accuracy. Staffing data are collected on the director of nursing, registered nurses (RNs) with administrative duties, RNs, licensed practical nurses (LPNs) with administrative duties, LPNs, certified nurse aides (CNAs), medication aides, and nurse aides in training. More information on this program is available hereStaffing Data Submission PBJ - Opens in a new window. The following measures on Care Compare – Nursing homes including rehab services, and Provider Data Catalog come from this data source:

    1. Total staffing (RN, LPN, CNA)

    2. RN staffing

    3. Physical Therapist hours

  3. The Minimum Data Set (MDS) national database - Data for quality of resident care measures come from the MDS database. The MDS is an assessment done by the nursing home at regular intervals on every resident in a Medicare- or Medicaid-certified nursing home. Information is collected about the resident's health, physical functioning, mental status, and general well-being. These data are used by the nursing home to assess each resident's needs and develop a plan of care. The following measures on Care Compare – Nursing homes including rehab services, and Provider Data Catalog come from this data source:

    1. Quality of resident care

    2. Staffing (resident characteristics used to estimate the amount of staffing needed)

    3. Resident census (used in calculating staffing hours per resident day)

  4. Medicare claims data - CMS uses bills that nursing homes and hospitals submit to Medicare for payment purposes to identify when hospitalizations and nursing home admissions take place. These are used to calculate hospital readmission rates, emergency room visits, and discharges. The following measures on Care Compare – Nursing homes including rehab services, and Provider Data Catalog come from this data source:

    1. Quality of resident care

This information changes often, as residents are discharged and admitted, or residents' conditions change. The data on Care Compare – Nursing homes including rehab services, and Provider Data Catalog should be used along with information from the Long-Term Care Ombudsman's office, the State Survey Agency, or other sources. Please see the Nursing Home Compare Technical Users' Guide for more information on where the data comes from.



Nursing homes including rehab services

The nursing homes that the Centers for Medicare & Medicaid Services (CMS) certifies regularly report clinical information about each of their residents. CMS uses this information to measure parts of nursing home care quality, like if residents have gotten their flu shots, are in pain, had one or more falls that resulted in a major injury, or are losing weight. These measures are often called the "quality of resident care", and Medicare posts each nursing home's scores for these measures on Care Compare – Nursing homes including rehab services, and Provider Data Catalog. By comparing scores, you can see how nursing homes may be different from each other.

Care Compare – Nursing homes including rehab services, and Provider Data Catalog has two different types of quality of resident care measures: short- and long-stay resident quality measures.

What to keep in mind when using quality of resident care measures

The quality of resident care measures on Care Compare – Nursing homes including rehab services, and Provider Data Catalog aren’t benchmarks, thresholds, guidelines, or standards of care, and aren't appropriate for use in a lawsuit. They are based on the average quality of care given to all the residents in a nursing home and don’t detail a single resident’s experience.

Most of these quality measures show residents’ health in the 7 days before the assessment was done. This means that the quality measures may not show the residents' health during the entire time between assessments.

Call your State Survey Agency or Long-Term Care Ombudsman for additional information


Skilled Nursing Facility Quality Reporting Program (SNF QRP)

Additional quality measures

Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program

The SNF VBP Program rewards skilled nursing facilities (SNFs) with incentive payments based on the quality of care they provide to people with Medicare, as measured by a hospital readmissions measure. Section 215 of the Protecting Access to Medicare Act of 2014 (PAMA) added sections 1888(g) and (h) to the Social Security Act, which required the Secretary to establish a SNF VBP Program. PAMA specifies that under the SNF VBP Program, SNFs:

  • Are evaluated by their performance on a hospital readmission measure;

  • Are scored on both improvement and achievement;

  • Receive quarterly confidential feedback reports containing information about their performance; and

  • Earn incentive payments based on their performance.

All SNFs paid under Medicare’s SNF Prospective Payment System (PPS) are included in the SNF VBP Program, but facilities with no eligible stays in the performance period are not reported in the facility-level dataset.

For more information on the SNF VBP Program, visit the Centers for Medicare & Medicaid Services (CMS) SNF VBP website.

Additional quality measures

The Skilled Nursing Facility Quality Reporting Program (SNF QRP) provides results for the quality and resource use measures for residents that get skilled care in nursing homes under the Medicare Part A benefit.