The Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program is a Centers for Medicare & Medicaid Services (CMS) program that awards incentive payments to skilled nursing facilities (SNFs) to encourage SNFs to improve the quality of care they provide to patients. CMS distributes four reports for this program each year: a Historical Results Workbook, two Full-Period Workbooks (one each for the baseline period and performance period), and a Performance Score Report. On July 31, 2026, CMS released the SNF VBP Fiscal Year (FY) 2027 Program Year August 2026 Performance Score Report. This report provides each SNF with an Overview of Performance, Measure Results, Measure Scores, the facility Performance Score, and possibly the biggest item of interest – each SNF’s Incentive Payment Multiplier for FY2027. Beginning October 1, 2026 (which is the start for FY2027), CMS will apply the multiplier to the SNF’s adjusted federal per-diem rate when payments are made for Medicare fee-for-service (FFS) Part A claims in FY2027.
Performance Score Report
CMS generates this report and delivers it to each facility representative through the Internet Quality Improvement and Evaluation System (iQIES). The entire report is presented as a spreadsheet with easy-to-understand explanations of the eight quality measure (QM) items in this program. These QMs are generated from three sources – Medicare FFS Part A Claims, the CMS Payroll-Based Journal (PBJ) System, and Minimum Data Set (MDS) Assessments. The specific measures include:
- SNF 30-Day All-Cause Readmission Measure (SNFRM) – Medicare FFS Part A Claims
- Skilled Nursing Facility Healthcare Associated Infections Requiring Hospitalization (SNF HAI) – Medicare FFS Part A Claims
- Discharge to Community – Post-Acute Care Measure for SNFs (DTC PAC SNF) – Medicare FFS Part A Claims
- Number of Hospitalizations per 1,000 Long Stay Resident Days (Long Stay Resident Days) – Medicare FFS Part A Claims
- Total Nursing Staff Turnover (Nursing Staff Turnover) – CMS PBJ System
- Total Nursing Hours per Resident Day (Total Nurse Hours) – CMS PBJ System
- Discharge Function Score for SNFs (Discharge Function Score) – MDS Assessments
- Percent of Residents Experiencing One or More Falls With Major Injury (Long-Stay) (Falls with Major Injury Long-Stay) – MDS Assessments
Improving QMs with iQIES
The FY2027 VBP program includes results calculated from data collected during a baseline period and performance period. Depending on the measure, the baseline period could reflect facility data collected during FY2021 or FY2023. The performance period reflects data collected for each facility during FY2025. After calculating measure results during a baseline period and a performance period for each measure, CMS calculates achievement, improvement, and measure scores for each measure for each SNF. Considering the age of the data CMS is utilizing to calculate the VBP incentive multiplier for FY2027, SNFs may determine that implementing close monitoring and process improvements now could improve the opportunity for an increased future incentive multiplier. CMS offers several facility reports in iQIES that can be helpful to improve MDS-related QM used in the VBP (the Discharge Function Score and Falls with Major Injury Long-Stay). These reports include:
- MDS 3.0 NH Final Validation Report – generated with every batch of submitted MDS. Review this report at least weekly; look for warnings that items may have been dash-coded on the MDS. Dash codes indicate missing data on the MDS, and impact how the QM is calculated.
- MDS 3.0 Package Reports – contains the MDS 3.0 Resident-Level QM Report, the MDS 3.0 Facility-Level QM Report, and the MDS 3.0 Facility Characteristics Report. The first two of these reports provide information about which residents triggered for the Falls with Major Injury (Long-Stay) and Discharge Function Score as well as how the facility is performing in these measures in comparison to state and national averages.
- SNF QRP Resident-LevelQMReport – lists each resident with a qualifying MDS record used to calculate the assessment-level quality measure values for a select 12-month period. The report displays each resident’s name and indicates how/if the resident’s stay affected the SNF’s quality measure scores.
- SNF QRP Facility-Level QM Report – provides facility-level quality measure results for a select 12-month period. Quality measure results are computed from the data submitted in the MDS, Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN), and Medicare FFS Claims data sources.
In August 2026, CMS will be moving PBJ reporting to iQIES. Once this transition is completed, iQIES will offer a robust catalogue of reports to support providers in improving their QM performance and monitoring their compliance with CMS reporting requirements. Facilities that are familiar with and incorporate these reports in weekly, monthly, and quarterly quality improvement efforts will achieve improved QM scores and potentially increased VBP incentive multipliers in the future.
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