Eleisha Wilkes

Q: What is the Skilled Nursing Facility Value-Based Payment Total Nurse Staffing Measure?

A: The Centers for Medicare & Medicaid Services awards incentive payments through the SNF VBP Program to encourage improvement in the quality of care provided to Medicare beneficiaries. CMS has long identified staffing as a vital component of quality care and uses staffing data to gauge its impact.

The Total Nursing Hours Per Resident Day Measure uses auditable electronic data reported to the Payroll-Based Journal system to calculate total nursing hours per resident day. It is one of two new measures that will begin affecting payments in the FY 2026 SNF VBP program year, the other being SNF Healthcare Associated Infections Requiring Hospitalization.

The numerator for this measure is the total nursing hours derived from PBJ data. Total nursing hours include RN, LPN and CNA hours per resident day. The denominator is a count of daily resident census derived from MDS assessments. The daily MDS census is summed across all days in the quarter.

The measure is also case-mix adjusted to account for differences in acuity and resident care needs. One bit of good news is that this measure is calculated using information that you already submit for the Five-Star Quality Rating System. It will not impose any new data collection or submission burdens.

The measure will be reported for the SNF VBP Program as an average rate of total nurse staffing per resident day across available quarters in the 1-year performance period of Oct. 1, 2023, through Sept. 30, 2024, for the FY 2026 SNF VBP program year. Performance periods will then advance by one year from the previous program year’s performance period.

Whether you knew it or not, the baseline period for this measure is already over, having ended on Sept. 30, 2022.

Eleisha Wiles, RN, RAC-CTA, RAC-CT, DNS-CT, is a clinical consultant at Proactive Medical Review. Send her your payment-related questions at [email protected]