Nursing Home Quality Incentive Payment Program

InsightsClient Alert

The Department of Health and Human Services (HHS) has released additional guidance on the $2 billion quality incentive payment program under the Nursing Home Infection Control Distribution from the Provider Relief Fund.  Nursing homes will not have to apply for this new program as HHS will be measuring nursing home performance and distributing payments based on required data submissions.

Facility eligibility requirements include:

  • Active certification as a nursing home or skilled nursing facility (SNF);
  • Receive reimbursement from Centers for Medicare & Medicaid Services; and
  • Report data to Certification and Survey Provider Enhanced Reports (CASPER).

A nursing home must meet two criteria to be eligible for the incentive payment as follows:

  • Demonstrate a rate of COVID-19 infections that is below the rate of infection in the county it is located; and
  • Have a COVID-19 death rate that falls below a nationally established performance threshold for mortality among nursing home residents infected with COVID-19.

Under this program, there are scheduled to be four monthly performance periods (September, October, November, and December) and an aggregate performance period for the entire four month period.  Each of the five performance periods has $400 million available for distribution to nursing homes.  The nursing homes’ data submissions will undergo additional HHS review and auditing before payments are issued the following month.

The payments received under this program are to follow the same terms and conditions and restrictions on use of funds as the Nursing Home Infection Control Distribution.

For more information, please contact our Albany office at (229) 883-7878 or our Atlanta office at (404) 220-8494.

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