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Updated Fiscal Years 2026 and 2027 Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program Performance Standards

This communication pertains to the Fiscal Year (FY) 2026 and FY 2027 Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program performance standards for the Total Nursing Staff Turnover (Nursing Staff Turnover) measure which the Centers for Medicare & Medicaid Services (CMS) published in the FY 2024 SNF Prospective Payment System (PPS) Final Rule [ https://www.federalregister.gov/documents/2023/08/07/2023-16249/medicare-program-prospective-payment-system-and-consolidated-billing-for-skilled-nursing-facilities ] on August 7, 2023, and in the FY 2025 SNF Prospective Payment System (PPS) Final Rule [ https://www.federalregister.gov/documents/2024/08/06/2024-16907/medicare-program-prospective-payment-system-and-consolidated-billing-for-skilled-nursing-facilities ] on August 6, 2024, respectively. The Nursing Staff Turnover measure is one of the four measures included in the SNF VBP Program for the FY 2026 Program year and one of the eight measures included for the FY 2027 Program year. This communication does not affect the current FY 2025 SNF VBP Program scoring and incentive payments nor does it affect prior FYs. SNFs do not need to do anything at this time, or in the future. The performance standards for each measure adopted by the SNF VBP Program consist of the achievement threshold and the benchmark. The achievement threshold is the 25th percentile of all SNFs' performance on a measure during the Program year's applicable baseline period. The benchmark is the mean of the top decile of all SNFs' performance on a measure during the Program year's applicable baseline period. For the FY 2026 SNF VBP Program year, the baseline period is FY 2022 and the performance period is FY 2024 for the Nursing Staff Turnover measure. For the FY 2027 SNF VBP Program year, the baseline period is FY 2023 and the performance period is FY 2025. The performance standards are used together with each SNF’s performance on a measure during the baseline period and the performance period to calculate a measure score for each measure, for each SNF.

CMS identified a technical update for the Nursing Staff Turnover measure which impacts the calculation of the achievement threshold and benchmark for the FY 2026 and FY 2027 SNF VBP Program years. In July 2024, CMS updated the Nursing Staff Turnover measure’s methodology to define turnover using a 90-day gap rather than a 60-day gap in days worked. To confirm the performance standards calculated using FY 2022 and FY 2023 data are as comparable as possible to the performance period measure results to be calculated using data from FY 2024 and FY 2025, respectively, CMS is updating the performance standards using the updated measure methodology. The technical measure specifications are described in more detail in the Nursing Home Five-Star Quality Rating System Technical Users' Guide [ https://www.cms.gov/medicare/provider-enrollment-and-certification/certificationandcomplianc/downloads/usersguide.pdf ].

The tables below display the original performance standards published in the FY 2024 and FY 2025 SNF PPS Final Rules and the updated performance standards. The updated performance standards will be used in upcoming FY 2026 and FY 2027 SNF VBP Program scoring and payment calculations, respectively. As mentioned above, this update does *_not_* affect SNF VBP Program scoring and incentive payments for the current FY 2025 SNF VBP Program, nor did it affect scoring and incentive payments in prior FYs. SNFs do not need to do anything at this time, and this process will not require any future action from providers.

*FY 2026 Program Year Nursing Staff Turnover Performance Standards*

* *



*Original Performance Standards Published in FY 2024 Final Rule*



*Updated Performance Standards*



*Benchmark*



0.72343



0.75149



*Achievement Threshold*



0.35912



0.38365



 

*FY 2027 Program Year Nursing Staff Turnover Performance Standards*

* *



*Original Performance Standards Published in FY 2025 Final Rule*



*Updated Performance Standards*



*Benchmark*



0.72959



0.75655



*Achievement Threshold*



0.38000



0.40230



 

Please contact the SNF VBP Program Help Desk at SNFVBP@rti.org with any questions.






Center for Clinical Standards and Quality








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