​​​​​​WQIP Program Policies and Letters - 2023 to Current

To prevent penalizing facilities due to a shorter measurement period, DHCS will adjust how points are awarded for the LTMW measure. Facilities will receive the higher score of the following two options: one based on the shortened LTMW measurement period (April 1, 2024 – June 30, 2024) and the other based on the full PY2 measurement period (July 1, 2023 – June 30, 2024).

For example, if a facility’s original score for the LTMW measure for the full PY2 measurement period was 6 points, but their score for the shortened LTMW measurement period was 2 points, they would receive the higher of the two scores, which would be 6 points.

 In the July 2024 Care Compare data refresh, the Center for Medicare and Medicaid Services (CMS) changed the Staffing Turnover methodology to define individuals who no longer work at a facility as those with a period of at least 90 consecutive days during which they did not work at all. This is an update from the previous methodology, which used a gap period of 60 days.

To mitigate the potential negative impact on facilities caused by the CMS’s updated methodology, DHCS will adopt a flexible approach of awarding facilities with the better of the two scores that they would earn using the prospective benchmarks and retrospective benchmarks. This approach will allow facilities to earn the highest possible points based on the final PY 2 rates and it will avoid penalizing facilities due to CMS’ methodology change.

the Department of Healthcare Services (DHCS) and its contractor, Health Services Advisory Group (HSAG) will calculate facility-specific rates for the claims-based clinical metrics for SNF WQIP for PY 1 (2023). This change is expected to delay the CY2023 WQIP final payments to SNFs.