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

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2025 Program Policies and Letters

​​​Letter number and Title
Program Year (PY) Impacted​Details and Direction​Date of Issue​


​SNF WQIP PL 24-004 SNF WQIP MDS Measures for PY3 (2025)

​PY3 (2025)
​​WQIP PL 24-004 SNF WQIP MDS Measures for PY3 (2025) outlines the MDS clinical measures for the SNF WQIP for PY 3 (2025). The MDS clinical measures that are being used in PY 3 are listed in the table below. Please note, DHCS will provide PY 3 benchmarks in December 2024 for the MDS measures listed. DHCS is providing these measures now as the measurement period, as in all prior PYs, is six months offset in advance of the calendar year. For PY 3, the MDS measurement period is July 1, 2024 to June 30, 2025.
​8/23/2024
SNF WQIP PL 24-008 SNF WQIP Disproportionate Share Metric PY3 (2025​)


​PY3 (2025)
​This policy letter (PL) provides an update to the data source for the Medi-Cal Disproportionate Share metric for the skilled nursing facility (SNF) Workforce and Quality Incentive Program (WQIP). Beginning in PY 3 (2025), this metric will utilize the Minimum Data Set (MDS) assessment data to determine the number of Medi-Cal days and the daily number of patients in place of the Medi-Cal Bed Day (MCBD) data and the Payroll Based Journal (PBJ) data, respectively.
​11/13/2024
SNF WQIP PL 24-010 Floor for Improvement Points in PY3 2025 ​
​PY3 (2025)
​DHCS will implement an achievement floor for facilities to be eligible to earn improvement points for MDS measures to minimize the chance that a facility receives an incentive under the Skilled Nursing Facility (SNF) Workforce and Quality Incentive Program (WQIP) and a sanction under the Accountability Sanctions Program (ASP) on the same Minimum Data Set (MDS) measure.​
​1/30/2025
SNF WQIP PL 24-011 Increases the Amount of Funding Tied to Workforce Metrics Domain for PY 3 (CY 2025) ​

​PY3 (2025)
DHCS will increase the funding allocated to the workforce metrics to 55 percent for PY 2025. The additional 5 percentage points are derived from the removal of the MDS Racial and Ethnic Data Completeness Measurement Area and a 2 percentage point reduction in the allocation tied to the Clinical Metrics Domain.
​1/30/2025

2024 Program Policies and Letters

​​Letter Number and Title​

Program Year (PY) Impacted​Details and Direction​Date of Issue​
​SNF WQIP PY2 (2024) Updates Letter
​PY2 (2024)
​The SNF WQIP PY2 (2024) Updates Letter provides a list of changes to SNF WQIP PY2 (2024). ​1/31/2024
SNF WQIP PL 24-006 Weight Loss Measure for PY2 (2024)​
​PY2 (2024)
​This policy letter (PL) outlines the updated and shortened measurement period for Percent of Residents Who Lose Too Much Weight, Long Stay measure. Performance during the shorter measurement period will continue to have the same weight in the overall WQIP score.   ​
​9/23/2024
​SNF WQIP PL 25-001 Second SNF WQIP Weight Loss Measure for PY2 (2024)​ 
SUPERSEDES PL 24-006
​PY2 (2024)
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.
​1/30/2025
SNF WQIP PL 25-002 MCP Webinar Timing Guidance and Payment Timeline​


​PY2 (2024)
​This policy letter (PL) provides guidance on the scheduling of Managed Care Plan (MCP) webinars and payment timeline for the Skilled Nursing Facility (SNF) Workforce and Quality Incentive Program (WQIP). Pursuant to All Plan Letter (APL) 25-002, each MCP must hold a webinar twice per program year for all SNF WQIP-eligible Network Providers subject to additional guidance from DHCS regarding the required timing, content, and duration of webinars. This PL provides additional direction and guidelines on this requirement.
​3/28/2025
PL 25-004 SNF WQIP Staffing Turnover Metric Updated Methodology​
​PY2 (2024)
​This Policy Letter (PL) outlines the plan to update the Staffing Turnover metric methodology in the Skilled Nursing Facility (SNF) Workforce and Quality Incentive Program (WQIP) for program year (PY) 2 (calendar year [CY] 2024). 
 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.

​4/14/2025

PL 25-005 SNF WQIP CY 2024 SNF WQIP Interim Payment Report Staffing Turnover
​PY 2 (2024)
​This Policy Letter (PL) outlines the potential updated methodology for the forthcoming Skilled Nursing Facility (SNF) Workforce and Quality Incentive Program (WQIP) Interim Payment for Program Year 2 (PY2, 2024). DHCS and HSAG assessed the potential impact of using limited data for MDS Data Completeness using PY1 (2023) rates. HSAG limited the look forward period for the PY1 (2023) MDS data to assessments submitted through August 31, 2023 (rather than November 30, 2023, for the full look forward quarter) to mirror the MDS data we currently have available for PY2 (2024). After limiting the data for PY1 (2023), most facilities were not impacted, and no facilities were negatively impacted. 

DHCS will utilize MDS data currently available for CY2024 (i.e., assessments submitted with submission dates through August 31, 2024) to ensure that the SNF WQIP Interim Payment can move forward, despite the lack of MDS data availability. Please note, the limited data for MDS Data Completeness (i.e. assessments submitted with submission dates through August 31, 2024) will be used in the PY2 Final Report as well to avoid overpayment. DHCS anticipates disseminating and publishing the PY 2 (CY2024) SNF WQIP Interim Payment Report by the end of May 2025. ​

​5/13/2025
PL 25-006 SNF WQIP CY 2024 SNF WQIP Interim Payment Report Staffing Turnover​
PY 2 (2024)
​This Policy Letter (PL) provides clarification for the Workforce Metrics Domain in the Skilled Nursing Facility (SNF) Workforce and Quality Incentive Program (WQIP) Interim Payment for Calendar Year (CY) 2024 (Program Year 2 [PY2]).  While the Care Compare data were refreshed, they were not available in time to allow DHCS and HSAG to include the Staffing Turnover Metric Measurement Area in the CY2024 (PY2) SNF WQIP Interim Payment Report. The Staffing Turnover Metric Measurement Area will be included in the SNF WQIP CY 2024 (PY2) Final Payment Report.
​6/12/2025 

​2023 Program Policies and Letters

​​Letter Nu​mber and Title​
Program Year (PY) Impacted​
Details and Direction​Date of Issue​
SNF WQIP PL 24-001 SNF WQIP Provisional Guidance on SNF WQIP Payment Process
​PY1 (20203)
​​This Policy Letter (PL) outlines provisional guidance for the Skilled Nursing Facility (SNF) Workforce & Quality Incentive Program (WQIP) to assist SNFs and Managed Care Plans (MCPs) with planning the reconciliation and payment processes for the Calendar Year (CY) 2023 final payments. This guidance will be incorporated into a forthcoming All Plan Letter (APL) directed to MCPs.
​7/1/2024
​SNF WQIP PL 24-002 MDS Data Completeness Updated Methodology and Clarification
​PY1 (2023)
WQIP PL 24-002 MDS Data Completeness Updated Methodology and Clarification” outlines updated Minimum Data Set (MDS) Data Completeness methodology and technical clarification for the SNF WQIP. DHCS updated the MDS Data Completeness Metric methodology using 150-day exclusion approach. This change is effective retroactively for PY 1 of SNF WQIP and is based on stakeholder feedback. The Technical Program Guide for PY 2 (2024) will include similar methodology. Please review the attached PL for additional information and background. 
​8/23/2024
​SNF WQIP PL 24-003 Claims-Based Clinical Metrics Update​

​PY1 (2023)
​​Due to the lack of data or biased rates from multiple managed care plans (MCPs), 
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.

​9/5/2024
SNF WQIP PL 24-005 PY 1 (2023) Technical Program Guide Update

​PY1 (2023)
​This Policy Letter (PL) outlines correction to the PY 1 (2023) Technical Program Guide for the Skilled Nursing Facility (SNF) Workforce & Quality Incentive Program (WQIP). 
​9/5/2024
​SNF WQIP PL 24-009 Second Claims Based Clinical Metrics Update​
SUPERSEDES PL 24-003
PY1 (2023)
​Following communication on the data issue and that Health Services Advisory Group, Inc. (HSAG) was to calculate facility-specific performance on these measures (reference WQIP-PL 24-003 Claims-Based Clinical Metrics Update), DHCS and HSAG were still unable to calculate facility-specific rates for SNF WQIP for PY 1 (2023) due to further data issues and timeline constraints. DHCS and HSAG will reallocate the percent of the total score for the Claims-Based Clinical Metrics Measurement Area to the Minimum Data Set (MDS) Clinical Metric Measurement Area or the Workforce Metrics Domain. This change is not expected to further delay the CY 2023 WQIP final payments to SNFs. This PL SNF WQIP PL 24-009 Claims-Based Clinical Metrics Update Version 2.0 supersedes WQIP-PL 24-003 Claims-Based Clinical Metrics Update​, which is published to the SNF WQIP webpage.​
​12/18/2024

Last modified date: 6/20/2025 2:57 PM