Supplemental Quality Incentive Payments

Georgia will provide a supplemental quality incentive payment to skilled nursing facilities that demonstrate improvement in certain quality metrics that measure the quality of care rendered to its Medicaid beneficiaries.

No. Only Georgia certified Medicaid Nursing Facilities are included in this report.

No. Only Nursing Facilities which demonstrated improvement in one or more of the specific quality metrics will receive the incentive payment.

The MDS Quality Measures, reported by the Nursing Facilities and released by CMS, was the source data used to evaluate nursing facilities’ performance.

The Nursing Facility’s MDS Quality Measure used to evaluate nursing facilities’ performance can be found on CMS.gov.

Each Nursing Facility’s performance was evaluated using the following four (4) long-stay resident quality measures:

• Percentage of high risk long-stay residents with pressure ulcers
• Percentage of long-stay residents who received an antianxiety or hypnotic medication
• Percentage of long-stay residents who received an antipsychotic medication
• Percentage of long-stay residents with a urinary tract infection.

The 4-quarter average score comparing one calendar year of data to the previous calendar year of data (e.g., 2020Q1 – 2020Q4 and 2021Q1 – 2021Q4). For each subsequent year after calendar year 2020, the base year will be adjusted annually to reflect improvement against the prior year. For example, CY2021 would be paid out for improvement for CY2020, CY2022 would be paid out for CY2021, and CY2023 against improvement in CY2022. Only those facilities which demonstrate improvement will be eligible for the add-on payment.

Each Nursing Facility’s 4-quarter average scores are compared for improvement. If the percentage for each measure decreases, which indicates improvement, the Nursing Facility is marked as an improved facility.

Supplemental payments will be distributed to eligible nursing facilities twice per year. However, in year one (SFY2022), eligible nursing facilities will only receive one payment.

For a specific quality measure, the improved facilities are ranked based upon the largest increase of improvement. Deciles are assigned based on the Nursing Facility’s ranking. Each Nursing Facility within the same decile will receive the same payment based on a weighted distribution of available funds.