Supplemental Quality Incentive Payments

In SFY 2022, the Georgia Legislators with support from Governor Brian Kemp appropriated $115 million dollars for a nursing home supplemental quality incentive payment.

The Centers for Medicare and Medicaid Services (CMS) accepted Georgia State Plan Amendment (SPA) GA 21-0009. The SPA allows DCH to pay a supplemental quality incentive payment to skilled nursing facilities that meet one of the following four quality metrics set by DCH. 

Quality Metrics:

• 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.

SFY 2026

The Department issued a Public Notice on November 14, 2024 notifying providers that the quality measures used in for the quality incentive payment would change. During calendar year 2025, nursing facilities must demonstrate improvement in at least one or more of the following four categories (as compared to calendar year 2024) in order to be eligible to receive a supplemental payment in SFY 2026.

• Percent of long-stay residents who lose too much weight
• Percent of long-stay residents with a urinary tract infection
• Percent of long-stay residents who received antipsychotic medication
• Percent of long-stay residents experiencing one or more falls with major injury

The supplemental payment will be based on each nursing facility’s overall ranking in each CMS Long Stay Quality Measure resulting in the nursing facility receiving a payment proportional to their improvement (e.g., a facility with the highest improvement will receive the highest supplemental payment for that measure).

This policy change is currently being reviewed by CMS.

Revised CMS Long Stay Quality Measures Utilized to Determine the Supplemental Quality Incentive Payments Made to Eligible Nursing Facilities Public Notice - Posted 09/02/25

SFY 2025

The Department issued two separate public notices regarding the quality incentive payments. The first public notice issued on September 12, 2024 identified the change in methodology to determine the amount of the quality incentive payments. The September 12, 2024 notice also informed skilled nursing facilities of the Department’s intent to revise to quality measures for 2024 and 2025.  The second public notice, dated November 14, 2024 identified the specific quality measures to be utilized in 2024 and 2025.  In October 2023, CMS discontinued use of the “high-risk long stay residents with pressure ulcers” measure. Consequently, DCH will discontinue its validation of the “high-risk long stay residents with pressure ulcers” measure for the calendar year 2023 to 2024 comparison. Only those facilities that demonstrate improvement will be eligible for the add-on payment. Only those facilities with 50% or more Medicaid Long-term residents are eligible.

The supplemental payment issued during SFY 2025 will be based on the percentage of improvement ranked by decile for each of the three categories listed below for calendar year 2024:

• Percent of long-stay residents who received antianxiety or hypnotic medication
• Percent of long-stay residents who received antipsychotic medication
• Percent of long-stay residents with a urinary tract infection

This policy change is currently being reviewed by CMS.

Revised CMS Long Stay Quality Measures Utilized to Determine the Supplemental Quality Incentive Payments Made to Eligible Nursing Facilities Public Notice - Posted 09/02/25

Increase Supplemental Quality Incentive Payments to Eligible Nursing Facilities Public Notice - Posted 09/03/25

SFY 2024 Payment

Supplemental Quality Incentive Payments were made from June 27, 2024 through August 7, 2025.

For additional information regarding the long-stay resident quality metrics, see the Frequently Asked Questions . - Posted 07/09/24

Quality Incentive Payment - Posted 09/02/25

SFY 2023 Payment

Supplemental Quality Incentive Payment made on the June 22, 2023 via MMIS remittance.

• Quality Incentive Payment - Updated 06/23/23

SFY 2022 Payment

Supplemental Quality Incentive Payment made on the June 2, 2022 via MMIS remittance.

• Quality Incentive Payment - Posted 06/08/22

The Department revised the nursing home Quality Incentive Supplemental Payment file to include nursing homes not previously included in the original file.  The CMS decile per nursing did not change, however the reallocation of state appropriated funds resulted in increases and/or decreases in the amount of supplemental payments for some nursing homes.

• Recalculated Quality Incentive Payment - Posted 11/28/22