HHS announced the details of its $2 billion performance-based incentive payment distribution to nursing homes, a component of its previously announced $5 billion Provider Relief Fund allocation for nursing homes.

In order to qualify for payments under the incentive program, a facility must have an active state certification as a nursing home or skilled nursing facility (SNF) and receive reimbursement from CMS. HHS will administer quality checks on nursing home certification status through the Provider Enrollment, Chain and Ownership System (PECOS)and facilities must also report to at least one of the following data sources that will be used to establish eligibility and collect necessary provider data to inform payment: Certification and Survey Provider Enhanced Reports (CASPER), Nursing Home Compare (NHC), and Provider of Services (POS). The incentive payment program will entail four performance periods (September, October, November, December) with $500 million in distributions for each period.

Using CDC’s Community Profile Reports (CPRs) to determine baselines for COVID-19 infections per capita and COVID-19 test positivity rates, HHS will measure facilities’ performance based on: (1) ability to keep new COVID infection rates low among residents; and (2) ability to keep COVID mortality low among residents. To measure facility COVID-19 infection and mortality rates, the incentive program will utilize data from the National Healthcare Safety Network (NHSN) Long-Term Care Facility (LTCF) COVID-19 module. CMS issued guidance in early May requiring that certified nursing facilities submit data to the NHSN COVID-19 Module (see Column J).(On August 27, HHS announced it had distributed the first $2.5 billion in payments to nursing homes to help with upfront COVID-19-related expenses for testing, staffing, and personal protective equipment (PPE) needs.)