Incentive Payments for Nursing Facilities

HPSM offers bonus payments for quality performance to in-network nursing facilities providing skilled and/or long-term care services to our Medi-Cal and CareAdvantage members. In-network facilities are automatically opted-in to the following upside-only bonuses:

• The Nursing Facility Quality Payment Program (NFQPP) offers bonus payments based on performance in quality metrics designed to improve HPSM member bed access, reduce inpatient and emergency department utilization, and improve care transitions.
• The Community Discharge and Retention Incentive for Long-Term Care offers long-term care facilities bonus payments for successfully discharging HPSM members with extended institutional stays to a community setting where they remain continuously for six months or more.

Resources

• 2023 Nursing Facility Quality Payment Program Guidelines – These program guidelines contain comprehensive information on structure and quality performance metrics.
• 2023 LTC Community Discharge & Retention Incentive Overview – This incentive overview provides information on the eligibility requirements for a credited discharge and community retention.