Skilled Nursing Facility Workforce Quality Incentive Program
HPSM is participating in the statewide Skilled Nursing Facility (SNF) Workforce Quality Incentive Program (WQIP). This Department of Health Care Services (DHCS) initiative provides bonus payments to eligible SNFs that improve workforce stability and quality of care for Medi-Cal members.
Eligibility: Only SNFs that are Freestanding Level-B Facilities or Adult Freestanding Subacute Level-B Facilities can participate in SNF WQIP. Learn more
How to participate in SNF WQIP
Providers interested in participating in SNF WQIP are required attend two online information sessions HPSM is offering. These sessions will present a comprehensive overview of the program and cover eligibility, payment processes and milestone timelines. Time will be set aside to address participants’ questions. To get an invite, email RAprogram@hpsm.org.
More information about SNF WQIP
Eligibility details
To be eligible for SNF WQIP payments through HPSM, facilities must be SNFs that are either Freestanding Level-B Facilities or Adult Freestanding Subacute Level-B Facilities. To be eligible for SNF WQIP payments through HPSM, eligible SNFs must be contracted with HPSM.
Other types of facilities are excluded from participation in SNF WQIP, including:
- Freestanding pediatric subacute care facilities
- Intermediate care facilities for the developmentally disabled homes
- Distinct part facilities
- SNFs with 100% designated special treatment beds
Class AA and A citations
HPSM will withhold payments from facilities that receive one or more Class AA or A citations issued by the California Department of Public Health (CDPH) occurring during the PY. If a citation is issued after an interim or final payment has been made, HPSM will retroactively recoup and withhold the applicable payments. Facilities with Class AA citations are disqualified from all payments for that PY.
Data sharing
HPSM will provide SNF WQIP-eligible providers with summary-level reporting within 30 calendar days of receiving the data from DHCS. If you find discrepancies in this report, email RAprogram@hpsm.org. Additionally, to ensure that you receive this report, verify your contact information by contacting HPSM’s Finance Department at Finance@hpsm.org or 650-616-8042. Phone hours are Monday through Friday from 9:00 a.m. to 6:00 p.m.
Payment process
DHCS calculates a per diem amount for each facility. This rate is determined based on the SNF’s performance on various quality metrics within the SNF WQIP. For each program year, DHCS aims to calculate quality scores and provide payments exhibits to HPSM.
Payments are typically made in two phases: interim per diem amounts and final per diem amounts. DHCS directs HPSM to pay the interim amount in the first part of the calendar year following the Rating Period, and the final amount in the second part of the calendar year.
HPSM will calculate the number of SNF WQIP qualifying bed days and will pay the directed per diem amount for all clean and complete qualifying bed days within 45 days of receiving payment exhibits from DHCS or within 30 calendar days of receiving a clean claim from the provider, whichever is later.
HPSM will net out any previously directed interim payment amounts from the final payment.
Qualifying bed days
SNF qualifying bed days are calendar days during which a member receives SNF Level-B services inclusive of the first day of a member’s stay and excluding the day of discharge unless it is also the first day of stay. This includes room and board, nursing and related care, commonly used equipment, supplies, and services, leave of absence days and bed holds.