MedicaidReimbursementMedium impact
2020 Nursing Facility Pay-for-Performace Scores
Maryland Medicaid·MD · Geriatrics·Provider Transmittal
Effective date
Jan 21, 2021
We identified it
Jun 20, 2026
Summary
Maryland Medical Assistance Program announces 2020 pay-for-performance (P4P) scores for nursing facilities, distributing approximately $13.2 million in quality incentive payments ($4.30–$8.61 per Medicaid patient day) to top-performing facilities and pay-for-improvement payments ($1.34–$2.69 per Medicaid patient day) to facilities showing score improvement. Nursing facilities have 30 days from January 21, 2021 to review results; scores are based on family satisfaction surveys (35%), staffing levels and stability (30%), MDS quality indicators (30%), and staff immunizations (5%).
Action Required
By February 20, 2021 (30 days from transmittal date): Nursing facility billing and administrative staff must review the enclosed P4P results enclosure to verify facility eligibility status, individual quality measure scores, total ranking, and projected award amount. Verify calculation accuracy and contact Lisa M. Jones at 410-767-5235 or lisam.jones@maryland.gov if calculation errors requiring significant modifications are identified. If errors are found, an additional 30-day review period will be provided. Eligible providers should reconcile projected P4P/pay-for-improvement payments with expected Medicaid revenue in billing systems. Note: supplemental data cannot be submitted to modify results; all scores are based on previously submitted and accepted departmental data.