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Member Handbook (EOC)

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Skilled Nursing Facility Quality Payments

Resources for Providers

Skilled Nursing Facility Quality Payments

The Skilled Nursing Facility Workforce and Quality Incentive Program (SNF WQIP) rewards skilled nursing facilities for good care and staffing.

The California Department of Health Care Services (DHCS) decides the payment rate for each facility. Community Health Group (CHG) uses that rate and the number of approved bed days to calculate payments.

Bed days and payment totals

Download CHG’s SNF WQIP bed day and payment report:

Download the SNF WQIP Bed Day and Payment Totals spreadsheet

The report lists:

  1. Facility name
  2. National Provider Identifier (NPI)
  3. HCAI identification number
  4. Approved bed days
  5. WQIP payment totals
  6. Program year

Last updated: September 1, 2026

The totals may change. Changes may happen because of new claims, corrected claims, payment updates, or state rules.

How payments are processed

DHCS gives CHG a payment rate for each facility. CHG uses the rate and the facility’s approved bed days to calculate the payment.

CHG may subtract earlier payments from the final payment. Payments may also change because of state findings called Class A or Class AA citations.

CHG pays facilities by the later of these two dates:

  1. 45 calendar days after CHG gets payment information from DHCS
  2. 30 calendar days after CHG gets a complete and correct claim

The payment notice will show the SNF WQIP program year.

 

How to determine responsible payer

CHG is responsible for the payment when:

  1. The facility had a contract with CHG on the date of service.
  2. The member was enrolled with CHG.
  3. Medi-Cal was the main payer.
  4. Medicare did not pay for any part of the bed day.
  5. The bed day meets DHCS rules.

Some bed days do not qualify. These may include hospice days, special treatment program days, fee-for-service days, and days when Medi-Cal was not the main payer.

If another health plan was responsible for the member’s care, please contact that health plan.

Questions about the report

Contact CHG Provider Services at (619) 240-8933  if you think the report has an error.

Or contact our LTSS Liaison: Yousaf Farook / Chief Operating Officer / Phone: (619) 498-6540 / Email: YFaroo@chgsd.com

How to file a provider grievance

A provider grievance is a formal complaint. You may file one if you have concerns about:

  1. The number of approved bed days
  2. A missing or late payment
  3. The amount of a payment
  4. An issue that has not been fixed

To file a grievance, contact CHG Provider Services at (619) 240-8933. 

Learn more