The Fiscal Year 2027 Skilled Nursing Facility Prospective Payment System Proposed Rule, released last week, introduces important signals for providers focused on post-acute performance, particularly within the Skilled Nursing Facility Value-Based Purchasing Program. A significant area of opportunity lies in the Discharge to Community Post-Acute Care Measure for Skilled Nursing Facilities (DTC PAC SNF), which, following recent threshold increases, is proposed to remain flat for the latest published program year. These stable benchmarks create a unique moment for SNFs to close performance gaps rather than chase another moving target.

DTC PAC SNF Measure
The DTC PAC SNF is one of the newer measures within the SNF Value-Based Purchasing program, beginning in Fiscal Year 2027, which runs from October 1, 2026, through September 30, 2027. This measure applies only to Medicare fee-for-service residents who meet all of the following criteria:

  1. They are discharged to home or self-care, with or without home health services, after a SNF stay
  2. They do not experience an unplanned readmission to an acute care hospital or long-term care hospital within 31 days of discharge
  3. They remain alive for at least 31 days following discharge

As with other measures, the rate is risk-standardized, meaning CMS adjusts results based on patient characteristics to ensure fair comparisons across facilities.

DTC PAC SNF Performance Standards
As with other measures, CMS establishes performance standards for DTC PAC SNF using two key metrics: the achievement threshold and the benchmark. These determine how many points a facility earns toward its SNF VBP score.

The achievement threshold represents the minimum level of performance a facility must reach to begin earning points. This is typically set near the national average for successful discharges to the community.

The benchmark represents a high-performance target. Facilities that exceed this level of successful discharges to home earn the maximum possible points for the measure.

Latest Performance Standards Update
In the most recent proposed rule, CMS estimates that the performance standards for the Fiscal Year 2030 program year for DTC PAC SNF will remain unchanged from those in the Fiscal Year 2029 final rule.

This marks a shift from the prior update between Fiscal Years 2028 and 2029, which included a 2.03 percent increase in the achievement threshold and a 1.10 percent increase in the benchmark.

CMS does not provide a specific explanation for why these values remain flat. However, this may indicate that industry-wide performance has not improved enough to justify raising expectations at this time. It is also important to note that these are still proposed values and could change in the final Fiscal Year 2027 SNF PPS rule.

Opportunity Window to Improve Success Discharges to the Community
If the achievement threshold and benchmark remain unchanged, this creates a valuable opportunity for facilities to make meaningful progress. Improved discharge planning and follow-up may translate more directly into better performance and outcomes. Now is an ideal time to evaluate your approach and identify areas for improvement. Contact Nexus Health Resources to learn how targeted strategies can help strengthen discharges to the community.