On October 1, 2026, the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program expanded from a four-measure framework to eight. For the first time, incentive payments will also reflect performance on long-stay hospitalizations, falls with major injury, discharge function, and discharge to community, alongside existing measures for 30-day readmissions, healthcare-associated infections, nursing staff turnover, and total nurse staffing hours.

For clinical teams, this marks a meaningful shift. SNF VBP is no longer focused primarily on short-stay readmissions and staffing structure. Long-stay outcomes, resident safety, and functional recovery are now directly tied to reimbursement, raising the importance of earlier risk identification, proactive intervention, and consistent clinical follow-through. 

Two New Measures That Put Long-Stay Outcomes in Focus 

Two of the new measures deserve particular attention because they are closely tied to the daily nursing workflow. 

Number of Hospitalizations per 1,000 Long-Stay Resident Days. This measure captures how often long-stay residents end up in the hospital, normalized per 1,000 resident days. It reflects a reality that clinical teams already live with: long-stay populations carry meaningful acute risk, and catching a change in condition early is often the difference between managing in place and sending a resident out.

Percent of Residents Experiencing One or More Falls with Major Injury (Long-Stay). Falls with major injury have long been a quality concern. The measure now carries reimbursement weight, and it relies on MDS data, which means the assessment cycle, coding accuracy, and interdisciplinary follow-through all sit inside the scoring loop.

Both measures share a common challenge: the outcomes they track often develop from small changes over time. A new medication. A change in vital signs. A shift in mobility. A decline in intake or function. Any single change may be easy to overlook on its own, but together they can reveal an emerging pattern of risk. Helping clinical teams recognize those patterns earlier is increasingly important as long-stay outcomes become part of VBP performance. 

What clinical teams need at the point of care

The measures are structural. The work is clinical.

For long-stay hospitalizations, teams need visibility into which residents are trending toward a change of condition before that change becomes a transfer. For falls with major injury, teams need to see which residents show new indicators of fall risk, and which fall risks are persistent and require a different intervention than the last one.

The common thread is early, resident-level insight that teams can act on during the normal course of care. 

How Saiva supports this work

Saiva’s Daily Risk Reports surface the clinical factors behind changing risk across both short-stay and long-stay residents, including residents with recent falls or indicators of fall risk. The reports explain the reasoning: what changed, when it changed, and what to look at next. That clinical intelligence is designed to help nursing teams recognize risk earlier and act within their existing workflows, including rounds and stand-up.

By prioritizing the residents who may need attention most, Saiva helps teams focus their review and intervene before a change in condition becomes a hospitalization or other adverse outcome.

As the FY2027 measures take effect, success on long-stay hospitalizations and falls with major injury will depend on how early teams can recognize emerging risk, understand what is driving it, and act within their existing workflow. That is where SAIVA is designed to help.

How to prepare before October 1 

If your organization already receives Saiva Daily Risk Reports, the next few weeks are a good moment to confirm three things:

• The right clinical staff are receiving the reports and reviewing them consistently.
• Changes in condition and fall-risk indicators are reaching the people who can act on them.
• The interdisciplinary team is following through on the care actions and clinical insights surfaced in the reports.

If your team would like to talk through how Saiva can support your facilities as the FY2027 measures take effect, we’d be happy to connect.