What the Florida QIP is
The Nursing Home Quality Incentive Program is part of Florida's Medicaid prospective payment system, set by s. 409.908(2)(b), Florida Statutes and Rule 59G-6.010. The Agency for Health Care Administration (AHCA) runs it and, since 2025, publishes every building's points and dollars each October.
Like the other state programs, it scores the quality measures CMS publishes on Care Compare, not your own MDS extract.
How the 49 points are built
Nine MDS measures, 3 points each
Antipsychotic use, antianxiety or hypnotic use, UTI, pressure ulcers, falls with major injury, increased need for help with daily activities, new or worsened bowel or bladder incontinence, physical restraints, and the long-stay flu vaccine.
Six other measures, 22 points
| Measure | Points |
|---|---|
| CMS overall Five-Star rating | 3 stars = 1, 4 = 3, 5 = 5 |
| Recognized accreditation or award | 5 |
| Direct-care staffing | 1 to 3 |
| Activities and social work staffing | 1 to 3 |
| Long-stay hospitalizations | up to 3 |
| RN turnover | up to 3 |
Scored against other Florida buildings
The ranked measures score by percentile among Florida buildings: the 90th percentile or better earns 3, the 75th earns 2, the 50th earns 1, and everything below earns nothing. So about half the state scores zero on each ranked measure, by construction, and you only gain a point by passing another building.
There is one way to score below the 50th percentile: a measure that improved by 20% or more over the year before earns half a point.
The floor
Below the floor, the quality per diem is not reduced; it is zero. From the October 2025 rate year the floor is tied to a third of available points. It was 16.5 for October 2025 rates, and AHCA's October 2026 rate file puts it at 16.5 again; it was 16.0 in 2024. Go by the number AHCA prints rather than working it out, because a third of 49 matches none of them.
Buildings cross the line both ways. Every year roughly 8 to 11% of paid buildings fall below it, and from 2023 to 2025 only about 69% of buildings were paid all three years.
What it pays
Every building gets the same value per point, times its points, on every Medicaid day. For rates starting October 2025 that value was $1.732, from a pool of about $560.6 million. For October 2026 it works out to about $1.45 per point per Medicaid day from AHCA's rate file; the pool itself isn't published yet.
At the floor, a single point can decide the whole payment: 16.5 points at $1.45 is about $24 per Medicaid day. For a building with 30,000 Medicaid days a year, each point above the floor is worth about $44,000.
See your building’s Florida points, floor margin and yearly dollars.
When your work shows up
Florida collects a calendar year of data and pays on it in the rate year that starts the following October. Calendar 2025 pays from October 2026 through September 2027. Calendar 2026, the year you're in now, pays from October 2027.
AHCA reads CMS's four-quarter rates as of the spring, and publishes each building's result every October.
What moves the score
- Watch the floor first. If you're within a few points of 16.5, manage it measure by measure.
- The headroom is in the MDS measures. In 2025, Florida buildings captured only about 28 to 45% of available points on incontinence, ADL decline, falls and pressure ulcers.
- Use the improvement half-point. A 20% year-over-year improvement scores even when it doesn't reach a band.
- Code what's documented. A documented prognosis of under six months removes a resident from ADL decline and antianxiety use. A refused or ineligible flu vaccine belongs in O0250.
- Don't forget the non-MDS points. Your overall star (up to 5 points) and accreditation (5) are strategic decisions, not coding ones.
How SuperQM helps Florida buildings
SuperQM scores each Florida measure from your own charting and shows where your building would land against the state, how far you are from the floor, and which residents are moving which measure. The people who can fix a measure hear about it while it can still change the year's rate. See how SuperQM works.
