The New Scorecard for CareInside TennCare's QuILTSS #18 Scoring Changes

9/22/2025 - By Cade Crawford

TennCare’s latest memo outlines important updates for Medicaid providers under the QuILTSS #18 initiative. QuILTSS serves as a value-based purchasing program designed to reward quality care in the nursing facility space. Your facility’s QuILTSS score from each measurement period plays a major factor in the calculation of your Medicaid reimbursement rate.

The QuILTSS #18 measurement period runs from January 1 to December 31, 2025, with a deadline to submit your data to TennCare by January 31, 2026. This data will shape your facility’s reimbursement rates for the 2026 fiscal year, running from July 1, 2026 to June 30, 2027.

What’s Changing?

QuILTSS #18 is revamping the scoring methodology for Resident and Family Satisfaction. Instead of comparing your scores to the statewide average, your facility will now be evaluated against a national Satisfaction Rate Average in these two survey areas. This benchmark-driven approach aims to better reflect true performance and align Tennessee’s standards with national best practices.

All other metrics and scoring methodologies will be in alignment with QuILTSS #17 and prior.

Support & Training

To help providers navigate these changes, QBlue Surveys Inc. will host a webinar on Tuesday, September 30, followed by a training session in October co-led by TennCare and Myers and Stauffer. Please be on the lookout for upcoming invitations as these sessions will cover submission requirements, scoring updates, and how performance data affects your Medicaid reimbursement.

If you have questions about these new scoring methodologies or any other questions concerning compliance, reimbursement, or operations for your skilled nursing facility, Saltmarsh’s team of experienced healthcare consultants can help. You can find all of the services our Healthcare Consulting team can provide to your facility on our website.

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