Free-standing skilled nursing facilities and skilled nursing facilities that are part of another type of hospital receive their PEPPER via PEPPER Resources Portal at https://securefile.tmf.org. View a map of SNF PEPPER retrievals by state.

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Current PEPPER User’s Guide

• Skilled Nursing Facility PEPPER User’s Guide (PDF, 11th Edition)

PEPPER Training Sessions

• April 2023 SNF PEPPER Review: This webinar will include the history/background of PEPPER, a high-level review of the target areas, a walk-through of a sample PEPPER, and guidance for accessing the PEPPER. Download the PowerPoint slides (PDF), transcript (PDF), or Q&As for this PEPPER update.
• Access a complete series of PEPPER training sessions, available as “chapters” for ease of access. A review of a sample SNF PEPPER is also available.
• New PEPPER Format: This session reviews changes to the PEPPER for greater accessibility, cleaner presentation and improved readability. Download the PowerPoint slides (PDF) or the transcript (PDF) for this PEPPER recording.

Data Resources

• National Target Area Analysis
• SNF Target Percent Boundaries for Free-standing SNFs and Short-term Acute Care Hospital SNFs
• State Target Area Analysis
• Peer Group Bar Charts

Demonstration PEPPER:

• Demonstration PEPPER version Q4FY22 (XLSX)

Jurisdictions:

• View a list of the 12 MAC jurisdictions and the number of providers in each jurisdiction in total and by state for PEPPER Q4FY22 (XLSX).

SNF PEPPER Testimonials

• Learn how a Michigan SNF uses PEPPER to improve care and billing accuracy in this article (PDF) and video.
• Learn how a Mississippi contract therapy company (PDF) uses PEPPER to help SNFs assess RUG assignment and patient care.

Other Resources:

• Refer to this document for guidance on how to create a listing of patients included in the PEPPER target areas (PDF).
• Access the (SNF) Medicare Claims Processing Manual (PDF)
• View this slide presentation (PPT, updated 7-11-2013) on percents and percentiles to help understand the differences between “percent” and “percentile” and how they are used in PEPPER.
• View a demonstration (DOC, updated 12-10-2014) Compare Targets report, with associated hospital target area data and graph.
• Audit tools shared with permission of Evergreen Rehabilitation Compliance Dept, Contact: Shawn Halcsik, VP of Compliance.
  • COT Audit tool (PDF or Excel) − Audits completion accuracy of required COTs by comparing Therapy Documentation for RUG Supported and Claim Form for RUG billed
  • Section O Audit tool (PDF or Excel) − Audits MDS section O accuracy by comparing minutes/modes supported in therapy documentation and minutes/modes reported on MDS
  • Triple Check (PDF or Excel) − The triple check form is used at monthly IDT meeting to match the clinical aspects with the billing items to ensure Medicare compliance with billing and coding requirements as well as ensure technical components on claim form are accurate