Training & Resources for Skilled Nursing Facilities

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 View a map of SNF PEPPER retrievals by state.

Skilled Nursing Facilities/swingbeds that are part of a short-term acute care hospital receive their PEPPER via QualityNet Portal at

View information on how to download your PEPPER via QualityNet Portal.

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Current PEPPER User’s Guide

PEPPER Training Sessions

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)


  • 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

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