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.

To download or save to your computer any of the files on this page, right click on the file name (link) and select "Save Target As...". To receive updates on training and other resources, please join our email list.

Current PEPPER User’s Guide


  • View a list of the 12 MAC jurisdictions and the number of providers in each jurisdiction in total and by state for PEPPER Q4FY15 (XLS, updated 3/17/2016).


  • PEPPER Update (Duration: 48:22): This session reviews changes in the Q4FY15 release of the PEPPER for SNFs, LTs and IRFs (NOTE: there are no changes in this release of the IRF PEPPER). It includes a brief walk-through of a sample SNF PEPPER.
  • Download the PowerPoint slides (PDF) for this PEPPER update.
  • Review Questions and Answers (PDF) from the session.

PEPPER Training Update for LT, IRF, HOSPICE, SNF and HHA; April 2015:

PEPPER Training Update, May 2014:

PEPPER Training, August, 2013:

Demonstration PEPPER:

  • Demonstration PEPPER version Q4FY15 (XLS, updated 3/17/2016)

Other Resources:

  • Refer to this document for guidance on how to create a listing of patients included in the PEPPER target areas (PDF).
  • View a list of the Skilled Nursing Facility target areas (DOCX, updated 3-9-16).
  • 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
  • Contact TMF through the Help/Contact Us page to request examples of Triple Check tools from Skilled Healthcare.