Figure 2. Distribution of Achievement and Improvement Scores in 2019 by Penalty Status.

Distribution of improvement scores (measured in 2017) by quartile of achievement scores (measured in 2015). Achiever refers to a skilled nursing facility (SNF) that had a higher achievement score than improvement score, and improver refers to an SNF that had a higher improvement score than achievement score. Penalty status was dichotomized such that SNFs were categorized regardless of the severity of the penalty or incentive. Table 1 lists the number of SNFs in the figure in each category by achievement score quartile.