CMS recently posted the updated Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users’ Guide. The updates note that effective with the January 2026 refresh, CMS will replace the existing long-stay antipsychotic medication quality measure with a respecified measure that incorporates Medicare and Medicaid claims data and Medicare Advantage encounter data to supplement MDS data.
The scoring cut points for this respecified measure will be set to place providers into ten equal deciles based on the distribution of providers’ performance and are based on data from Quarter 3, 2024 through Quarter 2, 2025.
Please refer to CMS Memorandum QSO-25-20-NH REVISED for more information about these changes. Note, all changes are identified in red, italicized text.
Questions about the Five-Star Quality Rating System may be directed to IHCA’s Brenda Irlbeck, VP, Regulatory Affairs.