The Centers for Medicare & Medicaid Services (CMS) has issued a revision to its June 2025 memo outlining upcoming changes to the Nursing Home Care Compare website. The only update in the revised memo, dated September 10, 2025, is a change to the implementation date for the updated long-stay antipsychotic medication measure.
Originally scheduled for October 29, 2025, the revised measure will now be incorporated into the Five-Star Quality Rating System beginning January 28, 2026. This update reflects a more complete methodology that includes Medicare and Medicaid claims data, as well as Medicare Advantage encounter data—intended to improve accuracy by capturing prescribing activity outside the Minimum Data Set (MDS) reporting window.
All other changes announced in the June memo remain unchanged. These include:
- Health inspection rating updates that remove the oldest survey cycle from calculations;
- Public reporting of chain-level data in a consumer-friendly format;
- Removal of COVID-19 vaccination measures from nursing home profile pages.
You can view the updated CMS memo here.
Compliance Perspective
Issue
On June 18, 2025, CMS announced several changes to the Nursing Home Care Compare website and the Five-Star Quality Rating System, with most changes taking effect on July 30, 2025. These changes included removal of the third-cycle standard survey from the health inspection rating calculation, public posting of aggregated performance data for nursing home chains, and removal of resident and staff COVID-19 vaccination measures from profile pages. Additionally, CMS announced an update to the long-stay antipsychotic quality measure that will incorporate Medicare and Medicaid claims and encounter data. As of a September 10, 2025, memo revision, this measure will now be implemented on January 28, 2026—delayed from the originally announced date of October 29, 2025. These changes may affect how nursing homes are rated and have implications for survey readiness, documentation practices, staff training, and quality improvement initiatives.
Discussion Points
- Review and update policies related to survey readiness, diagnosis coding, antipsychotic medication use, and quality measure documentation. Ensure protocols reflect the revised implementation date for the updated antipsychotic measure (January 28, 2026), the increased emphasis on recent survey results, and the integration of claims data into quality calculations. Facilities may also benefit from working with an external consultant to assess current practices and identify needed policy updates, especially in high-risk focus areas.
- Provide education to staff involved in MDS coding, diagnosis documentation, medication management, and survey preparation. Ensure staff understand how survey findings and diagnosis reporting affect quality measures and Five-Star ratings. Train staff on any changes to your facility’s policies related to diagnosis coding, medication use, and survey readiness. Med-Net Academy offers the course Understanding the 5-Star Rating Program, which covers the methodology behind the rating system, including the three performance domains, calculation of staffing measures, the impact of surveys (including focused infection control and complaints), and factors that can influence a facility’s rating.
- Conduct audits to ensure accurate reporting of diagnoses and antipsychotic medication use, and to verify that MDS coding is consistent with clinical documentation and claims data. Audit survey outcomes and related corrective actions to confirm that issues identified during inspections have been addressed. Review QAPI initiatives to ensure that quality of care and accuracy in documentation remain key focus areas. Engaging an external resource to assist with focused audits or mock surveys can help identify areas for improvement.
*This news alert has been prepared by Med-Net Concepts, Inc. for informational purposes only and is not intended to provide legal advice.*