What’s new: CMS released QSO-25-20-NH on June 18, 2025. The new memo describes updates coming to Nursing Home Care Compare. CMS will change to how items are displayed on the Care Compare website to:

• post performance data for nursing home chains;
• drop third cycle standard surveys from the Nursing Home Care Compare health inspection rating;
• incorporate updated long-stay antipsychotic measure on Nursing Home Care Compare; and
• remove COVID-19 vaccination measures.

Post performance data for nursing home chains: Beginning July 30, 2025, CMS will publish performance information, including the following: average overall 5-star ratings, health inspection ratings, staffing, and quality measure ratings for each chain. The information will be displayed on Nursing Home Care Compare.

• CMS notes that the introduction of this information on Care Compare is to provide the information in a more consumer-friendly format. This data is currently posted on CMS’s data webpage.

Drop third cycle standard surveys from the Nursing Home Care Compare health inspection rating: Beginning July 2025, CMS will no longer use the three most recent standard surveys and will only use the two most recent standard surveys for the health inspection rating calculation.

• CMS notes that this change is related to the continued standard survey backlogs.
• CMS will continue to use a three-year lookback period for complaint and infection control inspections to calculate the health inspection rating. CMS provided the table below to outline the updates to the Health Inspection Rating calculation methodology.

Updates to Health Inspection Rating Calculation Methodology

Incorporate updated long stay antipsychotic measure on Nursing Home Care Compare:

The Office of the Inspector General released a report in 2021, which reported that the use of the MDS for reporting the number of long-stay residents receiving antipsychotic medication may not accurately reflect the number of residents who are prescribed antipsychotic medications.

• To address this concern, CMS is updating the measure for long-stay antipsychotics by including Medicare and Medicaid claims data and Medicare Advantage encounter data to supplement the MDS data.
• CMS notes these updates will leverage data to improve the measure’s accuracy. For example, CMS will capture antipsychotic prescribing that falls within the nursing home stay, but not within the 7-day MDS look-back window.
• This update will occur on October 29, 2025, when CMS will incorporate the new measure on Nursing Home Care Compare.
• Due to the additional data, CMS projects that the percentage of residents receiving an antipsychotic will increase from the current 14.64 percent to 16.98 percent. In addition, the cut point will change to accommodate the new measure.
• For more information on how CMS calculates star ratings, see the Nursing Home Care Compare Five Star Technical Users’ Guide.

Removing COVID-19 Vaccination Measures: CMS will remove the COVID-19 vaccination section from the main profile page of each nursing home on Care Compare effective July 30, 2025.

Going deeper: AHCA is continuing to review the memo and the impacts of the changes. VHCA-VCAL will share any additional analysis of the impact of  QSO-25-20-NH when it is available. For questions, please contact regulatory@ahca.org.

Also of note: On June 18, 2025, CMS also released QSO-25-19-ALL, related to the release of CMS-2567.

• In this memo, CMS notes that this update aligns with the Nursing Home CMS-2567 process, which, per regulation, is releasable within 14 days of transmission to the facility. Therefore, this update does not change the current process for nursing homes.