See the Projected Impact of Five-Star Survey Changes
Your Topline on LTC Trend Tracker: AHCA/NCAL recently made available the 2025 third quarter edition of Your Topline for skilled nursing facility members. This report shows your projected two-cycle survey score and state ranking on July 30, 2025.
Most nursing homes (79%) will not see a change in their survey star ratings. Because the state-level fixed distribution of survey ratings remains, most centers will not see a change in their rating.
- For those that do see a change, most often it is only a one-star change.
Why the changes: In QSO-25-20-NH issued on June 18, CMS announced that it will be changing the survey cycles and weights with July’s Care Compare refresh.
- While CMS is dropping the third standard survey, it is keeping three years of complaint and infection control focused surveys. The table below summarizes these changes.
Updates to Health Inspection Rating Calculation Methodology
| Current | Starting July 30 2025 | |||
| Surveys Included | Weight | Surveys Included | Weight | |
| Cycle 1 | Standard – Most recent
Complaint – Past 12 months |
50% | Standard – Most recent
Complaint – Past 12 months |
75% |
| Cycle 2 | Standard – Second most recent
Complaint – 13-24 months ago |
33.3% | Standard – Second most recent
Complaint – 13-36 months ago |
25% |
| Cycle 3 | Standard – Third most recent
Complaint – 25-36 months ago |
16.7% | ||
Projected survey scores and ratings under the new scoring method: CMS is maintaining a state‐level fixed distribution of survey ratings.
- Using the survey data for every center on Care Compare as of June 25, AHCA/NCAL calculated each center’s new survey score and projected the new state‐level star cut‐
- The sample graphic below and in each Top Line report shows a center’s current survey score and the state-level cut points for survey ratings at the top and the projected survey score and cut points on the bottom. A lower survey score results in a higher survey star rating.
Final Ratings: Final July ratings will be available in iQIES preview reports in the middle of July, Care Compare on July 30, and Your Top‐Line 2025‐Q3 in early August.
- The projected ratings on Your Top Line may change as newer survey, staffing, and quality data are released on July 30.
Access Your Top Line in LTC Trend Tracker: If you are a registered LTC Trend Tracker user, you should have received an email with a link to the publication. If you missed the email on July 7 or it got caught in a spam filter, you can always access current and historic Top Line within LTC Trend Tracker by following the steps here.
- For help accessing or using LTC Trend Tracker, visit the Resource Center or email help@ltctrendtracker.com.
