The Centers for Medicare & Medicaid Services (CMS) recently issued the April 2026 Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users’ Guide.
What’s Been Updated
Per the Guide:
April 2026 Revisions
Effective with the April 2026 refresh, the long-stay antipsychotic medication quality measure calculation will be updated to ensure that all residents with a history of schizophrenia are excluded, consistent with established specifications. A subset of these residents was not appropriately excluded from the measure data released in January 2026. This change did not have a significant impact on scores for this measure or quality measure ratings. However, the scoring cut points for this measure will be reset to place providers into deciles using data from 2024Q4-2025Q3.
Quality Measure Update – Antipsychotics
Table 4 related to the Quality Measures used for the Five-Star Rating Calculation indicates that the Percentage of residents who received an antipsychotic medication was respecified in January 2026 to include Medicare and Medicaid claims and encounter data in addition to using MDS 3.0 data.
On page 35 of the Guide, the updated minimum/maximum point thresholds have been updated to reflect the recalibration. A footnote at the end of the document states that these cut points are based on data from 2024Q4-2025Q3.
View the April 2026 Technical Users’ Guide for more information.
