Important Nursing Home Care Compare & Five-Star Rating Updates
The Centers for Medicare and Medicaid Services (CMS) has announced a significant update to the Nursing Home Care Compare site, including a critical change to how the Five-Star Quality Rating System calculates health inspection scores. Beginning July 30, 2025, CMS will exclude the third (oldest) standard health inspection cycle from the calculation, focusing only on the two most recent standard inspections (survey/recertification) to provide a more accurate reflection of current facility performance. The new weighting will be 75% for the most recent survey and 25% percent for the second most recent. This is a shift from the current approach, where the most recent standard survey counted for roughly 50% of the score, the second for about one-third, and the third for about one-sixth. Complaint and infection control surveys will still use a three-year (36 month) lookback with the historic weighting.
CMS released QSO-25-20-NH on June 18, 2025, to describe updates coming to Nursing Home Care Compare. In the memo, CMS notes several changes to how items are displayed on the website related to performance data for nursing home chains, standard survey cycles for the inspection rating, updated long-stay antipsychotic measures, and removal of the COVID-19 vaccine measures. More details for each of these changes are laid out below.
Wisconsin Data
AHCA analyzed data on a state-by-state basis for these upcoming changes and overall, Wisconsin appears to fare well. About 6.5% of facilities can expect to lose a star(s), 79.9% will remain the same, and 13.6% will gain a star(s). These data points are all slightly better than the national changes expected.
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. The table below outlines the updates to the Health Inspection Rating calculation methodology.
Incorporate Updated Long Stay Antipsychotic Measure on Nursing Home Care Compare
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% to 16.98%. 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 notes they are removing the COVID-19 vaccination section from the main profile page of each nursing home on Care Compare effective July 30, 2025.
AHCA and WHCA will continue to monitor news out of CMS for additional changes. Please refer to the available AHCA resources or reach out to Kate Dickson with questions.
