Long Stay Antipsychotic Measure Update

• By: Maureen Carland
• On: 01/29/2026 07:59:57
• In: Quality/Regulatory

 As a reminder, with the next refresh, CMS will replace the existing long-stay antipsychotic medication quality measure with a respecified measure that incorporates Medicare and Medicaid claims data and Medicare Advantage encounter data to supplement MDS data.

Effective with the February 2026 (postponed from January) refresh, CMS will replace the existing long-stay antipsychotic medication quality measure with a respecified measure that incorporates Medicare and Medicaid claims data and Medicare Advantage encounter data to supplement MDS data.   Under this new measure it is expected the rate of LS antipsychotic rates will increase by 2-3%.   

The scoring cut points for this respecified measure will be set to place providers into 10 equal deciles based on the distribution of providers' performance. Please refer to CMS Memorandum QSO-25-20-NH REVISED for more information. Changes are identified in red, italicized text.

For more information also see the Five Star Users' Guide January 2026 (PDF)
 
Staff Contact: mcarland[at]mehca.org