CMS Adds Clarifications to the New Antipsychotic Measure

• By: Maureen Carland
• On: 05/05/2026 11:02:03
• In: Quality/Regulatory

The Centers for Medicare & Medicaid Services (CMS) has announced updates to the Minimum Data Set (MDS) 3.0 Resident-Level Quality Measure report for the revised hybrid long-stay antipsychotic measure, “Percent of Residents Who Received an Antipsychotic Medication”.
To help nursing homes better understand why the measure was triggered—and whether a resident was included or excluded—CMS has added new details to the report. In addition to indicating whether the measure was triggered, the report now includes three new data fields, along with explanatory footnotes to clarify the information.
The three new fields are: 

Trigger Source: Reflects the data source that caused the measure to be triggered:  
1 = MDS,  
2 = Claims,  
3 = Both 

Exclusion Reason: Reflects the reason the resident was excluded from the measure:  
1 = Enrollment-based exclusion,  
2 = Schizophrenia, Tourette's, or Huntington's on MDS and Claims,  
3 = At least one Medicare Part A/Medicaid record for hospice services during nursing home stay and overlapping with target period,  
9 = Other 

Inclusion Reason: Reflects the reason the resident was included in the measure:  
1 = Meets continuous enrollment requirement with no excluded diagnoses indicated,  
2 = Resident has excluded diagnoses on MDS, but no matching claims for that diagnosis,  
9 = Other 
 
For questions about this information, please contact the iQIES Service Center by phone: (800) 339-9313 or by email at iQIES@cms.hhs.gov with questions. You may also email regulatory@ahca.org?.  
 
Staff contact: mcarland[at]mehca.org