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12/04/2025

CMS Releases MDS 3.0 Quality Measures User’s Manual v18.0 and Related Files

CMS has released the MDS 3.0 Quality Measures User’s Manual v18.0 along with a full set of updated supporting files, all effective January 1, 2026. These materials outline the detailed specifications for the MDS-based quality measures included in the Nursing Home Quality Initiative and reflect several measure changes for the upcoming year. The complete file set is available in the Downloads section of the CMS Nursing Home Quality Measures webpage.

What’s new

  • The MDS 3.0 QM User’s Manual v18.0 includes updated measure specifications and a Notable Changes section that highlights revisions from version 17.0, including the respecification of the Long Stay Antipsychotic Measure and modifications to functional measures following the removal of item O0400 from MDS version 1.20.1.
  • The Risk Adjustment Appendix File provides updated logistic regression coefficients that support risk-adjusted measures within the Nursing Home Quality Initiative beginning January 1, 2026.
  • CMS has issued refreshed claims-based technical specifications for Nursing Home Compare, including an updated 2025 Claims-based Measures Technical Specifications document and its accompanying appendix.
  • The SNF QM User’s Manual v7.0, effective October 1, 2025, is included in the file set along with its Risk Adjustment Appendix. These documents incorporate the functional measure changes tied to the removal of item O0400.

Why it matters

  • The updated manual and risk adjustment files will guide quality measure reporting for the 2026 program year.
  • Changes to the functional and antipsychotic measures may influence future performance trends, public reporting, and quality improvement priorities.
  • Providers should review the revised measure specifications early to ensure internal processes and MDS workflows are aligned with the 2026 expectations.

Members with specific technical questions are invited to reach out to Stephanie DeWees at SDeWees@leadingageohio.org for support.

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