CMS Issues Important Updates to Nursing Home Care Compare

CMS recently released a revised memo (QSO-25-20-NH) that changes how nursing home performance is displayed on Care Compare. These updates—rolling out between July 2025 and January 2026—are meant to give consumers a clearer, more accurate picture of facility performance. Here’s what matters most:

1. Chain Performance Data
Starting July 30, 2025, CMS will begin publishing performance information for nursing home “chains” directly on Care Compare.

Families will now see aggregated 5-star ratings (overall, health inspections, staffing, and quality measures) for groups of facilities under the same ownership. This increases transparency and helps consumers make more informed decisions.

2. Health Inspection Rating Changes
Right now, the health inspection rating looks at the three most recent standard surveys. Because of pandemic backlogs, that third cycle can be more than 45 months old—hardly a reflection of current quality.

Beginning in July 2025, CMS will only use the two most recent surveys in the calculation. Weighting will also shift: 75% from the most recent cycle (plus complaint and infection control surveys in the past 12 months) and 25% from the second cycle.

About 80% of facilities won’t see a change, but for the other 20%, the impact is meaningful. Facilities that have improved won’t be penalized by old results, and those that have declined won’t get to coast on outdated strong performance.

3. Updated Long-Stay Antipsychotic Measure
CMS is tightening up the accuracy of the long-stay antipsychotic measure by adding Medicare and Medicaid claims data and Medicare Advantage encounter data alongside MDS reporting.

This change will better capture prescribing that doesn’t always show up on MDS. Under the new calculation, the national percentage of long-stay residents receiving antipsychotics will shift from 14.64% to 16.98%—not because of an increase in use, but because of better data.

Effective date: January 28, 2026. CMS originally planned to launch this in October 2025 but pushed it back in the September revision to give more time for accuracy and implementation.

4. Removing COVID-19 Vaccination Measures
CMS is removing the resident and staff vaccination rates from the main profile page of Care Compare, effective July 30, 2025.

The data won’t disappear entirely, but it won’t be front-and-center on each facility’s profile anymore.

Bottom Line
These updates keep Care Compare focused on what matters most—accurate, current, and transparent performance information.

• Ownership matters, and now chain-level data will be visible.

• Inspection ratings will finally reflect the present, not the past.

• Antipsychotic reporting will be more reliable.

• Outdated COVID-19 vaccination measures will be taken off the main page.

Facilities that have invested in quality improvement should welcome these changes, since they’ll be reflected more quickly and clearly.