On December 2nd, CMS released the MDS 3.0 Quality Measures User’s Manual v18.0, which goes into effect on Jan 1, 2026. Notable changes include: Percent of Residents who Received an Antipsychotic Medication Long Stay Measure: · This measure has been re-specified to include Medicare and Medicaid claims and encounter data, in addition to MDS data. The previous measure only included information from MDS section N0415A1, and diagnosis exclusions from MDS section I. · The updated measure includes not only MDS information; but also claims and encounter records for physician-administered antipsychotic medication from Medicaid RX, Medicare Part D,Medicaid, and/or Medicare OP claim and encounter records. · Furthermore, diagnosis exclusions will require the corresponding diagnosis codes entered into the diagnosis code fields on the Medicare/Medicaid claims and encounter data in addition to coding them in MDS section I. · Lastly, Hospice was added as an exclusion for the measure, and will be taken from claims data. Discharge Function Score · Due to the removal of items O0400B and C: OT/PT minutes and days from the MDS the risk adjuster of “no PT or OT” for the DC Function Measure has been respecified to MDS items O0425B and O0425C on the PPS DC Assessment. To download the new Quality Measure Manual: https://www.cms.gov/medicare/quality/nursing-home-improvement/quality-measures On a related note, CMS released the official Technical Specification Report for an updated Falls with Major Injury Measure. · This measure is also being respecified to include claims data. The old measure was based only on MDS item J1900C. · The new measure will include claims and encounter data from the Hospital, Emergency Department, or observation stays, to identify Fall with Major Injury events, including diagnosis codes and external causes of injury codes that are likely to result in a fall with major injury. · The date for implementation of the new specs has not yet been announced. To see the specs, please visit: https://www.cms.gov/files/document/fmi-technicalspecificationsreport-nh.pdf. If you have questions or need additional information, please email us at: Medicarequestions@enhancetherapies.com | 
