A New Chapter in Nursing Home Ratings: Navigating CMS’s 2025 Changes with SHP
Big changes are coming to the way nursing homes are rated, and if you're part of the industry, it’s vital to prepare now.
Starting in July 2025, the Centers for Medicare & Medicaid Services (CMS) is implementing updates to the Five-Star Quality Rating System to make ratings more accurate, transparent, and reflective of current performance. These changes are detailed in the QSO-25-20-NH memorandum, marking a significant shift for skilled nursing facilities (SNFs) across the country. Beyond understanding these updates, facilities must adapt quickly to maintain and improve their ratings—and that’s where Strategic Healthcare Programs (SHP) can help.
Here’s a closer look at what’s changing and how SHP’s solutions can empower your facility to thrive in this new landscape.
Out with the Old: Say Goodbye to Survey Cycle 3
What’s Changing
A core element of the Five-Star Quality Rating System is the health inspection rating, which relies on surveys conducted over a three-cycle period (up to 45 months). However, starting in July 2025, CMS will remove the oldest cycle—Cycle 3—from rating calculations.
Why the shift?
The third cycle has become outdated and less reliable due to inspection delays during the COVID-19 pandemic. By focusing only on the two most recent cycles, CMS aims to provide a clearer, more accurate representation of a facility’s current performance.
The New Scoring Breakdown
The updated methodology now weighs recent surveys more heavily to evaluate a facility’s health inspection score. Here’s how it works:
- Cycle 1 (the newest surveys) combined with recent complaint and infection control surveys will account for 75% of the score.
- Cycle 2 (previous surveys), plus older complaint and infection control data, will make up the remaining 25%.
What This Means for SNFs
For many facilities, this is a chance for a clean slate. If your past issues are in Cycle 3, those missteps will no longer hold you back. On the other hand, facilities relying on favorable older ratings may see their scores adjust downward.
How SHP Can Help:
SHP’s Five-Star Preview Reports provide advanced insight into how the new scoring system affects your ratings. With real-time analytics, you can focus on improving current performance while addressing areas for improvement before ratings are finalized. SHP's MDS Indicator Facility Rate Report provides a surveyor insight into potential issues for review and selects resident sample as well as the Pin Point Predictor Report that provides local comparative survey data analytics.
Antipsychotic Use Measure Gets a Makeover
What’s Changing
Starting October 29, 2025, CMS will overhaul the long-stay antipsychotic use measure. Previously reliant on the Minimum Data Set (MDS), the updated measure now incorporates Medicare Part D prescription drug claims and encounter data for greater accuracy.
This shift captures a broader view of antipsychotic prescriptions, including those not recorded during the MDS 7-day lookback period. With this change, the national average use rate is expected to rise from 14.64% to 16.98%—not due to an increase in actual use, but because of more comprehensive reporting. This adjustment will also impact star rating thresholds for many facilities.
What This Means for SNFs
Facilities with historically underreported data may experience increased transparency and accountability. While these shifts can initially feel challenging, they also offer a more accurate picture of prescribing practices.
How SHP Can Help:
SHP’s analytics incorporate claims data and automatically adjust to reflect the new quality measures. Our tools help facilities monitor changes, identify risks, and proactively align with CMS guidelines—all through customizable dashboards that simplify compliance.
Transparency in Ownership: Chain Ratings Go Public
What’s Changing
For the first time, CMS will begin publishing chain-level aggregated performance ratings. These metrics, spanning overall ratings, health inspections, staffing, and quality measures, will be publicly available starting July 2025.
What This Means for SNFs
This change allows consumers to see how chains perform across their affiliated facilities, increasing accountability for ownership groups. Transparent data empowers families to make more informed choices while emphasizing consistency across a network.
How SHP Can Help:
SHP provides tools to link facility data by ownership group, enabling chain operators to monitor aggregated performance metrics. With SHP, chains can take proactive steps to align their facilities with quality improvement goals.
Other Updates to Watch
COVID-19 Vaccination Measures Removed
Starting July 30, 2025, the resident and staff COVID-19 vaccination measures will no longer appear on public-facing Care Compare pages. While these metrics won’t impact star ratings, internal monitoring remains essential for health and safety.
A New Path for Special Focus Facilities
The Special Focus Facility (SFF) program will also align with the updated Five-Star methodology. This paves the way for facilities making significant improvements to graduate from SFF candidacy more effectively, while underperforming homes may be flagged sooner.
How SHP Can Help:
Whether you’re improving internal safety metrics or navigating out of the SFF program, SHP offers benchmarking and compliance tools that simplify the process while keeping your team focused on continuous improvement.
Why These Changes Matter
These updates underscore CMS’s commitment to providing caregivers, families, and stakeholders with transparent and timely data. For SNFs, this means greater accountability—and a renewed opportunity to stand out by delivering high-quality care.
But staying competitive requires more than understanding the changes. Facilities must take action to analyze their data, implement best practices, and adapt to stricter evaluations. This is where SHP becomes invaluable.
Actionable Insights with SHP
SHP empowers facilities to turn challenges into opportunities with solutions designed to adapt to evolving regulatory needs. Our platform includes key features like:
- Custom Dashboards - Offering easy insights into health inspection, staffing, and quality measure data.
- Benchmarking Tools - Compare your performance against state and national trends.
- Five-Star Preview Reports - Anticipate your facility’s ratings with detailed preview calculations.
- Concierge Support - Get personalized assistance from our knowledgeable team, ready to help you shine.
Take Action Today
With CMS’s 2025 changes on the horizon, adapting now is essential for success. Don’t wait until July to prepare—equip your team with the tools they need to thrive in this new era of nursing home ratings.
Request a free demo today and discover how our solutions can help your facility improve quality, boost transparency, and confidently meet CMS’s updated standards.
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