NHQI Spotlights and Announcements
Updates
December 1, 2025
NOW AVAILABLE: MDS 3.0 Quality Measures User's Manual v 18.0 and Associated User's Manual Files
The Minimum Data Set (MDS) 3.0 Quality Measures (QM) User's Manual v18.0 and accompanying Risk Adjustment Appendix File are now available. The MDS 3.0 QM User’s Manual V18.0 will be effective beginning January 1, 2026, and contains detailed specifications for the MDS 3.0 QMs. A Notable Changes section in the document summarizes the major changes from the MDS 3.0 QM User’s Manual V17.0. The Risk Adjustment Appendix File is a reference to be used in conjunction with the MDS 3.0 Quality Measures User’s Manual v18.0 and contains coefficient values used to calculate the risk-adjusted quality measures. The latest coefficient values in this appendix file reflect, where applicable, updates to the measure specifications for the risk-adjusted NHQI measures, effective January 1, 2026.
The manual and associated files can be found in the Downloads section on the NHQI Quality Measures webpage.
November 26, 2025
NOW AVAILABLE: Falls with Major Injury (FMI) NHQI Technical Specification Report
The Centers for Medicare & Medicaid Services (CMS) has released the official Technical Specification Report for the Falls with Major Injury (FMI) measure. This report incorporates feedback received during the cross-setting Technical Expert Panel (TEP) held on May 12 and 14, 2025. The report provides an overview of the measure, a high-level summary of the key features of the re-specified measure, a description of the methodology used to construct the FMI measure, and an overview of measure testing results. Additional guidance and related updates to the Quality Measure Calculations and Reporting s User’s Manual and public reporting timelines will be provided at a future date.
The report is available in the Downloads section of the NHQI Quality Measures webpage.
September 24, 2025
UPDATED: Final MDS 3.0 RAI User’s Manual version 1.20.1
The posted final Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.20.1 has been updated to align with the revisions to item J1900 in the release of the MDS item sets v1.20.1v4. The updated version is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS 3.0 RAI User’s Manual v1.20.1 will be effective beginning October 1, 2025.
September 23, 2025
UPDATED: Final MDS 3.0 Item Sets version 1.20.1v4
The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.20.1v4 and Item Matrix v1.20.1v4 are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. This revised final version (1.20.1v4) includes updates to the language in item J1900, which have been made in response to provider concerns; these are the only changes from the previous version. The MDS Item Sets v1.20.1v4 will be effective beginning October 1, 2025.
September 19, 2025
NOW AVAILABLE: MDS 3.0 Quality Measures User's Manual v17.0 Effective January 1, 2025 and Associated User Manual Files – Updated Claims and SNF QRP Measure Materials
An updated .zip file for the Minimum Data Set (MDS) 3.0 Quality Measures (QM) User's Manual v17.0 is now available. This .zip file package contains the updated 2025 Nursing Home Compare Claims-Based Quality Measure Technical Specifications and associated appendix and the updated Skilled Nursing Facility Quality Reporting Program (SNF QRP) Measure Calculations and Reporting User’s Manual V7.0 and associated risk adjustment and imputation appendix files.
The .zip file can be found in the Downloads section on the NHQI Quality Measures webpage.
September 12, 2025
Revised SNF QRP Data Elements Used for Reporting Assessment-Based QMs and Standardized Patient Assessment Data Elements Affecting FY 2027 APU Determination posted
The revised Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Overview of Data Elements Used for Reporting Assessment-Based Quality Measures and Standardized Patient Assessment Data Elements Affecting Fiscal Year (FY) 2027 Annual Payment Update (APU) Determination table is now available.
The SNF QRP APU Table can be accessed via the Downloads section of the SNF QRP Measures and Technical Information webpage.
September 12, 2025
SNF QRP Data Elements Used for Reporting Assessment-Based QMs and Standardized Patient Assessment Data Elements Affecting FY 2028 APU Determination and Data Collection and Final Submission Deadlines for FY 2028 posted
The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Overview of Data Elements Used for Reporting Assessment-Based Quality Measures and Standardized Patient Assessment Data Elements Affecting Fiscal Year (FY) 2028 Annual Payment Update (APU) Determination table and the SNF QRP Data Collection and Final Submission Deadlines for the FY 2028 SNF QRP are now available.
The SNF QRP APU Table can be accessed via the Downloads section of the SNF QRP Measures and Technical Information webpage. The SNF QRP Data Collection and Final Submission Deadlines can be accessed via the Downloads section of the SNF QRP Data Submission Deadlines webpage.
September 12, 2025
SNF QRP FAQs for FY 2026
An update to the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Frequently Asked Questions (FAQs) document is now available. This document has been updated to reflect the finalized policies for the SNF QRP in Fiscal Year (FY) 2026 and includes other useful resources available to providers.
The FAQ document can be accessed via the Downloads section of the SNF Quality Reporting FAQs webpage.
August 29, 2025
NOW AVAILABLE: Final MDS 3.0 RAI User’s Manual version 1.20.1
The final Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.20.1 is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS 3.0 RAI User’s Manual v1.20.1 will be effective beginning October 1, 2025.
August 15, 2025
UPDATED: Final MDS 3.0 Item Sets version 1.20.1v3
The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.20.1v3 and Item Matrix v1.20.1v3 are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS Item Sets v1.20.1v3 will be effective beginning October 1, 2025.
August 11, 2025
NOW AVAILABLE: May 2025 Falls with Major Injury Technical Expert Panel (TEP) Summary Report
The Centers for Medicare & Medicaid Services (CMS) convened a Technical Expert Panel (TEP) on May 12 and 14, 2025, to obtain input on potential cross-setting updates to the Falls with Major Injury (FMI) measure. The TEP was held in response to concerns regarding potential underreporting on the current measure and recommendations from the U.S. Department of Health and Human Services Office of Inspector General (OIG) in its 2023 report. The OIG report recommended that CMS pursue measure respecification, including consideration of alternative data sources, such as claims-based data, and transitioning the measure to a hybrid model. CMS has released the official TEP Summary Report, which provides an overview of the panel’s discussion and feedback on proposed updates to the measure.
CMS intends to move forward with updates to the FMI measure based on input received during the TEP. Additional guidance related to updates to the Quality Measures User’s Manual, clinical guidance manuals, technical specifications, and public reporting timelines will be provided at a future date. In the interim, stakeholders are encouraged to review the TEP Summary Report for additional detail on the proposed updates and the rationale discussed by the TEP.
The TEP Summary Report can be found in the Downloads section on the NHQI Quality Measures webpage.
May 23, 2025
UPDATED: Draft MDS 3.0 Item Sets version 1.20.1v3-Section_R removed Now Available
The draft Minimum Data Set (MDS) 3.0 Item Sets version (v)1.20.1v3-Section_R_removed and Item Matrix v1.20.1v3-Section_R_removed are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. This version reflects the changes proposed in the FY 2026 SNF PPS proposed rule (90 FR 18590).
IMPORTANT NOTE: The final MDS Item Sets v1.20.1 will be effective beginning October 1, 2025 and will be either this draft v3 which does not include items R0310, R0320, and R0330 and replaces item R0340 with item A1255 or the previously posted 1.20.1v2. The FINAL MDS Item Sets v1.20.1 will be posted in late summer, depending on the decisions finalized in rulemaking.
April 1, 2025
NOW AVAILABLE: Draft MDS 3.0 RAI User’s Manual version 1.20.1
The draft Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.20.1 is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS 3.0 RAI User’s Manual v1.20.1 will be effective beginning October 1, 2025.
March 18, 2025
UPDATED: Draft MDS 3.0 Item Sets version 1.20.1v2
The draft Minimum Data Set (MDS) 3.0 Item Sets version (v)1.20.1v2 and Item Matrix are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS Item Sets v1.20.1 will be effective beginning October 1, 2025.
December 23, 2024
NOW AVAILABLE: MDS 3.0 Quality Measures User's Manual v 17.0 and Accompanying Risk Adjustment Appendix File
The Minimum Data Set (MDS) 3.0 Quality Measures (QM) User's Manual v17.0 and accompanying Risk Adjustment Appendix File are now available. The MDS 3.0 QM User’s Manual V17.0 will be effective beginning January 01, 2025 and contains detailed specifications for the MDS 3.0 QMs. A Notable Changes section in the document summarizes the major changes from MDS 3.0 QM User’s Manual V16.0. The Risk Adjustment Appendix File is a reference to be used in conjunction with the MDS 3.0 Quality Measures User’s Manual v17.0 and contains coefficient values used to calculate the risk-adjusted quality measures. There are no coefficient changes to the Risk Adjustment Appendix from v16.0 to v17.0 since specification updates did not significantly change the coefficient values.
The manual and risk adjustment file can be found in the Downloads section on the NHQI Quality Measures webpage.
October 1, 2024
NOW AVAILABLE: Draft MDS 3.0 Item Sets version 1.20.1
The draft Minimum Data Set (MDS) 3.0 Item Sets version (v)1.20.1 and Item Matrix are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS Item Sets v1.20.1 will be effective beginning October 1, 2025.
September 3, 2024
NOW AVAILABLE: MDS 3.0 RAI User’s Manual v1.19.1R Hyperlink Update Supplement
The Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.19.1R Hyperlink Update Supplement is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page.
This is an informational document that includes hyperlinks (links) that have been identified as requiring an update over the lifetime of the MDS 3.0 RAI User’s Manual v1.19.1, effective October 01, 2024. Due to external webpage changes, links may occasionally redirect or become unreachable, or the information provided on the webpage may change. To ensure all links remain current, a list of non-functional/out-of-date links has been compiled, each with an up-to-date replacement link. Replacement pages for each affected page of the MDS 3.0 RAI User’s Manual v1.19.1 can be found following the list.
July 1, 2024
MDS 3.0 QM User’s Manual Version 16.0 Risk Adjustment Appendix File – Now Available
The Minimum Data Set (MDS) 3.0 Quality Measures (QM) User’s Manual v16.0 Risk Adjustment Appendix is now available. The Risk Adjustment Appendix File for the MDS 3.0 Quality Measures User’s Manual is a reference to be used in conjunction with the MDS 3.0 Quality Measures User’s Manual v16.0, and contains coefficient values used to calculate the risk-adjusted quality measures.
The latest coefficient values in this appendix file utilize assessment data received for 2024 Quarter 1 and reflect, where applicable, updates to the measure specifications for the risk-adjusted NHQI measures, effective October 1, 2023.
For more information, please visit the NHQI Quality Measures website.
June 3, 2024
NOW AVAILABLE: Draft MDS 3.0 RAI User’s Manual version 1.19.1
The draft Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual v1.19.1 is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual webpage. The MDS 3.0 RAI User’s Manual v1.19.1 will be effective beginning October 01, 2024.
This version of the MDS 3.0 RAI Manual contains guidance to support the addition of new items N0415K: Anticonvulsant and O0350: Resident’s COVID-19 vaccination is up to date. Additionally, the Discharge Goals column in items GG0130: Self-Care and GG0170: Mobility have been removed; and the guidance and examples in Section GG have been revised to reflect the modification. Various minor alignments and corrections have been implemented throughout; specifics can be found in the included chapter/section change tables following the guidance.
May 17, 2024
NOW AVAILABLE: Final MDS 3.0 Item Sets version 1.19.1
The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.19.1 are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS Item Sets v1.19.1 will be effective beginning October 01, 2024.