Understanding the July 2026 Revision to CMS Quality Measure Ratings
Find out how new star rating thresholds will affect your facilities and what you can do to prepare for future updates.
Administrators and staff for long-term care facilities and nursing homes across the United States depend on their Quality Measure star rating for reimbursement purposes and as an overall benchmark of their standard of care. Set by the Centers for Medicare & Medicaid Service (CMS), these ratings undergo periodic revision as CMS considers the different data points it receives from facility audits and reporting.
How are CMS Quality Measure ratings changing?
Rating thresholds are going up. It will now take more total points to earn each CMS “star” level. The level of increase has been set by CMS at one half of the average improvement in Quality Measure scores over the previous measurement period. So these new numbers reflect the gains made by facilities over that period (January 2025–April 2026).
July 2026 Revision
|
Star Level |
Point Threshold |
Threshold Increase |
|
One Star (★☆☆☆☆) |
299–927 |
— |
|
Two Stars (★★☆☆☆) |
928–1120 |
+23 points |
|
Three Stars (★★★☆☆) |
1121–1299 |
+29 points |
|
Four Stars (★★★★☆) |
1300–1493 |
+33 points |
|
Five Stars (★★★★★) |
1494–2300 |
+38 points |
(New threshold numbers shown in blue)
What do these new CMS Quality Measure rating thresholds mean?
By making this change in star thresholds, CMS has made “keeping up” with your facility’s current Quality Measure effectively the same as falling behind. As each star above one now requires more total points to earn, facilities and organizations at the lower end of their current star threshold will need to conduct their own assessments to determine where they can improve—or risk losing a star even while keeping a consistent overall QM score.
It should be noted that CMS has not increased any of the individual Quality Measure thresholds, nor have they added any new areas for QM at this time. By changing only the overall star thresholds, the July 2026 revision does not indicate a shift in focus for Quality Measure efforts. Instead, this revision should be read as part of CMS’s ongoing, expressed drive toward continual improvement.
The change has industry observers bracing for more threshold increases in the future, with some analysts expecting another ratings bump as early as January 2027. Indeed, this six-month cadence may become the new normal for CMS, with threshold increases derived from the average level of QM improvement.
As reported in McKnight’s Long-Term Care News, this anticipation of future threshold changes has providers calling for more transparency and longer lead times before changes are made.
How to prepare for the July 2026 CMS Quality Measure revision
Long-term care facilities can no longer afford to adopt a “wait and see” approach toward Quality Measure scores. With a full five-star rating becoming a moving target, it will be important for nursing homes and other care facilities to internally monitor their own quality improvement efforts and develop benchmarks they can use to respond rapidly to these changing conditions.
McKnight’s quotes industry consultant Melissa Brown as saying, “The facilities that will thrive under these changes aren’t necessarily the ones providing dramatically different care. They’re the ones that know how to measure it, monitor it and improve it every day.”
However, knowing where to start can be daunting, especially with these new time crunch realities. GuideStar Eldercare can help.
How GuideStar Eldercare can help improve your Quality Measure scores
With our proven expertise in neurology, clinical psychiatry and behavioral health, GuideStar Eldercare is the leading provider of neurobehavioral services. We work with long-term care facilities like yours to help improve quality of life for patients with dementia and other neuropsychiatric conditions.
Working alongside our partner facilities in states around the country, GuideStar Eldercare’s mission is to transform dementia care. Together, we can bridge the gap between leading-edge neuroscience and the day-to-day realities of long-term care. We offer a range of consultative services that can help your facility improve on a range of Quality Measures.
At the beginning of 2026, CMS updated its methodology for calculating the Long-Stay Antipsychotic Quality Measure. The GuideStar model for neuro-forward dementia care can help you reduce rates of antipsychotic usage and pursue other treatments that have proven to be effective in treating patients with dementia and BPSD—without recourse to these types of drugs. Skilled nursing facilities that partner with GuideStar Eldercare have a Long-Stay Antipsychotic rate that is 3% below the national average.
GuideStar Eldercare gets results
- 58% decrease in Emergency Department visits
- 57% decrease in psychiatric hospitalizations
- 68% decrease in antipsychotic prescriptions
Our partner facilities have an average Quality Measure star rating of 4.11—a half star above the national average of 3.59.
Contact GuideStar Eldercare today to start taking command of your QM ratings.