CMS Issues Errata Clarifying Long-Stay Antipsychotic Quality Measure Changes
The Centers for Medicare & Medicaid Services (CMS) has released an errata change table for the MDS 3.0 Quality Measures (QM) User’s Manual, Version 18.0, providing important clarifications related to the Long-Stay Antipsychotic Quality Measure (CMS ID: N047.01).
These updates apply to Chapter 1, Section 6 and are intended to clarify guidance tied to the respecification of the measure effective January 1, 2026.
As always, Simple continues to monitor regulatory updates like these to help skilled nursing facilities stay informed and prepared.
Background: Expanded Data Sources for N047
The Long-Stay Antipsychotic measure was previously re-specified to expand beyond MDS data alone. The updated methodology now incorporates:
- Medicare claims data
- Medicaid claims data
- Encounter data
While this respecification was initially communicated in Version 18 (effective October 1, 2025), CMS has continued refining how the measure is reported and interpreted.
Key Clarification: Measure Availability Timeline
The most significant update in the errata relates to when the re-specified measure has been available in provider reporting systems.
CMS has now confirmed:
- The re-specified Long-Stay Antipsychotic measure has been available in iQIES Facility-Level and Resident-Level QM Reports beginning in Q2 2024
This represents a meaningful clarification from earlier guidance.
Timeline of CMS Clarifications
- January 2026: Measure initially tied to Q3 2025
- February 2026: Expanded to include four quarters through Q3 2025 for Five-Star and iQIES reporting
- March 2026 (Errata): Confirmed availability in iQIES reports dating back to Q2 2024
Public Reporting Remains Unchanged
While provider-level reporting has been clarified, public reporting timelines remain the same.
- Public reporting on Nursing Home Care Compare began January 2026
- Updates will continue on a quarterly basis
CMS also removed references linking NHQI public reporting to the Five-Star Technical Users’ Guide, helping reduce confusion between provider-level reporting and public-facing ratings.
Updates to Supplemental Files
CMS also updated the supplemental files used to calculate the measure, noting that the original Version 18 release did not include all production updates.
HCPCS Code Updates
Two new HCPCS codes were added:
- J2427 – Paliperidone palmitate ER (Invega Trinza / Hafyera)
- J2428 – Paliperidone palmitate ER (Erzofri)
Antipsychotic NDC File Expansion
- Previous version: 5,439 NDCs
- Updated version: 7,639 NDCs
Many of these additions reflect different strengths and formulations of existing medications, increasing the measure’s sensitivity in identifying antipsychotic use.
Hospice Exclusion Codes
- No changes were made to Part A Hospice Codes
What This Means for Your Facility
These clarifications reinforce that the re-specified Long-Stay Antipsychotic measure has been present in iQIES reporting longer than previously understood.
Facilities should:
- Review historical performance data in iQIES dating back to Q2 2024
- Ensure internal monitoring aligns with the expanded data sources
- Understand the distinction between provider-level reporting and public reporting timelines
While no immediate action is required, these updates provide important context for how performance has been calculated and reported over time.
CMS will continue refining quality measure guidance as implementation progresses. Simple will continue tracking these updates and sharing insights to support your team.
Where to Find the Updated Materials
All updated materials—including the revised manual, errata change tables and supplemental files—are available here:
https://www.cms.gov/medicare/quality/nursing-home-improvement/quality-measures