January 2026 Five-Star Report Update: What Changed and Why It Matters

CMS updated Care Compare on February 5, 2026, to reflect values for the new hybrid antipsychotic quality measure. However, when reviewing the January 2026 Five-Star Preview Reports today compared to when they were first released, the data presentation and scoring methodology appear to have changed.

What the Five-Star Report Initially Showed

When CMS first released the Five-Star Preview Reports on January 21, 2026, the new hybrid antipsychotic quality measure displayed “N/A” values for quarters prior to Q3 2025. As a result, the measure score and associated rating points were calculated using Q3 2025 data only.

This approach aligned with prior CMS guidance. The MDS 3.0 Quality Measure Manual indicated that the initial data collection period for the hybrid antipsychotic measure would begin with data from July 1, 2025, through September 30, 2025.

What Has Changed Since Then

CMS has since updated the Five-Star Preview Reports. The same hybrid antipsychotic measure now appears to include four quarters of data in the calculation. This suggests that CMS is applying the new hybrid measure retroactively across earlier quarters, rather than limiting the calculation to Q3 2025 forward.

As a result, facilities reviewing the Five-Star Report today may see different measure values, averages, and rating point outcomes than what was originally released in the original file on January 21, 2026.

Why This Is Important for Providers

This change has meaningful implications for Five-Star ratings. Expanding the calculation to four quarters can materially affect a facility’s quality measure performance and overall rating, particularly when earlier quarters were not expected to be included based on previously released CMS guidance. Providers are seeing the percentages reported to be different than what was previously finalized in prior Five-Star preview reports.

Providers should be aware that the Five-Star data they reviewed in January may no longer reflect the current scoring methodology and should re-check their January 2026 Five-Star Preview Reports to understand how this update impacts their ratings.

What to Do Next

SNFs should:

• Re-review the January 2026 Five-Star Preview Reports as currently displayed

• Compare updated measure calculations to the originally released data

• Document any significant changes for internal tracking and future projections

As CMS continues to refine Five-Star methodologies and introduce new hybrid measures, close monitoring of updates and alignment with published guidance remains critical.