Five-Star Users’ Guide 2025 – Updated July 2025
Effective with the July 2025 refresh, CMS is implementing a change to the methodology for calculating the health inspections domain, shifting from using the three most recent standard health inspection surveys to the two most recent standard health inspection surveys to calculate health inspection ratings. CMS will continue to use a three-year lookback period for complaint and infection control inspections. For more details on the updated methodology, please review the “Health Inspection Domain” section of this document. CMS is updating the risk-adjustment models for the four claims-based measures to add risk adjustors using variables from Section GG (resident’s functional ability) in the Minimum Data Set (MDS). To minimize the impact of this change, CMS is revising the thresholds for the claims-based measures to maintain the same distribution by points based on data from the April 2025 refresh. Changes are identified in red, italicized text.