If you thought quality measures were complicated already, just wait. An advance care planning quality measure may soon enter the conversation for nursing homes, and that shift could directly affect how your community documents, communicates, and delivers care. According to McKnight’s Long-Term Care News reporting on CMS weighing an advance care planning quality measure for nursing homes, the Centers for Medicare & Medicaid Services is reviewing whether to add this metric to its reporting programs. CMS wants to track whether communities document advance care planning discussions that clearly reflect residents’ goals of care and end-of-life preferences.
You can find this proposal on the 2025 Measures Under Consideration list overview released by CMS, which outlines the quality metrics CMS currently reviews for possible inclusion in federal programs. Placement on the list does not guarantee adoption, but it signals serious intent. When CMS signals intent, communities should review their own processes. Most communities already hold goals-of-care discussions, address code status, and document resident preferences in care plans and interdisciplinary meetings. The key difference now is measurement. Once CMS turns a best practice into a quality measure, it becomes reportable, comparable, and visible to regulators and the public.
That visibility brings both opportunity and accountability. Clear documentation of advance care planning strengthens resident-centered care, reduces confusion during changes in condition, and aligns treatment decisions with resident wishes. At the same time, communities must answer practical questions. How will CMS define a qualifying conversation? What documentation will meet the standard? How often must staff revisit these discussions? Surveyors will likely look for consistent documentation and clear evidence that staff updated discussions as residents’ conditions changed. Communities will need to train staff, reinforce documentation expectations, and audit records to confirm accuracy.
Although CMS has not finalized the proposal, now is the time to evaluate your approach. Do staff initiate goals-of-care conversations early? Do they document those discussions clearly and consistently? Could a surveyor quickly locate and understand the resident’s expressed preferences? CMS continues to push quality programs toward transparency and measurable resident-centered outcomes. If CMS adopts an advance care planning quality measure, communities that already prioritize timely conversations and strong documentation will stand on solid ground. Advance care planning is not just a regulatory task. It reflects how well we listen, communicate, and honor resident choice.
Stay well and stay informed!
