The Minimum Data Set (MDS) 3.0 Quality Measures (QM) User's Manual v18.0 and accompanying Risk Adjustment Appendix File are now available. The MDS 3.0 QM User’s Manual V18.0 will be effective beginning January 1, 2026, and contains detailed specifications for the MDS 3.0 QMs. A Notable Changes section in the document summarizes the major changes from the MDS 3.0 QM User’s Manual V17.0. The Risk Adjustment Appendix File is a reference to be used in conjunction with the MDS 3.0 Quality Measures User’s Manual v18.0 and contains coefficient values used to calculate the risk-adjusted quality measures. The latest coefficient values in this appendix file reflect, where applicable, updates to the measure specifications for the risk-adjusted NHQI measures, effective January 1, 2026. The manual and associated files can be found in the Downloads section on the NHQI Quality Measures webpage.