Thank you for your inquiry about the advanced illness and frailty exclusion criteria for CMS122v13 (performance period 2025). The eCQMs are designed to use clinical data extracted from structured fields in EHRs. The intent of the exclusion for those patients living long term in a nursing home is to identify individuals who are likely to be living in a nursing home any time on or before the end of the measurement period and receiving institutionalized long-term care services. The intent is to capture those patients who live in facility long term and not those who are only in the facility for short term. The exclusion criteria "Is Age 66 or Older Living Long Term in a Nursing Home" requires patients 66 or older at the end of the measurement period where the last housing status assessment performed (LOINC code 71802-3) has a result of "lives in a nursing home (finding)" (SNOMED code 160734000). If you have questions about reading the measure specification or understanding data requirements, you may refer to the "Guide for Reading eCQMs" for additional guidance. You may find this resource on the eCQI Resource Center: https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs .