Thank you for your inquiry about the advanced illness and frailty exclusion criteria for CMS130v13 (performance period 2025). To clarify, 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). The intent of this exclusion 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 exclusion captures those patients who live in the facility long term and not those who are only in the facility for short term (e.g., rehabilitation). This is reflected in the measure specification which requires the most recent housing assessment indication of living in a nursing home. Please review the measure specification for further details about measure requirements: https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS130v13.html .