The long-stay weight loss measure counts residents whose most recent assessment shows significant weight loss that no physician planned. It comes down to one item, K0300, and one distinction: a code of 2 counts against the building, and a code of 1 doesn’t.
Where the measure is used
- CMS ID N029.03, a long-stay MDS measure (101 or more cumulative days in the building).
- Care Compare: yes. Five-Star: no. It isn’t one of the seven MDS measures in the long-stay QM rating.
- Texas QIPP scores it as Component 1, Metric 3 for state fiscal year 2027. Component 1 is open to non-state government-owned buildings only. See Texas QIPP, explained.
- New York’s NHQI scores it in its 2025 methodology, with its own risk adjustment.
What puts a resident in the numerator
“The measure captures the percentage of long-stay residents who had a weight loss of 5% or more in the last month or 10% or more in the last 6 months who were not on a physician prescribed weight loss regimen noted in an MDS assessment during the selected quarter.”
| K0300 | Meaning | In the measure |
|---|---|---|
| 0 | No, or unknown | Denominator only |
| 1 | Yes, on a physician-prescribed weight-loss regimen | Denominator only |
| 2 | Yes, not on a physician-prescribed weight-loss regimen | Numerator |
Who is left out
- Residents whose target assessment is an OBRA Admission or a PPS 5-Day.
- Life expectancy of less than 6 months (J1400 = 1), or J1400 missing.
- Hospice care (O0110K1b = 1), or that item missing.
- K0300 missing (dashed) on the target assessment.
CMS does not risk-adjust this measure. The reported rate is the observed rate.
The two snapshots
K0300 compares the current weight (K0200B, the most recent weight in the last 30 days, rounded to the whole pound) with two earlier weights: the one closest to 30 days before it, and the one closest to 180 days before it.
“The resident’s weight captured closest to these two time points are the only two weights considered for this item, but the resident’s weight should be monitored on a continual basis and weight loss assessed and addressed on the care plan as necessary.”
The math is a multiplication. Take the weight closest to 30 days ago and multiply by 0.95. Take the weight closest to 180 days ago and multiply by 0.90. If the current weight is equal to or less than either result, the loss is significant.
A worked example. Resident C weighed 160 lbs about 30 days ago. 160 × 0.95 = 152. Resident C weighs 152 lbs today. That is exactly the line, and “equal to or less than” means it counts. With no weight-loss plan in the chart, K0300 is 2, and if this is the target assessment Resident C is in the numerator.
When it counts, and when it clears
Only the target assessment is read: the resident’s latest qualifying assessment, dated no more than 120 days before the episode ends or the quarter closes. There is no look-back scan. A resident coded 2 on one quarterly and 0 on the next is out of the numerator on the next.
The 180-day comparison is the one that lingers. A resident who lost 10% and has since held steady can still be at or below the 90% line on the next assessment, because the weight from 180 days back is still the heavier one.
Code 1 needs a documented goal
The difference between 1 and 2 is the whole measure, and the chart has to carry it.
“To code K0300 as 1, yes, the expressed goal of the weight loss diet or the expected weight loss of edema through the use of diuretics must be documented.”
A diet order on its own isn’t a weight-loss regimen:
“On occasion, a resident with normal BMI or even low BMI is placed on a diabetic or otherwise calorie-restricted diet. In this instance, the intent of the diet is not to induce weight loss, and it would not be considered a physician-ordered weight-loss regimen.”
Common coding mistakes
- Coding 1 for diuresis without the note. Planned diuresis can support code 1, but only when the expected weight loss is documented.
- Picking the wrong comparison weight. When there are several weights around the 30- or 180-day mark, use the one on the date closest to the time point, not the highest or the lowest.
- Skipping the rounding. Round weights to the whole pound, as K0200B says, before doing the calculation.
- Forgetting an amputation. The RAI Manual works an example that adds the weight of the removed limb back before comparing. Without it, a surgical change reads as weight loss.
- Working from a stale current weight. K0200B has to be a weight taken within 30 days of the ARD. If the last one is older, weigh the resident again before coding K0300.
The weights themselves need to be reliable: the RAI Manual asks for consistent measurement under facility policy (shoes off, and so on). A single bad scale reading can put a resident in the numerator.
See your building’s weight loss rate against the nation, free.
SuperQM shows who is coded 2 on their latest assessment, so the team can check the weights and the chart while the next assessment is still ahead.
Sources
- MDS 3.0 Quality Measures User’s Manual v18.0 (effective January 1, 2026), Table 2-25 and Chapter 1
- MDS 3.0 RAI User’s Manual v1.20.11 (October 2026), Chapter 3, Section K
- Texas HHSC, Quality Incentive Payment Program (QIPP)
- New York State Department of Health, 2025 Nursing Home Quality Initiative Methodology
