Is MIPS 286 the same as MIPS 286?

Yes. CMS uses zero-padded three-digit Quality IDs (286) in official specifications, while clinicians often search for MIPS 286 or Quality ID 286 without the leading zero. Both refer to the same 2026 MIPS quality measure reported through the Quality Payment Program (QPP).

How do I report MIPS Measure 286 in 2026?

MIPS Measure 286 (Quality ID 286) is reported through the Quality Payment Program (QPP) as a MIPS Clinical Quality Measure (CQM) via qualified registry, or Medicare Part B claims where applicable.

Is MIPS 286 a topped-out measure?

Yes, MIPS 286 is currently topped out, which means most clinicians perform well on this measure and it may be subject to a 7-point scoring cap.

Measure ID: MIPS 286|Dementia|2026 Performance Year

2026 MIPS Measure #286: Dementia: Safety Concern Screening and Follow-Up for Patients with Dementia

Percentage of patients with dementia or their caregiver(s) for whom there was a documented safety concerns screening in two domains of risk: 1) dangerousness to self or others and 2) environmental risks; and if safety concerns screening was positive in the last 12 months, there was documentation of mitigation recommendations, including but not limited to referral to other resources.

Process – High PriorityDementiaGeriatricsPatient Safety

Measure ID:MIPS 286 (Quality ID 286)

Collection:MIPS CQM

Topped Out:Yes

View CMS Spec ↗

Measure Specification

Eligible Population

All patients regardless of age

ANDDiagnosis for dementia

ANDPatient encounter during the performance period

Exclusions

None

Numerator

Patients with dementia or their caregiver(s) for whom there was a documented safety concerns screening in two domains of risk: 1) dangerousness to self or others and 2) environmental risks; and if safety concerns screening was positive in the last 12 months, there was documentation of mitigation recommendations, including but not limited to referral to other resources.

Reporting Codes

Performance Met:

G9922Safety concerns screen provided and if positive then documented mitigation recommendations

G9923Safety concerns screen provided and negative

Performance Not Met:

G9925Safety concerns screening not provided, reason not otherwise specified

G9926Safety concerns screening positive screen is without provision of mitigation recommendations, including but not limited to referral to other resources

○ Exceptions:

G2183Documentation patient unable to communicate and informant not available

VBCA Insights

Why This Measure Matters

Dementia patients and their caregivers face serious safety risks: wandering, medication confusion, falls at home, or harm from weapons or vehicles they don't know how to handle safely anymore. This measure requires a documented screening in two domains—safety to self/others and home environment—at least once. If you find problems, you must document how you addressed them. Regular safety assessments prevent tragedy and give families concrete steps to take, from removing car keys to installing door alarms.

VBCA is a CMS-approved Qualified Clinical Data Registry (QCDR) that submits MIPS Measure 286 to the Quality Payment Program (QPP). Practices can report this measure as a MIPS Clinical Quality Measure (CQM) or through qualified registry submission.

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Specialty Measure Sets

Clinical Social Work Geriatrics Mental/Behavioral Health Neurology Physical Therapy/Occupational Therapy Speech Language Pathology

Related Measures

Dementia

MIPS 282: Dementia: Functional Status Assessment MIPS 288: Dementia: Education and Support of Caregivers for Patients with Dementia MIPS 291: Assessment of Cognitive Impairment or Dysfunction for Patients with Parkinson’s MIPS 513: Patient Reported Falls and Plan of Care

Geriatrics

MIPS 048: Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in MIPS 050: Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years MIPS 155: Falls: Plan of Care MIPS 181: Elder Maltreatment Screen and Follow-Up Plan MIPS 238: Use of High-Risk Medications in Older Adults MIPS 282: Dementia: Functional Status Assessment MIPS 288: Dementia: Education and Support of Caregivers for Patients with Dementia MIPS 500: Acute Posterior Vitreous Detachment Appropriate Examination and Follow-up MIPS 501: Acute Posterior Vitreous Detachment and Acute Vitreous Hemorrhage Appropriate MIPS 513: Patient Reported Falls and Plan of Care

Patient Safety

MIPS 130: Documentation of Current Medications in the Medical Record MIPS 145: Radiology: Exposure Dose Indices Reported for Procedures Using Fluoroscopy MIPS 155: Falls: Plan of Care MIPS 164: Coronary Artery Bypass Graft (CABG): Prolonged Intubation MIPS 168: Coronary Artery Bypass Graft (CABG): Surgical Re-Exploration MIPS 181: Elder Maltreatment Screen and Follow-Up Plan MIPS 259: Rate of Endovascular Aneurysm Repair (EVAR) of Small or Moderate Non-Ruptured MIPS 275: Inflammatory Bowel Disease (IBD): Assessment of Hepatitis B Virus (HBV) Status Before MIPS 351: Total Knee or Hip Replacement: Venous Thromboembolic and Cardiovascular Risk MIPS 354: Anastomotic Leak Intervention MIPS 355: Unplanned Reoperation within the 30-Day Postoperative Period MIPS 357: Surgical Site Infection (SSI)MIPS 374: Closing the Referral Loop: Receipt of Specialist Report MIPS 384: Adult Primary Rhegmatogenous Retinal Detachment Surgery: No Return to the Operating MIPS 385: Adult Primary Rhegmatogenous Retinal Detachment Surgery: Visual Acuity Improvement MIPS 392: Cardiac Tamponade and/or Pericardiocentesis Following Atrial Fibrillation MIPS 393: Infection within 180 Days of Cardiac Implantable Electronic Device (CIED) Implantation,MIPS 413: Door to Puncture Time for Endovascular Stroke Treatment MIPS 422: Performing Cystoscopy at the Time of Hysterectomy for Pelvic Organ Prolapse MIPS 432: Proportion of Patients Sustaining a Bladder or Bowel Injury at the time of any Pelvic MIPS 513: Patient Reported Falls and Plan of Care

Official Resources

📄 CMS Measure Specification (PDF)🔗 QPP Quality Payment Program

Clinical Rationale

The assessment of safety is an identified gap in dementia care (Black BS, Johnston D, Rabins PV, et al. Unmet Needs of Community-Residing Persons with Dementia and Their Informal Caregivers: Findings from the MIND at Home Study. J Am Geriatr Soc 2013;61(12):2087-2095.) Persons with dementia are at increased risk of having safety concerns for several reasons.

Cognitive loss can lead to confusion regarding use of medications, handling of weapons or machinery, or the ability to remember to turn off appliances, such as ranges and stoves. Dementia also impairs the person’s judgment, and as such, increases the risk for financial abuse and exploitation. The risk of falls among persons with dementia is greater, and following injury, persons with dementia are less likely to recover than other seniors (Allan LM, Ballard CG, Rowan EN, Kenny RA.

Incidence and prediction of falls in dementia: a prospective study in older people. PLoS ONE. 2009;4). Persons with dementia are at greater risk of burns due to hot water. Similarly, persons with dementia may exhibit aggressive behaviors towards themselves or others (Salzman C, Jeste D, Meyer RE, Cohen- Mansfield j, et.al. Elderly Patients with Dementia-Related Symptoms of Severe Agitation and Aggression: Consensus Statement on Treatment Options, Clinical Trials, Methodology and Policy.

J Clin Psychiatry 2008 June:69(6):889-898). These and other types of injuries are preventable through mitigating strategies, however, the risks must be identified. This quality measure requires screening for safety concerns in two risk domains: dangerousness to self/others and environment. Current treatment guidelines for the management of dementia recommend that healthcare providers screen for safety risks.

There are community and online resources to facilitate home safety. By routinely screening for safety issues, the clinician will also become increasingly more familiar with the range of problems identified, and thus be able to continuously improve the quality of care delivered.

Clinical Recommendations

The following clinical recommendation statements are quoted verbatim from the referenced clinical guidelines and represent the evidence base for the measure: • “Recommended assessments include evaluation of suicidality, dangerousness to self and others, and the potential for aggression, as well as evaluation of living conditions, safety of the environment, adequacy of supervision, and evidence of neglect or abuse (Category I).

Important safety issues in the management of patients with dementia include interventions to decrease the hazards of wandering and recommendations concerning activities such as cooking, driving, hunting, and the operation of hazardous equipment. Caregivers should be referred to available books [and other materials] that provide advice and guidance about maximizing the safety of the environment for patients with dementia…As patients become more impaired, they are likely to require more supervision to remain safe, and safety issues should be addressed as part of every evaluation.

Families should be advised about the possibility of accidents due to forgetfulness (e.g., fires while cooking), of difficulties coping with household emergencies, and of the possibility of wandering. Family members should also be advised to determine whether the patient is handling finances appropriately and to consider taking over the paying of bills and other responsibilities.

At this stage of the disease [i.e., moderately impaired patients], nearly all patients should not drive.” (1) For mild to moderate Alzheimer's disease “Assess for safety risks (e.g.

Implementation Notes

This measure contains one strata defined by a single submission criteria. This measure produces a single performance rate. For the purposes of MIPS implementation, this patient-process measure is submitted a minimum of once per patient during the performance period. The most advantageous quality data code will be used if the measure is submitted more than once.

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