On October 1, 2025, pursuant to the Federal Government shutdown, CMS released QSO- 26-01-ALL Contingency Plans – State Survey & Certification Activities in the Event of Federal Government Shutdown.
The memorandum outlined Medicare Survey activities that will continue during the Federal Government shutdown and those that are suspended.
Medicare Survey Activities that will continue during the federal government shutdown:
- Complaint Investigations Alleging Harm: Complaints that are triaged as credible allegations of immediate jeopardy (IJ) or harm to an individual.
- Certain Federal Enforcement Actions: Enforcement actions that result from surveys that indicate a finding of immediate jeopardy or actual harm or there is a need to address a pending termination. State survey agencies will continue to process enforcement that meet the Immediate Imposition of Federal Remedies requirements as these represent resident harm.
- Revisit Surveys Approved by Exception and Necessary to Prevent Termination: State Survey Agencies may request approval to conduct a revisit when:
- A provider or supplier has alleged compliance with CMS requirements (pursuant to a prior determination of noncompliance) and
- The revisit survey is necessary to determine compliance and prevent the scheduled Medicare termination of a provider, and
- The Medicare termination is likely to occur due to timing or specific circumstances.
- Immediate Threats to Life or Safety (Emergencies and Natural Disasters): State Survey Agencies should take action to prevent or mitigate any other immediate threats to the life or safety of a beneficiary even if the situation does not fit into any of the above categories, such as survey and certification activities that may be necessary during a declared public health emergency to prevent injury or harm to beneficiaries.
Activities Not Supported During a Federal Government Shutdown:
- Standard Surveys: No Medicare-funded recertification surveys including statutorily mandated surveys (NHs, HHAs).
- Certain Revisit Surveys: Revisits, including both onsite and desk revisits, that are not required to prevent termination of Medicare participation within the subsequent 45 days. Among those that should not be conducted are revisits (related to establishing regulatory compliance) that would end a per-day civil monetary penalty or denial of payment for new admissions.
- Certain Complaint Investigations: No Medicare complaint investigations should be performed, except those alleging immediate jeopardy or actual harm to individuals,
- MDS or OASIS: No minimum data set (MDS) or OASIS activities should be conducted except those necessary to maintain provider reporting.
- Informal Dispute Resolutions (IDRs): No IDRs or Independent IDRs should be conducted unless they are pursuant to the excepted complaint investigations for which there is an immediate adverse action that will be taken against the facility or provider during the period of the shutdown.
- New CMP-Funded Improvement Projects: No new improvement projects funded by collected civil monetary penalty funds should be implemented unless approval has already been granted by the CMS Location. Projects already approved by CMS are not affected and may continue, since such projects require no further federal action.
State Survey Agencies may complete other tasks that began prior to September 30th, 2025, provided that the tasks can be accomplished within four hours of CMS notification to the State Survey Agency of a federal shutdown (such as completing the upload of completed surveys to the ASPEN and iQIES information system). Surveys completed before the Federal Government shutdown that do not fit into the above noted categories, for which the written survey report Form CMS-2567) has not been completed prior to the orderly shutdown, will generally remain valid if completed after the shutdown.