To prevent issues with access to nursing home care during the federal government shutdown, LeadingAge in an October 15, 2025 letter to the Centers for Medicare and Medicaid Services (CMS) requests the agency temporarily revise enforcement. During the federal government shutdown, survey and certification activities, including those needed to end certain enforcement remedies, have been largely suspended.  With end date to the shutdown in sight, and anticipated backlogs in survey once activities resume, the implications of these policies could be far-reaching.