The Centers for Medicare & Medicaid Services (CMS) will be making adjustments to the number of Federal Monitoring Surveys being completed in Fiscal Year (FY) 2026 as a result of the government shutdown at the beginning of the fiscal year during which surveys were not authorized.

CMS is statutorily required to complete federal monitoring surveys in “at least 5% of the number of skilled nursing facilities surveyed by the state in the year, but in no case less than five skilled nursing facilities in the state.” The agency will continue to meet these requirements but is adjusting the basis for calculating the required number of surveys in each state.

Fewer federal monitoring surveys will be conducted in FY26; however, at least five nursing homes in each state will be surveyed. Federal monitoring surveys will include both Resource and Support Surveys (RSS) and Health Comparative surveys. Life Safety Code / Emergency Preparedness federal monitoring surveys will additionally include desk audits. The CMS location will work with the state agency to identify nursing homes for surveys and will be focusing on nursing homes that provide good training opportunities. Priorities include those at risk for noncompliance, those with a history of noncompliance, those with allegations of noncompliance, CMS-specific concerns, and media attention. Health surveys will breakdown to 60% of federal monitoring surveys being conducted on complaint surveys and 40% being conducted on standard recertification surveys. For Life Safety Code / Emergency Preparedness, surveys will be split between 80% of surveys being completed on recertification surveys and 20% being completed on revisits.

Recall that while the purpose of the federal monitoring survey is to evaluate state agency performance, federal surveyors may cite noncompliance and may impose enforcement remedies in comparative surveys, including suspension of the nurse aide training and competence evaluation program (NATCEP).

More information, including actual numbers of surveys per state, can be found in CMS Administrative Information Memo 26-06-NH.