On January 13, 2026, the Centers for Medicare & Medicaid Services (CMS) released the annual State Performance Standards System (SPSS) Guidance for Fiscal Year (FY) 2026. The SPSS is the metric by which state survey agency performance is measured across CMS-certified settings and contains 10 measures for FY 2026. State survey agencies are scored as having “Met” or “Not Met” measures and must submit corrective action plans for any “Not Met” measures. Notably returning for FY 2026 is the “Nursing Home Recertification Survey Composite” measure, introduced in FY 2025 and comprised of six sub-measures:

• Number of Deficiencies per 1,000 Beds
• Percentage of Deficiency-Free Surveys
• Percentage of Surveys Identifying G, H, or I Scope and Severity
• Percentage of Surveys Identifying J, K, or L Scope and Severity
• Percentage of Surveys where 1 or more Mandatory Tasks Not Investigated
• Percentage of Surveys where 1 or more Triggered Tasks Not Investigated

While CMS explicitly states that this measure “is not an attempt to establish deficiency or investigation quotas,” it seems unlikely that the measure does not illicit such perceptions among state surveyors, particularly when the state survey agencies will be required to review data and “explore with CMS potential underlying reasons for a lower composite score and, if necessary, strategies to improve its performance on these measures in the future.”

At this time, no data is available to determine the impact of this measure on survey behaviors in FY 2025, as the FY 2025 SPSS results will not be publicly released until spring / summer 2026 and the Quality, Certification, and Oversight Reports (QCOR) website has still not been updated since the July 2025 transition of the long-term care survey process from QIES to iQIES.

LeadingAge will be evaluating this data once it becomes available and determining next steps.