On February 2, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a memorandum outlining contingency plans for state survey and certification (S&C) activities during a federal government shutdown. The memorandum is effective as of January 31, 2026, and remains in effect for the duration of the shutdown.
CMS explains that only survey and certification activities necessary to protect human life or safety may continue during a lapse in federal funding. All other Medicare-funded survey and certification activities are temporarily suspended unless specifically identified as allowable.
According to CMS, certain activities are not affected by the shutdown because they are supported by mandatory or non-federal funding. These include CLIA surveys funded through user fees; hospice surveys funded through the Consolidated Appropriations Act of 2021; state-funded licensure surveys; surveys of Medicaid-only facilities; and work performed under CMS or state contracts awarded and funded on or before January 31, 2026, provided the work does not involve otherwise prohibited activities.
CMS considers some Medicare survey and certification functions essential and has authorized them to continue during the shutdown. These include complaint investigations and facility-reported incidents alleging immediate jeopardy or actual harm, along with any necessary enforcement actions and revisits to ensure prompt correction of deficiencies. Revisit surveys may also occur by exception when necessary to prevent termination of Medicare participation or a mandatory denial of payment for new admissions. CMS also allows state survey agencies to respond to emergencies or other immediate threats to life or safety, and to oversee voluntary nursing home closures to ensure the safe and orderly relocation of residents.
All other Medicare survey and certification activities are suspended for the duration of the shutdown. CMS confirms that routine recertification surveys, initial Medicare surveys and certifications (including deemed status), non–immediate jeopardy complaint investigations, and most revisit surveys will not be conducted. Informal Dispute Resolutions (IDRs) are also suspended unless tied to an excepted complaint investigation that will result in an immediate adverse action during the shutdown. Routine Medicare provider certification actions, such as changes of ownership or changes in location, will not be processed until funding is restored.
CMS notes that surveys completed prior to the shutdown that do not involve immediate jeopardy or actual harm, and for which the Form CMS-2567 has not been finalized, should be held until further instruction is provided. CMS may issue additional guidance if the shutdown continues, including instructions related to survey timelines.
The memorandum is available here.
Compliance Perspective
Issue
On February 2, 2026, CMS issued memorandum QSO-26-04-ALL outlining contingency plans for state survey and certification activities during a federal government shutdown, effective as of January 31, 2026. The guidance clarifies which survey and enforcement activities may continue to protect resident health and safety, and which routine Medicare survey and certification functions are suspended for the duration of the shutdown. Providers should remain aware of these limitations and continue to focus on internal compliance efforts to support ongoing survey readiness.
Discussion Points
- Although most routine Medicare survey activity is suspended during the shutdown, complaint investigations involving immediate jeopardy or actual harm may still occur. Facilities should review policies and procedures related to high-risk areas, prior survey findings, and existing Plans of Correction to ensure they remain current and effectively implemented. This is also a good time to work with a consultant to conduct targeted policy or process reviews and strengthen compliance in areas most likely to draw regulatory scrutiny.
- Educate staff about the current limitations on survey activity and emphasize that core expectations around compliance and quality remain unchanged. Med-Net Academy offers the course Long-Term Care Survey Process, which reviews entrance protocols, sample selection, survey phases, both mandatory and triggered facility tasks, and the purpose and scope of Survey Pathways (formerly Critical Element Pathways). This training helps staff understand the survey process in detail and supports ongoing preparedness and quality improvement efforts.
- Use this period to conduct focused audits or reviews in priority areas. While many survey functions are on hold, facilities can benefit from proactive evaluations tied to recent citations or QAPI findings. A mock survey can help identify gaps, and engaging a consultant can help structure these reviews and ensure findings are addressed promptly before full survey activity resumes.
*This news alert has been prepared by Med-Net Concepts, Inc. for informational purposes only and is not intended to provide legal advice.*