BriggsNetNews

In response to the government shutdown, CMS released Memo QSO 26-01-ALL dated today, October 1, 2025, which outlines guidance to State survey agencies (SAs) pertaining to which essential survey & certification functions can continue during this unique time.

Citing the need for “basic public protection,” the following survey activities can continue:

1. Complaints triaged as credible allegations of immediate jeopardy (IJ) or harm to an individual.
2. Enforcement actions that result from the above noted complaint surveys
   • if the surveys indicate a finding of immediate jeopardy or actual harm, or
   • here is a need to address a pending termination.
     
     Processing enforcement and transfer cases that meet the Immediate Imposition of Federal Remedies requirements as these remedies represent resident harm.
3. SA’s may request approval to conduct revisits for a provider or supplier that has:
   • alleged compliance with CMS requirements (pursuant to a prior determination of noncompliance) and when
   • The revisit survey is necessary to determine compliance and prevent the scheduled Medicare termination of a provider or supplier, and
   • The Medicare termination is likely to occur due to timing or specific circumstances.
4. Immediate Threats to Life or Safety (Emergencies and Natural Disasters): SAs 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 preceding categories.
5. Orderly Shutdown of Other Tasks: SAs may complete other tasks begun prior to September 30th, 2025, if such completion is necessary to ensure an orderly shutdown, provided that the tasks can be accomplished within four hours of CMS notification to the SA of a federal shutdown (e.g., completing the upload of completed surveys to the ASPEN and iQIES information system).

The following survey activities will NOT be performed during the shutdown:

1. Initial Surveys – (unless otherwise permitted with the allowed activities described above)
2. Initial Certification via Deemed Status – (e.g., compiling the documentation for an initial certification kit) for applicants to participate in Medicare who seek to demonstrate compliance via accreditation under a CMS-approved Medicare accreditation program.
3. Certain Complaint Investigations – (except as noted above for those alleging immediate jeopardy or actual harm to individuals)
4. MDS or OASIS – (no minimum data set (MDS) or OASIS activities should be conducted except those necessary to maintain provider reporting).
5. Informal Dispute Resolutions (IDRs) – (unless they are pursuant to the excepted complaint investigations noted above for which there is an immediate adverse action that will be taken against the facility or provider during the period of the shutdown),
6. New CMP-Funded Improvement Projects – (unless approval has already been granted by the CMS Location and no further federal action is required).

Should the Government shutdown continue beyond a few weeks, CMS has indicated they may provide further guidance to SAs.