Here we go again . . . on February 2, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a new QSO Memo, “Contingency Plans – State Survey & Certification Activities in the Event of Federal Government Shutdown” (QSO-26-04-ALL).
We’re all too familiar with these contingency plans given the government shutdown which occurred in late 2025. The guidance issued in this new QSO Memo is similar to the prior guidance, so we are updating our October 2025 shutdown-related posts with the current information below.
Excepted Medicare Functions During the Shutdown
CMS notes in the new QSO Memo that it considers several functions to be essential and should continue even during a federal government shutdown, so heads up that there are instances when you may get a visit from a surveyor.
Complaint Investigations where there is an Allegation of Harm or Immediate Jeopardy
- Complaints which are credible and have been triaged as allegations of harm or immediate jeopardy (IJ) will continue to be assessed and investigated according to usual protocols.
Certain Enforcement Actions
- For enforcement actions which result from complaint investigations where harm or IJ has been identified per the above, the State Agency should continue to act related to enforcement. This includes processing enforcement and transferring cases which require an Immediate Imposition of Federal Remedies.
Some Revisit Surveys
Revisit surveys which have been approved by exception and deemed necessary to prevent termination of a provider may be conducted by the State Agency, with approval, under certain conditions. The following conditions must be met for the State Agency to request approval for a revisit:
- The provider has alleged compliance and
- The revisit survey is needed to determine the provider’s compliance and prevent a scheduled Medicare termination or
- Prevent a statutorily-mandated (three-month) denial of payment for new admissions.
Immediate Threats to Life or Safety (Emergency or Natural Disasters)
- If there is an immediate threat to life or safety due to an emergency or natural disaster, the State Agency should take action to address/prevent further threats, even if the scenario doesn’t fit into one of the excepted categories for survey activity, such as if a PHE is declared.
- CMS locations which are operating related to this situation would continue operating in order to assist with emergency needs.
Voluntary Nursing Home Closure
- Routine monitoring and oversight by the SA to ensure the safe and orderly relocation of resident may continue in the event that a nursing home voluntarily closes.
Orderly Shutdown of Other Tasks
- Tasks which were started prior to January 30, 2026 where completion is necessary in order to ensure an orderly shutdown are allowed, so long as those tasks were completed within 4 hours of CMS notification to the SA that there would be a shutdown.
- Surveyors completed before the shutdown where the CMS-2567 has not been completed and that do not fit into the above categories should be held and not issued. Special instructions for issuring
Survey and Certification Activities Not Affected by a Federal Government Shutdown
The following S&C activities have been determined not to be impacted by the shutdown:
- State-funded surveys – Any states that use state-only funding for surveys can continue to do those
- Medicaid-only Facility Surveys – Medicaid funding is considered mandatory funding and remains available, so states may conduct surveys of facilities which only receive Medicaid.
- Hospice Surveys – Funding that was provided as part of the CAA Act of 2021 is considered mandatory, so these surveys may continue.
- CLIA S&C activities
- Performance under CMS or State Vendor Contracts which were awarded on or before January 31, 2026
Activities Prohibited During a Federal Government Shutdown
Although it remains to be seen how long the shutdown will last, there are a handful of routine S&C activities which would not fall into any of the other categories addressed in this Memo and therefore will not be performed during the shutdown. Here’s what to know:
- Standard Surveys – No Medicare-funded recertification surveys shall be performed.
- Processing of recently completed surveys where IJ or patient/ resident harm has not been identified should be held until funding is restored.
- Complaint Surveys for Medicare complaint investigations which do not rise to allegations of actual harm or immediate jeopardy are paused.
- MDS and OASIS activities are paused, except for anything required to ensure providers can report.
- IDRs/IIDRs cannot be conducted unless they are linked to the excepted complaint investigations indicated above where immediate adverse action needs to be taken against a provider during the shutdown.
- Some Revisit Surveys – The only authorized and execepted revisits are to:
- Ensure IJ or actual harm has been addressed
- Prevent termination within 45 days of the termination date
- Prevent mandatory DPNA within 15 days of imposition
- Note that desk revisits may be conducted for lower-level tags if needed to clear DPNA or mandatory termination
- Initial Surveys will not occur (unless meeting an exception above) and Initial Certification via Deemed Status activities will be paused.
- New CMP-funded Improvement Projects are also paused unless a CMS location has already provided approval.
- SMQT Training
- Processing of Certification Actions
