The Centers for Medicare & Medicaid Services (CMS) released
Admin Info Memo 26-06-NH on May 15, 2026, outlining Fiscal Year (FY) 2026 guidance for Federal Monitoring Surveys (FMS) in nursing homes. The memo details how CMS will oversee Long Term Care (LTC) Health, Emergency Preparedness (EP), and Life Safety Code (LSC) surveys conducted by federal surveyors. It also informs how CMS Locations will select facilities, conduct oversight activities, and issue State Reports, while also clarifying the reconsideration process for State Agencies (SAs).
CMS noted that the FY2026 calculation for the required number of LTC FMS Health and EP/LSC was adjusted by 10% due to the 2025 federal government shutdown that caused delays in travel and survey activity.
While this adjustment will result in a reduction in the total number of FMS conducted on skilled nursing facilities surveyed by States during the year, CMS will ensure that the statutory minimum requirements are met, surveying at least five skilled nursing facilities in each State, Puerto Rico, and Washington, D.C.
Three Types of Federal Monitoring Activities
- Resource and Support Surveys (RSS): Federal surveyors accompany SA surveyors to provide real-time guidance, education, and survey process support.
- Comparative Surveys: Federal surveyors conduct an independent survey within 60 days of the SA’s standard or complaint survey to determine whether deficiencies were appropriately identified and cited.
- EP/LSC Desk Audits: Federal surveyors conduct a desk audit after the SA completes a standard survey.
Enforcement
If deficiencies are identified during any FMS activity that requires facility action, the CMS Location will take appropriate enforcement action based on the survey findings.