Late last week, the Centers for Medicare and Medicaid Services (CMS) released an updated
QSO-26-03-NH on surveyor guidance. The updated memo primarily clarifies provisions in the State Operations Manual, specifically chapters 5 and 7, introduced previously in a January 30, 2026 memo. The updates will take effect on April 30, 2026.
KEY UPDATES FOR PROVIDERS- The updated memo clarifies the minimum amount of time survey teams are expected to be on-site on the first day of a survey.
- Survey teams are expected to remain in the facility after entrance for a minimum of five consecutive hours. The survey team may leave sooner if all required first-day activities have been completed or if there is an emergency.
- The memo provides updated guidance on the minimum number of consecutive days survey teams should remain onsite for both standard and abbreviated surveys.
- The first two days of a standard survey must be conducted on consecutive calendar days from the day of entrance.
- Abbreviated surveys must be conducted on two consecutive calendar days from the day of entrance. In addition, the surveyor/survey team should plan to be on-site for at least five hours after entry unless the investigation can be completed in less time.
- It also states that an abbreviated survey may be permitted on complaints received, a change in ownership, management, or other indicators of specific concerns.
These clarifications can be seen as helpful to prevent a situation where a survey is initiated on a date, but the surveyors do not return to continue or complete the survey until days later. This is often problematic for facilities.
CMS also noted in the memo that the
Civil Monetary Penalty (CMP) enforcement revisions will be reflected in the CMP Analytic Tool for all enforcement cycles starting on and/or after March 31, 2026, and that per-instance CMPs will be displayed on Nursing Home Care Compare beginning June 24, 2026. AHCA is seeking further information from CMS.
A revised webinar series is available on
ahcancalED with the updates from the latest memo included. The AHCA Regulatory Team will continue conducting a detailed review of all the updates, and questions should be sent to
regulatory@ahca.org.