CMS Issues Updated Memo to Outline Contingency Plans During Government Shutdown

CMS; Regulations
 
Published:October 21, 2025
Hawley Hunt
​The Centers for Medicare and Medicaid Services (CMS) today issued an updated QSO memo detailing its contingency plans for operations during the continued federal government shutdown. The memo established that the activities, which are not allowed throughout the shutdown, are not legally authorized to be performed. 

Additional updates to the previously released memo include: 
  • Revisits to prevent DPNA: In addition to the previously announced allowable reasons for revisits, States should also conduct revisits to prevent a statutorily-mandated (three-month) denial of payment for new admissions (DPNA). 
  • Pending CMS-2567: Surveys completed before the Federal Government shutdown that do not fit into the excepted work categories, for which the CMS-2567 has not been completed prior to the orderly shutdown, should be held and not issued, and will generally remain valid if completed after the shutdown. CMS will issue special instructions for the completion of such reporting in the future.  
  • Standard Surveys: Any processing of recently completed surveys where immediate jeopardy or patient/resident harm has not been identified should be held until funding is restored.  
  • Certain Revisit Surveys: The only authorized and excepted revisits are those necessary to 1) ensure that immediate jeopardy or actual patient/resident harm has been addressed, 2) to prevent termination of Medicare participation within 45 days of the termination date, or 3) prevent mandatory denial of payment for new admissions within 15 days of imposition. A revisit for any other reason is not authorized or accepted. CMS will issue instructions on how those situations will be handled once the shutdown ends. SAs may remove any enforcement remedies, as appropriate, as a result of an excepted revisit. 
  • Initial Surveys: No Medicare initial surveys shall be performed unless otherwise permitted with the allowed activities outlined in the QSO. For example, Medicaid-only surveys may continue upon consultation with the State Medicaid Agency. 
  • Initial Certification: States shall not conduct any initial surveys or take any action on initial certification kits (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.  
  • Certain Complaint Investigations: No Medicare complaint investigations should be performed, except those alleging immediate jeopardy or actual harm to individuals, as noted in the QSO.  All intakes with federal allegations are still required to be entered into the federal information systems. 
  • State-funded surveys may be continued, but they cannot be assumed to count as federal surveys during the lapse in appropriations. 
  • States should continue investigating complaints and facility-reported incidents, which allege harm. 
    • In the event a facility is cited with a harm-level citation, States should issue a Form CMS 2567 to the provider and conduct any necessary revisits to ensure the deficiencies are addressed immediately. 
  • If a nursing home voluntarily closes, the State must ensure a safe relocation of the nursing home residents. 
  • Any provider enrollment activities, including initial surveys and surveys needed for a change of ownership (CHOW), should not be conducted until the shutdown has ended.  
  • Regardless of funding, contractors may not perform federal work that is otherwise prohibited as non-expected activities. 
Information on the previously released memo can be found here. A full table outlining the contents of the memo is provided here. 

For any questions, please email regulatory@ahca.org.