In a newly updated memo to state survey agency directors, the Centers for Medicare and Medicaid Services (CMS) on Tuesday clarified what work can and cannot be performed during the current federal government shutdown, spelling out in more blunt language that there is a narrow window of activities permitted.

“In this memorandum we identify functions that (a) are not affected by a Federal shutdown, (b) excepted functions that are to be continued in the event of a shutdown [also referred to as “essential functions”], and (c) other activities that are directly affected, are not legally authorized to be performed, and therefore should not be operational during a Federal shutdown,” CMS said.

Important to SNFs, the memo said while state licensure surveys can continue, they do not count as federal surveys. “The lapse in appropriations does not impact state work for those states that are completing licensure surveys. However, those licensure surveys may not be assumed to count as federal surveys during the period of the lapse in appropriations,” CMS said.

Under the subtitle, “Excepted Medicare Functions During the Shutdown,” the memo spells out that during a lapse in appropriation, “it is not legal for CMS or States [acting on CMS’ behalf] to carry out federal survey and certification activities beyond those deemed to be ‘excepted activities.’ Excepted activities are those related to the safety of human life or protection of property. If States carry out non-excepted functions under the auspices of the State Government, they should not represent these as Federal Survey and Certification activities.”

In a listing of what state Medicare activities the agency considers to be “Excepted Work,” or essential activities that should continue during a federal government shutdown, the memo said state agencies can skip one step when conducting “Complaint Investigations and Facility Reported Incidents Alleging Harm.”

“Complaints that are triaged as credible allegations of immediate jeopardy (IJ) or harm to an individual should continue to be assessed and investigated according to standard CMS protocols except that, for the duration of any Federal Government shutdown, it is not necessary for SA’s to obtain prior CMS Location approval to conduct a complaint investigation for a deemed provider or for an EMTALA survey [approval is normally required],” the memo said.

Revisions to prior guidance were also made to “Activities Prohibited During a Federal Government Shutdown.”

This list includes standard surveys, certain revisit surveys, and initial surveys, among others. For complete information, read the memo at QSO-26-01-ALL REVISED 2025-10-01.

Questions or comments, contact Patrick Connole at pconnole@parkplacelive.com.