In a memo released on Monday, the Centers for Medicare and Medicaid Services (CMS) answered 14 questions intended to help state survey agency directors and providers understand issues related to survey, enforcement, and certification activities impacted by the federal government shutdown.

CMS said they were responding “to questions we received from states and providers with regard to the manner in which survey, enforcement, and certification activities should accommodate the effects of the federal government shutdown that occurred from Oct. 1, 2025, through Nov. 12, 2025.”

The legislation that ended the shutdown expires on Jan. 30, 2026, under a so-called Continuing Resolution. So, naturally, one of the first questions centered on whether all survey, enforcement, and certification activities by states can continue from now until the funding deadline possibly hits again on Jan. 30.

CMS said yes, pointing out “there are no restrictions on activities to be conducted. States should resume all activities suspended during the shutdown. Additionally, Section 118 of Public Law 119-37 – allows for retroactive reimbursement for activities back to Oct. 1, 2025, [e.g., surveys, training, dispute resolution].”

Complaints Must Go to Feds

A second leading query was whether state work on complaints or state licensure recertification surveys completed during the shutdown would now have to be completed under federal oversight? Or can the states write an F-tag citation using the crosswalk?

CMS answered that if a state licensure recertification or lower-level complaint was investigated under state licensure, it will have to be repeated federally because licensure requirements vary by state.

“CMS does not crosswalk state licensure standards to federal Medicare/Medicaid law. For complaints that were conducted as part of excepted activities, the tags for those citations can be written as federal deficiencies.”

Another query focused on states not being able to conduct statutorily required nursing home or home health agency surveys, causing a lag in performance expectations. The question was, “Will CMS make adjustments to the state performance expectations for FY2026 to reflect these factors outside of state control?”

CMS answered in the affirmative, saying it would make adjustments and communicate with states in advance of finalizing such adjustments.

All of the Q&A is at Center for Clinical Standards and Quality.

Questions or comments? Contact Patrick Connole at pconnole@parkplacelive.com