Admin Info: 26-06-NH | May 15, 2026
The Centers for Medicare & Medicaid Services (CMS) released Admin Info: 26-06-NH on May 15, 2026, outlining guidance for Fiscal Year (FY) 2026 Federal Monitoring Surveys (FMS) for nursing homes. The memo explains how CMS Location staff will conduct monitoring activities related to long-term care health surveys, Emergency Preparedness (EP), and Life Safety Code (LSC) survey activity.
Federal Monitoring Surveys, referred to in statute as validation surveys, are designed to evaluate the effectiveness and consistency of state survey agency performance. These activities help CMS determine whether state survey findings are being appropriately identified, cited, documented, and followed through during the survey process.
CMS notes that, due to the federal government shutdown from October 1, 2025, through November 12, 2025, the basis for calculating the required number of FY 2026 FMS activities will be reduced by approximately 10 percent. However, CMS will continue to meet the statutory minimum requirement of surveying at least five skilled nursing facilities in each state, including Puerto Rico and Washington, D.C.
The memo outlines three primary monitoring activities:
- Resource and Support Surveys (RSS): Federal surveyors accompany state surveyors during standard, complaint, or revisit surveys to observe survey performance and provide real-time education, guidance, technical assistance, and support.
- Comparative Surveys: Federal surveyors conduct an independent survey in the same facility following a state survey to evaluate whether deficiencies were appropriately identified and cited. These surveys should generally be conducted within 60 calendar days of the original state survey exit date.
- EP/LSC Desk Audits: CMS will continue to use desk audits to review state agency performance related to the correction of EP and LSC findings. These audits include review of the Form CMS-2567, the accepted Plan of Correction, and evidence of compliance obtained through an offsite revisit when applicable.
The memo also clarifies that FMS selection may prioritize providers based on data indicating risk of noncompliance, a history of noncompliance, allegations of noncompliance, CMS Location-specific concerns, media attention, or other justifications. For providers, this is an important reminder that facilities with elevated risk indicators or significant survey history may be more likely to experience additional federal oversight of the survey process.
Although FMS activities are primarily intended to evaluate state survey agency performance, the facility impact can be significant. CMS states that Federal Comparative survey findings may confirm deficiencies identified by the state or identify additional deficiencies that directly affect the facility's compliance status and potential enforcement exposure. When a Federal Comparative Form CMS-2567 identifies deficiencies requiring facility action, CMS will impose remedies according to current enforcement protocols. If substandard quality of care is identified during a Comparative survey, loss of the Nurse Aide Training and Competency Evaluation Program (NATCEP) will occur.
For EP and LSC compliance, the desk audit process reinforces the importance of clear, complete Plans of Correction and defensible evidence of compliance. Facilities should ensure that corrective actions are specific, sustainable, and supported by documentation that demonstrates the facility has returned to compliance and can maintain compliance going forward.
For nursing home leadership teams, the memo is a reminder that survey readiness must extend beyond the annual survey window. Facilities should maintain strong documentation practices, validate that Plans of Correction are complete and sustainable, and ensure Emergency Preparedness and Life Safety Code compliance activities are current and well supported.
Because Federal Monitoring Surveys may confirm or identify additional deficiencies, leaders should view this guidance as another reason to keep compliance practices survey-ready every day. Consistent documentation, complete corrective action follow-through, and well-supported evidence of compliance help protect the facility's regulatory position and reduce avoidable enforcement risk.
Source: CMS Admin Info: 26-06-NH, Guidance for Federal Monitoring Surveys (FMS), May 15, 2026. https://www.cms.gov/files/document/admin-info-26-06-nh-original-release-date-2026-05-15.pdf
Admin Info: 26-06-NH | May 15, 2026
The Centers for Medicare & Medicaid Services (CMS) released Admin Info: 26-06-NH on May 15, 2026, outlining guidance for Fiscal Year (FY) 2026 Federal Monitoring Surveys (FMS) for nursing homes. The memo explains how CMS Location staff will conduct monitoring activities related to long-term care health surveys, Emergency Preparedness (EP), and Life Safety Code (LSC) survey activity.
Federal Monitoring Surveys, referred to in statute as validation surveys, are designed to evaluate the effectiveness and consistency of state survey agency performance. These activities help CMS determine whether state survey findings are being appropriately identified, cited, documented, and followed through during the survey process.
CMS notes that, due to the federal government shutdown from October 1, 2025, through November 12, 2025, the basis for calculating the required number of FY 2026 FMS activities will be reduced by approximately 10 percent. However, CMS will continue to meet the statutory minimum requirement of surveying at least five skilled nursing facilities in each state, including Puerto Rico and Washington, D.C.
The memo outlines three primary monitoring activities:
- Resource and Support Surveys (RSS): Federal surveyors accompany state surveyors during standard, complaint, or revisit surveys to observe survey performance and provide real-time education, guidance, technical assistance, and support.
- Comparative Surveys: Federal surveyors conduct an independent survey in the same facility following a state survey to evaluate whether deficiencies were appropriately identified and cited. These surveys should generally be conducted within 60 calendar days of the original state survey exit date.
- EP/LSC Desk Audits: CMS will continue to use desk audits to review state agency performance related to the correction of EP and LSC findings. These audits include review of the Form CMS-2567, the accepted Plan of Correction, and evidence of compliance obtained through an offsite revisit when applicable.
The memo also clarifies that FMS selection may prioritize providers based on data indicating risk of noncompliance, a history of noncompliance, allegations of noncompliance, CMS Location-specific concerns, media attention, or other justifications. For providers, this is an important reminder that facilities with elevated risk indicators or significant survey history may be more likely to experience additional federal oversight of the survey process.
Although FMS activities are primarily intended to evaluate state survey agency performance, the facility impact can be significant. CMS states that Federal Comparative survey findings may confirm deficiencies identified by the state or identify additional deficiencies that directly affect the facility's compliance status and potential enforcement exposure. When a Federal Comparative Form CMS-2567 identifies deficiencies requiring facility action, CMS will impose remedies according to current enforcement protocols. If substandard quality of care is identified during a Comparative survey, loss of the Nurse Aide Training and Competency Evaluation Program (NATCEP) will occur.
For EP and LSC compliance, the desk audit process reinforces the importance of clear, complete Plans of Correction and defensible evidence of compliance. Facilities should ensure that corrective actions are specific, sustainable, and supported by documentation that demonstrates the facility has returned to compliance and can maintain compliance going forward.
For nursing home leadership teams, the memo is a reminder that survey readiness must extend beyond the annual survey window. Facilities should maintain strong documentation practices, validate that Plans of Correction are complete and sustainable, and ensure Emergency Preparedness and Life Safety Code compliance activities are current and well supported.
Because Federal Monitoring Surveys may confirm or identify additional deficiencies, leaders should view this guidance as another reason to keep compliance practices survey-ready every day. Consistent documentation, complete corrective action follow-through, and well-supported evidence of compliance help protect the facility's regulatory position and reduce avoidable enforcement risk.
Source: CMS Admin Info: 26-06-NH, Guidance for Federal Monitoring Surveys (FMS), May 15, 2026. https://www.cms.gov/files/document/admin-info-26-06-nh-original-release-date-2026-05-15.pdf
