On October 1, 2025, the CMS Center for Clinical Standards and Quality issued a memorandum outlining its contingency plans regarding state survey and certification activities in light of the federal government shut down. The memo sets out which activities will and will not be affected by the shutdown.
The following activities will remain fully functional during the shutdown:
- Clinical Laboratory Improvement Amendments (CLIA) Survey and Certification activities continue despite the government shutdown because it is funded directly through user fees.
- CMS or state vendor contracts that were fully awarded and funded on or before September 30, 2025 will not be impacted, but if a contractor’s current contract funding expires, the contractor shall refer to its specific contractual “stop work” provisions and reach out to its Government Contracting Official.
- State-funded surveys will continue.
- Surveys of Medicaid-only facilities depend on the length of the government shutdown, as the first quarter of Medicaid funding is not impacted. CMS suggests that state survey agencies continue to communicate with their state Medicaid agency regarding the availability of Medicaid funds.
- Hospice surveys funded through the Consolidated Appropriations Act (CAA) of 2021 continue despite the shutdown because the CAA is considered mandatory.
- Investigations into complaints that are triaged as containing credible allegations of immediate jeopardy or harm to an individual shall continue, but state agencies need not obtain prior CMS approval to conduct a complaint investigation for a deemed provider.
- Enforcement activities resulting from surveys mentioned above continue if the surveys indicate a finding of immediate jeopardy or actual harm, if there is a need to address a pending termination, or if the case meets the Immediate Imposition of Federal Remedies requirements.
- State survey agencies may request approval to conduct a re-visit survey if the following three requirements are met:
- A provider or supplier has alleged compliance with CMS requirements (pursuant to a prior determination of noncompliance);
- The re-visit survey is necessary to determine compliance and prevent the scheduled Medicare termination of a provider or supplier; and
- The Medicare termination is likely to occur due to timing or specific circumstances.
- Any action that is needed to prevent or mitigate any other immediate threats to the life or safety of a beneficiary that does not fit into the preceding categories will continue, such as any necessary survey and certification activities during a declared public health emergency that would be needed to prevent injury or harm to beneficiaries.
- State survey agencies may complete tasks that began before September 30, 2025, if completion of those activities is necessary to ensure an orderly shutdown only if the tasks can be accomplished within 4 hours of CMS notification to the state survey agency of a federal shutdown.
In addition to the above, CMS indicates that States should maintain the infrastructure capabilities to support complaint investigations, enforcement, and survey information system entries for Medicare activities that are authorized by the memorandum.
Any survey and certification functions that are normally conducted on CMS’s behalf that do not fall into one of the above categories shall not be performed during the government shutdown. Examples of activities that will not be performed during the shutdown include:
- Medicare-funded recertification surveys, including statutorily mandated surveys (except for hospice surveys as discussed above).
- Re-visits that are not required to prevent termination of Medicare participation within the subsequent 45 days.
- Medicare initial surveys, unless otherwise permitted, in connection with the allowed activities described above.
- Any action on initial certification kits for applicants to participate in Medicare who seek to demonstrate compliance via accreditation under a CMS-approved Medicare accreditation program.
- Medicare complaint investigations, except those alleging immediate jeopardy or actual harm to individuals or as permitted above.
- Minimum data set or OASIS activities, except those necessary to maintain provider reporting.
- Any Informal Dispute Resolutions (IDRs) or Independent IDRs unless pursuant to the excepted complaint investigations noted above for which there is an immediate adverse action that will be taken against the facility or provider during the period of the shutdown.
- Any new improvement project funded by civil monetary penalties unless approval has already been granted by CMS.
CMS will provide further instructions or special provisions should the shutdown persist for more than a few weeks. For more information regarding the specific CMS Survey & Operations Group Leadership points of contacts, please refer to the full CMS memorandum here.
