Long-Term Care Operations During Oct. 1, 2025, Federal Government Shutdown

Oct. 1, 2025, a U.S. federal government shutdown was announced. Nursing home operations are expected to continue operations with minimal immediate impact.

• QSO-26-01-ALL was published Oct. 1, 2025: https://www.cms.gov/files/document/qso-26-01-all.pdf

What to know:

• Medicare and Medicaid payments are considered mandatory spending and funding will continue.
• There will be administrative backlogs and delays due to staffing reductions at the Centers for Medicate & Medicaid Services that might be related to payments, waiver approvals, and technical assistance. Nursing home administrators and beneficiaries may have longer waiting times and difficulties reaching federal agencies for assistance because of reduced staffing.
• There will be limited Federal surveys and certifications for nursing homes, and the focus will be the most serious complaint investigations related to harm. Routine surveys, such as recertification surveys and inspections for less serious complaints, will be suspended for the duration of the shutdown.
• CMS will pause its oversight activities of major contractors.
• No IDRs or Independent IDRs should be conducted unless they are pursuant to the excerpt complaint investigations for which there is an immediate adverse action that will be taken against the facility or provider during the period of the shutdown.

Note the following:

Revisit Surveys Approved by Exception and Necessary to Prevent Termination: SA’s may request approval to conduct a revisit when:

(a) A provider or supplier has alleged compliance with CMS requirements (pursuant to a prior determination of noncompliance) and

(b) The revisit survey is necessary to determine compliance and prevent the scheduled Medicare termination of a provider or supplier, and

(c) The Medicare termination is likely to occur due to timing or specific circumstances.

Residential surveys and complaint investigations will continue.