CMS Launches Risk-Based Survey Process for High-Performing Nursing Homes Nationwide
CMS announced July 16 nationwide implementation of a risk-based survey process for high-performing nursing homes, effective September 2026 following state agency training. Approximately 12% of nursing facilities will initially qualify based on criteria including five-star ratings, zero harm citations, and accurate data submission. Qualifying facilities receive streamlined recertification surveys and a new Care Compare icon, though state agencies retain authority to use traditional surveys when safety concerns arise. All nursing homes continue receiving surveys at least every 15 months regardless of performance tier.
Medicaid MCOs with nursing home contracts should monitor facility Care Compare ratings and RBS eligibility status, as streamlined surveys may affect oversight requirements and five-star facilities may gain competitive advantage in network adequacy and quality reporting.
Long-Term Care · LTSS · Managed Care
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