CMS Releases the FY26 Mission and Priority Document
9/29/2025
The Centers for Medicare & Medicaid Services (CMS) released the Fiscal Year (FY) 2026 Mission and Priority Document (MPD),
which is issued annually to direct and prioritize the agency’s work for
the year. The document reflects regulatory changes, budget adjustments,
new initiatives, and statutory requirements. It outlines survey,
certification, enforcement, and Medicare funding allocations for states,
while also providing background information on certified provider and
supplier types, as well as accreditation and deeming surveys. Survey
activities must be scheduled and conducted according to the priority
tier structure set forth in the MPD. These four tiers reflect statutory
mandates and program emphasis, with Tier 1 representing the highest
priority and Tier 4 representing the lowest.
Survey
activity remains central to CMS oversight, and the agency continues to
emphasize a tiered survey prioritization structure to ensure resources
are focused where they are most needed.
Under
Tier 1, nursing homes must receive a standard recertification survey no
later than every 15.9 months, with a national goal of maintaining a
12.9-month average between surveys. States are also required to conduct
at least 10 percent of surveys “off-hours,” with at least half of those
completed on weekends. Special Focus Facilities (SFFs) must be surveyed
at least once every 186 days.
For
Intermediate Care Facilities for Individuals with Intellectual
Disabilities (ICFs/IID), CMS has reinforced similar expectations. These
facilities must also adhere to the 15.9-month maximum interval between
surveys, with a statewide average of 12.9 months or less. Initial
certifications for ICFs/IID fall under Tier 3 and are scheduled based on
state priority.
CMS
continues to strengthen regulatory compliance and quality improvement
efforts. The agency is reinforcing timely survey practices, particularly
for Special Focus Facilities.
In
addition to survey requirements, CMS discussed new initiatives designed
to modernize oversight and address ongoing staffing challenges.
One
of the most significant is the continuation of Risk-Based Survey (RBS)
testing, a pilot program that focuses resources on higher-performing
nursing homes. Facilities that consistently demonstrate strong quality
performance may receive a more targeted survey, which is intended to
improve efficiency while still ensuring compliance with health and
safety standards.
Another
major initiative is the Nursing Home Staffing Campaign, supported by a
$75 million investment. According to the memo, this campaign aims to
raise awareness of career opportunities in nursing homes, provide
tuition reimbursement and stipends, and work with states to expand Nurse
Aide Training and Competency Evaluation Programs (NATCEPs). By reducing
barriers to workforce entry, CMS hopes to expand the pipeline of
certified nurse aides available to nursing homes.
Questions about this memo can be sent to regulatory@ahca.org.