CMS Releases the FY26 Mission and Priority Document
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.
- 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.
- Tier 2 requires states to maintain the 12.9-month average for nursing home recertification and prioritizes initial certifications if applications have been pending for more than 150 days without a deeming option, or when CMS determines there is an access-to-care issue.
- Tier 3 applies to Medicaid-only nursing homes and other initial certifications not included in Tiers 1 or 2.
