CMS Announces Launch of NH Risk Based Surveys Nationwide!
On July 16, the Centers for Medicare and Medicaid Services (CMS) released the long-awaited guidance on the Nursing Home Risk-Based Survey (RBS) National Implementation. Expanding RBS was one of AHCA’s key recommendations to CMS in how to rationalize the regulatory environment, a pillar of AHCA’s Better Way agenda.
This announcement is a result of ongoing advocacy efforts with the Administration and will make a dramatic difference by helping to reduce staff burden, survey backlog, and incentivize high-quality care. CMS plans to implement the nationwide RBS on September 8, 2026. Currently, about 12% of all nursing facilities nationwide will qualify for the new RBS survey process.
See QSO-26-14-NH and the announcement from CMS for more information.
Here’s a brief overview:
How It Will Work
CMS began a pilot program of the RBS in 2023. The agency noted in the memo that the goal of RBS is to improve the effectiveness and efficiency of nursing home oversight to protect residents’ health and safety. It also notes that the RBS will allow the agency to focus less survey resources on facilities that continue to excel at providing quality care.
The QSO memo provides the current number and percentage of nursing facilities that qualify under the current RBS criteria in each state (Washington 38 of 193=19.3% qualify), along with the number of facilities that do not qualify and the reasons for their exclusion. Again, about 12% of all nursing facilities nationwide will qualify for the new RBS survey process.
At the end of each quarter, CMS plans to provide State Agencies with a list of RBS-qualified facilities. The list of qualifying nursing homes, each quarter, will be made publicly available on CMS’s Provider Data Catalog and the Nursing Home Care Compare website beginning September 30, 2026. To identify the higher-performing facilities that qualify for the RBS, CMS will include an icon (a gold trophy) on the facility’s Care Compare site to recognize such facilities.
Examples of reasons why a facility would not qualify for an RBS include:
- Less than a 5-Star Overall Rating
- Less than 3-star Staffing Rating
- Any citation(s) for Actual Harm, or Immediate Jeopardy (IJ), or Substandard Quality of Care (SQC) in the last survey cycle (the last standard survey and any complaint investigations in the last year)
- More than 18 months without a standard survey
- Any staffing waivers in effect
- Failed Payroll-Based Journal (PBJ) staffing data audit
- Failed resident assessment Minimum Data Set audit (MDS)
- Health Inspection Score higher than the 50th percentile in the state (lower scores indicate better performance)
- Two or more residents aged 65 or older who are coded with a diagnosis of schizophrenia after being admitted without this diagnosis
- A change in ownership since the last standard survey
- Special Focused Facility Candidate
More information on webinars and additional member materials from AHCA will be made available soon. If you have questions, please contact Elena Madrid (Co-Chair of the AHCA Survey/Regulatory Committee) or you can reach out to [email protected].
