On October 1, 2025, current funding for the federal government expired. As a result, funding for discretionary federal programs will not continue until Congress agrees on a funding extension. While some discussions are underway in Congress to pass a continuing resolution that would extend funding for discretionary programs, it is unclear when the House and the Senate will reach a consensus.
The impact of the funding expirations will affect federal programs deemed “non-essential,” meaning programs that do not have mandatory funding. Critical programs, including Medicare, Medicaid, and Social Security, have mandatory funding; however, the critical services that support these programs will still be impacted.
The Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have posted contingency plans for the shutdown, noting that nearly half of CMS will not be retained during the shutdown. The plan makes clear that the impact of a shutdown will be significant on nursing home survey and certification. The plan states:
“CMS survey and certification activities would focus on complaint investigations alleging the most serious incidents of resident or patient harm. Other survey activities, such as recertification surveys, initial surveys, and less serious complaint investigations, and all surveys by federal staff would be suspended.”
The suspension of recertification surveys puts residents at risk. According to data from CMS, 2,396 nursing homes, or 16.3% of all homes, have not undergone an annual survey in the past 18 months, outside the required 9-15 months. With recertification surveys stopped, this backlog will only increase, placing potentially hundreds of thousands of nursing home residents at heightened risk of harm. Importantly, complaint surveys will continue, however, focused on the most “serious” incidents.
