Could risk-based nursing home surveys finally provide some relief from the pressures of the survey process? The Centers for Medicare & Medicaid Services (CMS) seems to think so. In September 2026, CMS began implementing a new approach to surveying higher-performing nursing homes. The goal is to reduce survey time and allow state agencies to focus their resources where they are needed most. Sounds promising, doesn’t it? However, not everyone is convinced.

According to McKnight’s Long-Term Care News, the new process could ease some survey pressure. However, backlogs remain a concern. CMS estimates that approximately 12% of nursing homes will initially qualify for the new process. These communities must meet specific criteria, including a five-star overall rating and a history of compliance. Additionally, surveys will take less time and require fewer surveyors. The hope is that this will free up resources to address facilities with greater concerns.

I have to say, the thought of a more efficient survey process sounds wonderful. After all, we know how stressful surveys can be for our communities. However, does a shorter survey necessarily mean less oversight? Or could it allow surveyors to spend more time where problems actually exist?

Of course, there are those who question the new approach. As McKnight’s reports, advocacy groups have raised concerns about the legality of the process and its potential impact on residents. They question whether shorter surveys will identify problems that might otherwise go unnoticed. Meanwhile, CMS maintains that the process will continue to identify noncompliance and protect residents.

Adding to the discussion, the Long Term Care Community Coalition recently released a report examining nursing home oversight and enforcement. According to its Accountability Gap study, financial penalties declined approximately 55% between 2022 and 2024. The report also found that surveyors classified approximately 94% of health deficiencies below the level of actual harm. Those are interesting numbers, aren’t they? The organization questions whether current enforcement practices adequately address violations of federal requirements.

And just when you think the regulatory picture couldn’t get more complicated, another legal challenge enters the conversation. A nursing home has taken its fight over CMS’s authority to impose penalties to the Supreme Court. This raises another question about how federal oversight and enforcement may evolve. Clearly, the discussion surrounding nursing home regulation is far from over.

So, where does this leave our communities? On one hand, risk-based nursing home surveys could provide much-needed relief for consistently high-performing facilities. On the other hand, we certainly don’t want important concerns to be overlooked. There has to be a balance between meaningful oversight and allowing staff to focus on caring for residents.

Maybe I’m being optimistic, but I would like to believe we can accomplish both. After all, isn’t the goal to provide quality care without unnecessary regulatory burdens? Regardless of how the survey process changes, our responsibility to residents remains the same. Keep doing the right things, document your care, and remember that quality doesn’t begin or end with a survey.

Stay well and stay informed!