Medicare Starts a New Risk-Based Nursing Home Inspection System This Week, With a Care Compare Label Coming September 30

The Centers for Medicare and Medicaid Services is rolling out its risk-based survey approach for nursing homes nationwide, beginning September 8, 2026. The new system adjusts inspection frequency and depth based on each facility's recent performance record, directing more intensive reviews to lower-rated facilities while streamlining inspections at consistently high-performing ones.

To qualify for the shortened inspection, a nursing home must meet four criteria each quarter: a five-star overall rating on Medicare's Care Compare website, accurate data submissions to CMS, no citations from its most recent survey indicating harm or substandard quality of care, and no recent ownership changes. CMS estimates that roughly 12 percent of nursing homes in the country will qualify at any given time.

Facilities that meet those standards will undergo a streamlined on-site review conducted with fewer surveyors and covering fewer areas than the full standard inspection process. CMS described the rationale as freeing state inspection agencies to direct more time to facilities where residents may face greater safety risk.

Starting September 30, 2026, CMS will mark qualifying facilities with a dedicated icon on the Nursing Home Care Compare tool at Medicare.gov, allowing families, residents, and caregivers to identify those designations when comparing nursing home options in their area.

The policy was detailed in a CMS quality, safety, and oversight memorandum (QSO-26-14-NH) released on July 16, 2026. State agencies completed training for the new approach throughout August and September in preparation for this week's national launch.