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The Centers for Medicare & Medicaid Services instituted a partial hiring freeze in July, and a top official said state survey agencies could take a hit if Congress can’t reach a federal budget deal. 

CMS Administrator Chiquita Brooks-LaSure told participants at an event in Washington, DC, on Wednesday that the agency’s operations will be in peril if the fiscal standoff continues, news first reported by Politico, a media publication focused on Congress and federal agencies.

The federal government is moving closer toward a shutdown, after narrowly averting one last month. Lawmakers have until Nov. 17 to reach a deal, but once again, agencies are activating contingency plans and preparing to close down, if lawmakers can’t strike a broad deal or at least pass stop-gap, continuing resolutions to fund specific agencies. 

In September, CMS said that it had “sufficient funding” for Medicaid through the end of the year, due to its 2023 appropriations. At that time, the agency would not say if all of its operations would continue. McKnight’s Long-Term Care News attempted to reach CMS Friday, but there was no response with federal offices closed in observation of Veterans Day.

Politico reported that Jon Blum, principal deputy administrator for CMS, provided a statement that said state survey agencies “would likely not be able to complete all statutorily required nursing home surveys” if funds expire and the partial hiring freeze continues. The agency has been working to improve oversight of nursing homes and other facilities, the publication noted. 

But McKnight’s recently reported that year-end data for FY2023 for CMS shows that there has been little improvement in long-standing survey delays that were worsened by the pandemic. Nearly 30% of nursing homes have not had a recertification survey in more than 15 months, according to CASPER data captured between Oct. 1, 2022, and Sept. 30, 2023.

US Sen. Bob Casey (D-PA) issued a report in May that was severely critical of CMS’ survey system. The report from the Special Committee on Aging gathered 2,000 pages of documents and data on survey lapses and found 32 survey agencies had inspector vacancy rates of 20% or higher, with the highest in Kentucky, Alabama, and Idaho.

“The current funding uncertainty poses an immense threat to CMS and nursing home state survey agencies around the country,” Casey, who chairs the Special Committee on Aging, told McKnight’s in a statement Friday. “These critical agencies are already facing a crisis of understaffing and underfunding, and a hiring freeze extended by an unnecessary government shutdown would exacerbate a problem that is putting nursing home residents at risk.”

If the government does shut down at the end of this week, agencies will furlough staff unless they are deemed “essential.” Federal contractors would also cease work, although some may continue in essential roles.

Just as in October, it remains unclear what impact furloughs will have on CMS. Last month, the agency said that 49% of its staff – 3,236 employees – would be retained in roles that are already funded, are exempt, or are “deemed necessary.” Those roles were not defined in the agency’s contingency plan.