Mission & Priority Information

To ensure health care providers and facilities nationwide meet basic quality standards, the Centers for Medicare & Medicaid Services (CMS) relies on survey and certification efforts to provide onsite, objective and outcome-based verification conducted by knowledgeable and trained individuals.

When standards are met, facilities maintain their certification. When regular surveys or complaint investigations identify problems, CMS has the authority to implement prompt and effective solutions to protect patient safety. 

Our Reach

• Over 400,000 providers, suppliers, and laboratories are subject to survey and certification 
• Approximately 40,000 initial and recertification surveys conducted each year
• Over 70,000 onsite complaint investigations are conducted each year 

The Survey & Certification program covers a wide range of health care settings, including: 

• Ambulatory Surgical Centers (ASCs)
• Clinical Laboratories
• Community Mental Health Centers (CMHCs)
• Comprehensive Outpatient Rehabilitation Facilities (CORF)
• Critical Access Hospitals (CAHs)
• End Stage Renal Disease (ESRD) Facilities
• Federally Qualified Health Centers (FQHCs)
• Home Health Agencies (HHAs)
• Hospices
• Hospitals
• Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)
• Nursing Homes / Long Term Care (LTC)
• Organ Procurement Organizations (OPO)
• Organ Transplant Programs
• Outpatient Physical Therapy and Speech-Language Pathology Services (OPT/SLP)
• Portable X-Ray Suppliers
• Psychiatric Hospitals
• Psychiatric Residential Treatment Facility (PRTF) Providers
• Religious Nonmedical Healthcare Institutions (RNHI)
• Rural Emergency Hospitals (REHs)
• Rural Health Clinics (RHCs)

CMS accomplishes quality assurance functions under the Social Security Act (the Act) and the Public Health Service Act (for clinical laboratories), working jointly with SAs, Accrediting Organizations (AOs), and contracts with qualified organizations. 

The Act mandates the establishment of minimum health and safety standards that must be met by participating providers and suppliers.  When significant problems are determined, CMS has legislative authority to impose remedies on the provider or supplier. 

If a provider or supplier fails to implement appropriate remedial actions for serious deficiencies, CMS can terminate their Medicare (and Medicaid, when applicable) provider agreements or supplier approval, which also ends federal funding. 

For clinical laboratories, failure to correct issues may also result in sanctions, like revoking their Clinical Laboratory Improvement Amendments (CLIA) certificate. Once revoked, the laboratory can no longer perform any human specimen testing.

The Secretary of the Department of Health and Human Services (DHHS) designated CMS to carry out the survey and certification functions through agreements with States, territories, and the District of Columbia. State operations are supported by Congressionally-appropriated Federal Hospital and Supplementary Medical Insurance Trust Funds (Medicare) and matching Federal grants (Medicaid). Refer to Section 1864 of the Act for more details about how these agreements are authorized and funded. 

CMS is responsible for supporting the States as they administer these functions, including:

• Setting policy and providing policy interpretations on certification program standards.
• Consulting with agencies administering Federal requirements.
• Managing costs associated with SA functions. 
• Funding allowable State costs once submitted for payment.  
• Managing Federal trust funds and grants for Medicare (Title XVIII) and Medicaid (Title XIX) program administration.
• Training and qualifying Federal and State personnel to conduct Medicare and Medicaid surveys and provider certification.