CMS Releases FY 2024 State Performance Standards System Findings

(August 11, 2025) On August 6, 2025, the Centers for Medicare & Medicaid Services (CMS) released its Fiscal Year (FY) 2024 performance evaluation of state survey agencies through the State Performance Standards System (SPSS). SPSS is CMS’s accountability framework for state survey agencies, measuring performance across 13 key indicators, assigning scores of “Met,” “Partially Met,” or “Not Met.” The findings reveal both progress and persistent challenges in survey execution nationwide. These indicators span three domains:

• Survey and Intake Process
• Survey and Intake Quality
• Noncompliance Resolution

Key Highlights from the FY 2024 SPSS Report

• Recertification Survey Timeliness: Only 14 states (27%) met the standard of conducting a standard recertification survey in every active nursing home at least once every 15.9 months. Another 12 states partially met this benchmark, meaning 50% of states failed to meet this critical standard.
• Survey Upload Timeliness: 43 states met the standard for timely upload of nursing home recertification surveys, while 8 states did not meet it.
• Immediate Jeopardy (IJ) Protocols:
  • 94% of states met the standard for using the IJ template appropriately.
  • 82% met the requirement for initiating IJ investigations within the mandated time frame.
• Data Submission Accuracy: 85% of states met standards for complete and accurate data submission, including the presence of CMS-2567 text in survey documentation.
• Timeliness of Nursing Home Revisits: 79% of states met the performance standard for conducting timely revisits following deficiency citations.

Implications for Oversight and Quality

The FY 2024 SPSS findings underscore the importance of consistent and timely survey activity to ensure resident safety and regulatory compliance. While many states demonstrated strong performance in areas like IJ response and data integrity, the lag in recertification survey frequency remains a concern.

CMS requires states that scored “Not Met” in FY 2024—or “Partially Met” in both FY 2023 and FY 2024—to develop Corrective Action Plans (CAPs). These plans will be monitored to ensure measurable improvements in future performance cycles.  CMS will continue to monitor CAPs submitted by underperforming states and provide technical assistance where needed. The agency emphasizes that the SPSS is not just a compliance tool, but a mechanism to drive continuous improvement in care quality and regulatory oversight.  For full details, refer to CMS memo Admin Info: 25-04-ALL.

Contact:  Carrie Mosley, cmosley@leadingageny.org, 518-867-8383 x. 147