C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER G—STANDARDS AND CERTIFICATION › PART 488—SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES › Subpart E—Survey and Certification of Long-Term Care Facilities

42 C.F.R. § 488.308

Survey frequency

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(a) Basic period. The survey agency must conduct a standard survey of each SNF and NF not later than 15 months after the last day of the previous standard survey.

(b) Statewide average interval. (1) The statewide average interval between standard surveys must be 12 months or less, computed in accordance with paragraph (d) of this section.

(2) CMS takes corrective action in accordance with the nature of the State survey agency's failure to ensure that the 12-month statewide average interval requirement is met. CMS's corrective action is in accordance with § 488.320.

(c) Other surveys. The survey agency may conduct a survey as frequently as necessary to—

(1) Determine whether a facility complies with the participation requirements; and

(2) Confirm that the facility has corrected deficiencies previously cited.

(d) Computation of statewide average interval. The statewide average interval is computed at the end of each Federal fiscal year by comparing the last day of the most recent standard survey for each participating facility to the last day of each facility's previous standard survey.

(e) Special surveys. (1) The survey agency may conduct a standard or an abbreviated standard survey to determine whether certain changes have caused a decline in the quality of care furnished by a SNF or a NF, within 60 days of a change in the following:

(i) Ownership;

(ii) Entity responsible for management of a facility (management firm);

(iii) Nursing home administrator; or

(iv) Director of nursing.

(2) [Reserved]

(f) Investigation of complaints. (1) The survey agency must review all complaint allegations and conduct a standard or an abbreviated survey to investigate complaints of violations of requirements by SNFs and NFs if its review of the allegation concludes that—

(i) A deficiency in one or more of the requirements may have occurred; and

(ii) Only a survey can determine whether a deficiency or deficiencies exist.

(2) The survey agency does not conduct a survey if the complaint raises issues that are outside the purview of Federal participation requirements.

[53 FR 22859, June 17, 1988, as amended at 82 FR 36635, Aug. 4, 2017]
Notes of Decisions
Cited in 12 cases (2 in the last 5 years), 2007–2025 · leading case: Woodruff v. Mason, 542 F.3d 545 (7th Cir. 2008).
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Woodruff v. Mason, 542 F.3d 545 (7th Cir. 2008). · cites it 4× “" See 42 C.F.R. § 488.308 . When a survey reveals deficiencies that preclude a finding of substantial compliance, a facility has six months to rectify the deficiency or face mandatory decertification.”
Dep't of Health v. Off. of Open Records, 4 A.3d 803 (Pa. Commw. Ct. 2010). · cites it 2× “42 C.F.R. § 488.308 (a). The Department must conduct "a standard survey of each SNF [Skilled Nursing Facility] and NF [Nursing Facility] not later than 15 months after the last day of the previous standard survey.”
Wilkes & Mchugh, P.A. v. LTC Consulting, L.P., 830 S.E.2d 119 (Ga. 2019). “See 42 CFR § 488.308 (f). Federal law requires nursing homes to post at the facility the most recent survey results and a notice of the availability of reports for the preceding three years.”
Woodruff v. Wilson, 484 F. Supp. 2d 876 (S.D. Ind. 2007). · cites it 3× “42 CFR § 488.308 (a). However, ISDH may conduct surveys as frequently as necessary to^ — (1) determine whether a facility complies with the participation requirements; and (2) confirm that the facility has corrected deficiencies previously cited.”
Emerald Shores Health Care Assocs., LLC v. United States Dep't of Health & Human Servs., 545 F.3d 1292 (11th Cir. 2008). “See 42 C.F.R. § 488.308 (a). It also must perform special surveys whenever complaints are brought, including follow-up visits to monitor facilities that are attempting to correct previously-noted deficiencies.”
Columbus Park Nursing & Rehab. Ctr. v. Sebelius, 940 F. Supp. 2d 805 (N.D. Ill. 2013). “See 42 C.F.R. § 488.308 . And of these thousands of surveys, many uncover deficiencies; in 1992, only 7.”
In re Bayou Shores SNF, LLC, 525 B.R. 160 (Bankr. M.D. Fla. 2014). “42 C.F.R. § 488.308 . . 42 C.F.R. § 488.330 (b)(2).”
SunBridge Care & Rehab. v. Leavitt, 340 F. App'x 929 (4th Cir. 2009). “§ 1395i — 3(g); 42 C.F.R. §§ 488.308 , 488.332. Although CMS administers the Medicare and Medicaid programs, MacKenzie Med.”
Woodruff, Randall L. v. Mason, Jo Ann (7th Cir. 2008). · cites it 2× “” See 42 C.F.R. § 488.308 . When a survey reveals deficiencies that preclude a finding of substantial compliance, a facility has six months to rectify the deficiency or face mandatory decertification.”
Avon Nursing & Rehab. v. Becerra, 119 F.4th 286 (2d Cir. 2024). “at 36,635-36 (codified at 42 C.F.R. § 488.308 (f)(1)) (emphasis added).”
Wilkes & Mchugh P.A. v. Ltc Consulting, L.P., 306 Ga. 252 (Ga. 2019). “See 42 CFR § 488.308 (f). Federal law requires nursing homes to post at the facility the most recent survey results and a notice of the availability of reports for the preceding three years.”
Elevate Care Country Club Hills, LLC v. Kennedy, Sec'y of United States Dep't of Health & Human Servs., in his Off. capacity (N.D. Ill. 2025). “42 C.F.R. § 488.308 (c). When a SNF survey identifies deficiencies, the facility completes a “Plan of Correction” to explain how it will cure those deficiencies.”
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