On April 3, 2026, CMS released revisions to the QSO-26-03-NH memo, which includes updates to survey prioritization under the State Operations Manual. Under §5075.1, CMS defines Immediate Jeopardy (IJ) as a situation in which the provider’s noncompliance with one or more requirements of participation has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident. Complaints are assigned this priority if the alleged noncompliance indicates there was serious injury, harm, impairment or death of a patient or resident, or the likelihood for such, and there continues to be an immediate risk of serious injury, harm, impairment or death of a patient or resident unless immediate corrective action is taken. For a priority level of Immediate Jeopardy, the State Agency must initiate an onsite survey within 3 business days of receipt of the initial report.
Importantly, CMS includes unsafe transfers and discharges as a clear Immediate Jeopardy risk. For nursing homes, all complaints where a resident was discharged to an unsafe setting, or in a manner that place the resident at risk for serious harm (e.g. the resident still has medical needs but they cannot be supported in the setting they were discharged to), will be assigned the priority of Immediate Jeopardy.
Additional examples of intakes that are assigned this priority include, but are not limited to, the following: