Risk-Based Surveys in Iowa

What the High Performing icon is

CMS added a High Performing Icon field (Y/N) to Provider Information in the September 2026 release. CMS's data dictionary describes it as marking homes that exceed the traditional five-star rating, with fewer citations, higher staffing levels and other quality indicators. CMS memo QSO-26-14-NH sets out the criteria for risk-based surveys. CMS's data dictionary does not say the icon is the same thing as eligibility for a risk-based survey, so this page shows the icon and recorded risk-based surveys side by side and does not treat one as proof of the other. The icon is reported exactly as CMS publishes it.

Star ratings and footnotes

Overall, Staffing and Health Inspection ratings are CMS's five-star ratings from the same Provider Information file. Where CMS gives no rating it publishes a footnote code instead, shown here as “fn”. In this release every facility with footnote 18 on its overall rating is a CMS Special Focus Facility, so the table labels those “Not rated: Special Focus Facility”. Other codes are shown as CMS publishes them; see CMS's Provider Information data dictionary for their definitions. In this release every staffing rating that carries footnote 23, 24 or 25 is a 1.

What "risk-based survey" means

CMS marks a standard health inspection with footnote 29 when it was a risk-based survey: “shorter visit with a smaller inspection team.” The column shows the most recent such survey in CMS Inspection Dates. 119 facilities have one on record; 46 of them do not carry the icon in this release. Eligibility and completed inspections are reported separately for that reason.

CMS-recorded risk-based survey dates run from Apr 11, 2024 to Jul 15, 2026; 108 are in 2026. These are historical inspection records, not a count of surveys conducted after nationwide rollout.

CMS revised QSO-26-14-NH (September 29, 2026) confirms that testing began in 2023 in 22 states and more than 100 facilities; nationwide implementation began September 8, 2026. The source fields do not identify pilot participation for individual inspections. PBJ320 preserves CMS footnote 29 and survey dates as published; it does not independently reclassify surveys or label all earlier records as pilot inspections.

What this page does not say

• A missing icon is not a finding about care. CMS applies criteria that are not all public, and the icon can change month to month.
• The icon is CMS's designation, not a PBJ320 prediction or rating.
• A dash in the risk-based survey column means CMS Inspection Dates has no footnote-29 inspection for the facility. It is not evidence that no survey took place.
• Star ratings and HPRD are context from different sources and periods, listed below.

Dates on this page

History

The September 2026 release is the first in which CMS published the High Performing icon and footnote 29. PBJ320 stores each release's designations separately; from the next release on, this page will show which facilities gained or lost the icon and when each risk-based survey first appeared.

Releases on file: September 2026 (1,699 designated)

Sources

• CMS Provider Information (NH_ProviderInfo_Sep2026_3.csv), field "High Performing Icon". SHA-256 378d76a43f89.
• CMS Inspection Dates (svdt-c123_2026-09-30_NH_SurveyDates_Sep2026_2.csv), "Survey Footnote" = 29. SHA-256 336d5389b93d.
• CMS QSO-26-14-NH original memo (July 16, 2026), Appendix A eligibility criteria; see the revised policy linked above.
• PBJ320 facility staffing, CMS Payroll-Based Journal, Q1 2026. See Data sources.

Inspection reports

Survey dates and types come from CMS Inspection Dates. PBJ320 does not link individual CMS-2567 inspection reports: it has no source that resolves a specific survey date to its official report, and it will not attach a different inspection's report to a risk-based survey. Each facility's PBJ320 page links to its Care Compare listing.

Questions or corrections: corrections.