CMS just published something rare: a concrete, measurable definition of what "high performing" looks like for a nursing home.
On July 16, 2026, CMS announced the nationwide rollout of its Risk-Based Survey (RBS) process, beginning September 8. Facilities that qualify get a lighter-touch standard recertification survey, meaning fewer surveyors, a smaller resident sample, and roughly half the onsite time… plus a new "high-performing facility" icon on Nursing Home Care Compare starting around September 30. Right now, CMS estimates only about 12% of nursing homes nationwide meet the bar.
That's a small number. But it's also a clear one, and that's what makes this worth paying attention to: for the first time, CMS has laid out exactly which levers determine whether a facility gets this recognition.
What RBS Eligibility Actually Requires
To qualify, a facility needs, among other things:
- A 5-star overall rating on Care Compare
- At least a 3-star staffing rating
- No Actual Harm, Immediate Jeopardy, or Substandard Quality of Care citations in its last survey cycle
- Clean PBJ (staffing) and MDS (resident assessment) audit results
- Strong recent health inspection performance
- No recent change of ownership or Special Focus Facility designation
Look closely at that list, and a pattern emerges. Staffing retention. Citation avoidance. Documentation accuracy. Sustained inspection performance. These are all outcomes that trace directly back to how well a facility trains, supports, and retains its staff.
Where Training Fits In
Every one of the criteria above is something a strong training program influences directly:
- Staffing rating is a function of retention as much as recruitment. Facilities that invest in real onboarding and ongoing competency-building tend to keep staff longer, and staffing stability is one of the most reliable predictors of a higher staffing star rating.
- Citation avoidance starts with competent, confident staff who understand not just what to do, but why. Abuse prevention, infection control, and care-planning training exist precisely to prevent the kinds of findings that would disqualify a facility from RBS.
- PBJ and MDS accuracy depends on staff who understand how to document what they're doing as an accurate reflection of the care being delivered. Training gaps here show up as audit failures, regardless of how good the actual care is.
- Health inspection performance reflects the sum of everything above, sustained over time, not a single good day.
CMS didn't design RBS around training requirements. But by choosing these specific criteria, it effectively published a roadmap for what quality-driven operations look like, and training is central to how facilities get there.
Why This Isn't a One-Time Achievement
It's worth being clear about one thing: RBS eligibility isn't a badge you earn once and keep forever. CMS reassesses the underlying metrics on an ongoing basis, and a facility that qualifies today can fall out of eligibility if staffing turnover spikes, a citation lands, or documentation accuracy slips.
That means that the path to RBS eligibility isn't a project with an end date; it's the same work of building genuine competency and quality systems that facilities should be doing anyway. RBS just gives that work a name, a public marker, and a lighter survey as the reward for sustaining it.
How Showd.me Can Help
Whether your facility is already close to qualifying or just starting to build toward it, the underlying question is the same: where are the gaps between where you are and what these criteria require? That's a training and competency question first, and a regulatory one second.
We help post-acute providers build the kind of sustained training and quality culture that shows up in staffing retention, clean surveys, and accurate documentation, the same things CMS is now measuring and rewarding publicly.
Want to talk through where your facility stands on the path to RBS eligibility? Schedule a conversation or demo with our team to see how we can help you get there, and stay there.
