CMS Rescinds Prior Voting Guidance, Issues New Special Alert on Resident Voting Rights

• By: Maureen Carland
• On: 07/22/2026 08:50:27
• In: Quality/Regulatory

On July 20, 2026, CMS issued QSSAM-26-04-NH, a Quality & Safety Special Alert Memo reminding nursing homes of their obligation to protect residents' right to vote — while formally rescinding the two prior QSO memos on the topic, QSO-21-02-NH (2020) and QSO-24-21-NH (2024). CMS notes the new memo doesn't create new regulatory requirements or update the State Operations Manual; it reinforces the existing standard under 42 C.F.R. § 483.10(b) that residents retain full voting rights and must be free from facility interference, coercion, or influence.
The alert was prompted by recent enforcement cases, including a Texas social worker facing 134 felony election-fraud counts for registering residents without consent, and a Wisconsin investigation into mail-in ballots allegedly submitted on behalf of residents with diminished capacity. CMS is clear that facilities may not register residents to vote or complete ballots on their behalf without authorization and must notify a resident's authorized representative of any change in the resident's voting-related legal or civil rights.
Centers should ensure residents who need voting assistance can choose their own helper — including their authorized representative — and CMS encourages coordinating with state election officials to bring in bipartisan election workers where state law allows, reducing reliance on facility staff. Residents or representatives who believe these rights have been violated can file a complaint with the State Survey Agency orr refer allegations of coercion to the DOJ Civil Rights Division at 800-253-3931 or voting.section@usdoj.gov.
 
Staff contact: mcarland[at]mehca.org