State Survey Agency (SA)
Definition: The state government agency contracted by CMS to conduct surveys and inspections of Medicare/Medicaid certified nursing homes. Typically part of the state's department of health or aging services.
In Practice
Each state has a designated survey agency responsible for conducting surveys, investigating complaints, and recommending enforcement actions. While CMS sets the federal standards, state agencies implement and enforce them. The quality and approach of surveys can vary by state, and some states have additional state-specific requirements.